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Certificate No. 2321
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Delores &/or Stephen Lino �
3970 OId Dixie Highway
Malabar, FL 32950
In and for consideration of the sum of $4,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 5, lots 9& 10
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 2"d day of February, 2012.
CITY OF EBASTIAN, FLORIDA ATTEST:
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AI Minner
City Manager
Sally A. N�aio, MMC
Cit�/Clerk
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Block
Lot
Date of Mark-out._�� � � � � � —
Date of Burial S�� � /��� Time
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STEPHEN W. LINO
Stephen W. Lino, 73, died May 27, 2012 at Sebastian River Medical
Center, Sebastian.
He was born April 3, 1939 in Camden, New ]ersey and lived in
Sebastian and Malabar for 34 years coming from Bucks County,
Pennsylvania.
He was a longtime commercial fisherman in Sebastian and was a
partner with his wife Delores in Dee's All Breed Pet Resort of Malabar,
FL.
He was a member of United Schutzhund Club of America.
Survivors include his wife, Delores "Dee" Lino of Malabar and a son,
Mike Lino of Fort Myers.
FUNERAL DIRECTOR'S REQUEST TQ CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNlC1PAL CEMETERY
wra
HOAE� OF �E11CM415lAAD
For information contact:
Kip Kefso - Csmefery Sexton
Sebastian Muni�lpat Cemetery
(772) 589-2545
FUNERAL HOME:
ADDRESS:
PHONE #:
City Clerk's O�ce
City Hall, 1225 Main Strest
Sebasffan, Ft 32958
Office (772} 388-82?5 car 388-8294
Fax: (772) 589-5570
$TRUNK �UNERAL HOME � CREMA30RY
1623 No. Cen ral evp
FL 32958
( k One� n u-
OPEN BURIAL LOT Lot —I Block � Unit T
OPEN CREMAINS LOT Lot Block Unit
OPEN COLUMBARIUM NlCHE Niche Block Unit
BURIAL DATE AND SERVICE TIME: ����-S , N��� E�.�iV��
G•.
FOR DECEASED:
Name
r�_ �n
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of o ership} ,
I�. �I �r,CS I,.i n(� �i �( c11�S �--�n� 5�-1 2
1 I�
Name Signature Date
I certify that I have �letermined the ownership of the above described site, fhat alI site fees and
administrative fees have been paid and authorize opening of same.
�E AND SIGNATURE OF LICENSED FU�L DIR TOR: '
I�.I� I�fG�h. �� l� ��ul ��/z� �� z
Name Signature Date
Cemetery Sexton Certification: w �Y��� � � «pN
I certify that i have checked the awnership information by viewing the owner's deed and confirming
with Clerk's office and th t all fees have been paid:
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Cem ery exton D te
This form to be provided to Clerk's Office by Sexton for permanent reCOrd upon oornpletion.
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F,.v,unanrr�xra�rnF; ;' State of Florida, Department of Health, Bureau of Vital Statistics
��-+ ��T BURIAL TRANSIT PERMIT
DATE PRINTED: May 29, 2012 TRACKING NUMBER: 2012072177
�, DECEDENT INFORMATION
Name of Deceased Date of Death
STEPHEN W LINO May 27, 2012
Place of Death - County City, Town or Locatlon Name of facility, or street address if not a facflity
INDIAN RIVER SEBASTIAN SEBASTIAN RIVER MEDICAL CENTER
Name and Address of Funerat HomelDirect Disposal Establishment Fla. Uc. NoJReg. No. Phone Number
STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000
1623 N CENTRAL AVE
SEBASTIAN, FLORIDA, 32958
Funeral Director/Direct Dlsposer Fla. Lic. NoJReg. No.
TIMOTHY W. MARVIN F�22�89
Z, BURIAL - TRANSIT PERMIT
The Florida Department of Health, Bureau of Vital Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes.
Permit Number: 2o�2-FOats7o-5o�s
/ �� Date Issued: May 2s, 2012
. aG4 ��7 rJ
J
Meade Grigg, State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner DisUict Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: SEBASTIAN CEMETERY //EG��G "
Method of Disposition: BURIAL Date of Disposition: ,�' /� "
Signatu of s on or person-in-charge r by the funeral director/direct disposer when there is no sexton)
DH 326E, 1/11
64V-1.011, Florida Administrative Code
CITY OF SEBASTIAN � � � �
CITY CLERK'S OFFICE -
RECEIPT
Name / '' � � 5 L 1 � � ❑ Cash
nate � � �' 1 Z C�heck#
No.
001001 208001
001501 322900
001501 341920
001501 341910
001501 341930
601010 343800
001501343805
Sales Ta�c
Garage Sales
CopieslBid Specs.
LDCICode of Ordinances
Election Qualifying Fees
Cemetery Lots
LoUNiche '�" Iv, Block�_, Unit?
Cemetery Fees
Amount Paid
�UO v�,1
� Total Paid ���_�U
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
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Ff{?�l+�E C3F PE�.ICr1C�1 lS�D
City of Sebastian Niur�icipal 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.
e� c� r�es Q-�/o � s%e.�o h� n L ��, �
Name(s)
�j�70 Oid .�(ui� ��wy, l�GL.�CL�C�ri ��- JZ�l �JO
Address
I `7Z�- �173
Area Code & Phone umber
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
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Dollars ($ ) -� �
U��on this. Z, ��� day of F�h , 20 � Z for the purchase of the following described
�' Cemetery Lot(s) and/or Niche(s).
Unit �_, Block � , Lot(s) � �- / G 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 & Installation
Signature of Purchaser
Interment
/W O H
Circle One
Disinterment
_t V�/'�1L �P Z�D� . � O
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C� of Sebastian
The following documents were provided as Proof of
Residency:
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