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HOME OF PELICAN ISLAND
Certificate No. 2427
C1W OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Jennifer Chester
745 Carnation Drive
Sebastian, FL 32958
In and for consideration of the sum of $3,000,00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 2, Block 9, Lots 9, 10, 11
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 22nd day of July, 2014.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
Sally A. M �o, MMC
City Cler
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4892
- RECEIPT
Name f - t7 Cash
Date -7/ # C1
No. Amount Paid
001001208001 Sales Tax
001501 322900 Garage Sales
001501 341920 CopieslBid Specs.
001501 341910 LDCICode of Ordinances
001501341930 Election Qualifying Fees
an
601010 343800 Cemetery Lots r
Lot/Niche i Block _,Unit
001501 343805 Cemetery Fees
Z?W Total Paid
T Initials
e White - Dept. of Origin • Yellow - finance • Pink - Applicant
CULT
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HOME OF PELICAN ISLAND
Burial rights in the Sebastian Municipal Cemetery lots /niches purchased by me
ern a-hi &I
J enn es -I-er
(Please print name and address of purchaser)
(Lot/niche, block, unit description)
are intended for interment of the following individuals: (,n. d`t GLQ�
Please print name(s):
Ch
1 h O m CAs H e Ch e s 4e -,c—=,
W Via. I` rCj
d
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:�]�OL-n L+n, C) a �'(-d W I I I
Interment tots /niches are not to be transferred without written approval of the City of
Sebastian. Interment lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
I have read and understand the terms of this agreement.
dLj�� CjNd/&� / y
Signature Date
Subscribed and sworn� to before
ubiic, S to of Florida
Names of Int form
me this ay of
who is personally know
identification.
by
n to e, or has produced
.'R.;*nY' ^rye ; SALLY A. MAIO
:.: Commission # EE 024350
Expires October 5, 2044
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F9O1',+lE Of PELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Name(s) U
-Ns ( a-'t- �'�y Z_q t5e
Address
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
Dollars ($ ano °�- }
on this CJQ24 day of , 20_1'�_ for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit Block q 1 1 Niche(s)
for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed
therefore by the City of Sebastian.
Additional Fees paid at time of purchase:
Corner Markers (set of 4 - $20) Opening & Closing
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installatio
Signature of ur haser
I:IW W- DATAWs- CemeterylRECEI PT.doc
Interment
!W O H
Circle One
Disinterment
TOTAL $ '3c)pe
City of
The following documents were provided as Proof of
sidency:
L and I �U�Gb