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Home My WebLink About2-04-070 o Sts"'T" HOME OF PWCM ISI M Certificate # 1892 (C(DF'r Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Mary B. Curiale (name) (name) 601 N. Dolphin Circle, Barefoot Bay, F1 32976 (address) (address) in and for consideration of the sum of $1,125.00 , has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 2 , Block 4 , Lot(s) 7 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 8th day of April 1 2003 Y OF SEBASTIAN, FLORIDA A Te nce R oo e Sally A. aio, CMC City Manager City Clerk CITY OF SEBASTIAN CITY CLERK'S OFFICE 1668 RECEIPT Name 0 Cash Date AmountPald 001001 208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances 001501362100 Community Center Rent 001501362100 Yacht Club Rent 001501362150 Non Taxable Rent 001501343800 Cemetery Lots 601010 343800 Cemetery Lots Lot/Niche _, Block , Unil -2,_ 001501 369400 Interment Fee 001501 369400 Weekend Service 680800 220681 Yacht Club Security Deposit 680800 220682 Community Center Security Deposit 680800 220683 Riverview Park Security Deposit Total Paid" LWZe Initlals Whits — Dept. of Origin • Yellow — Finsnes • Pink • Applicant BURIAL - REMOVAL - TRANSIT PERMIT Funeral Home First Assuming Custody of Body I / ` ' r V ` /I Name ?,� �1, Gl '�5 )� %l. Address f�t / f r L) Phone Name and Address of Funeral Home Handling Final Disposition if other than Funeral Home Named Above Strunk Funeral Home, 1623 North Central Avenue, Sebastian, FL 32958 Permission is hereby granted to remove this body and upon compliance with the requirements of the laws of this state to dispose of the remains. If disposal is by cremation or burial at sea, a certifieptjopy of the death certificate and, when required by law, an authorization by the medical examiner Tust be attached to .t 's permit prior ispositi n Signature of Registrar or other ethorized issuing officer Date Issued Name and Address of Cemetery or Crematory For Use Only By Corner Is uing Permit Sebastian Cemetery 1921 N. Central Avenue Was (or will) death (be) actively investigated? ❑ Yes ❑ No Sebastian, FL 32958 DHEC Form 676 (Rev. 7/90) Date f Disposition Signature of Sexton or Person in Charge �' %p/©:r> THIS COPY FOR FUNERAL DIRECTOR 00 and 61 2:65102 SOUTH CAROLINA DEATH NOTIFICATION m PERMIT NUMBER DEPT. OF HEALTH and ENV. CONTROL ty-lit OFFICE OF VITAL RECORDS AND PUBLIC HEALTH STATISTICS Death Certificate Attached XYes ❑ No COUNTY Name r'"' J C-Lo— of Deceased r l Ct Date of Death q Hour of Death l � Fetal Death ❑Yes XNo a_ 1 e_ �, % ✓ 1 z.� I d li` Place of Death ( Hospital or Street & Number) "�- . ^ Latylo Hal# City or Town � / / %) o of If Hospital Death ❑ D.O.A. In- Patient � � I ❑ Emer. Rm. ❑ Out - Patient CERTIFIER (Physician, Medical Exa iner or Coroner who is to provide ca se of death a`�ertif /y earn certifi�te..i {� �-�J j_ ��. L" i /�/% cJ+ 111 Ma h taw ' / (ly Address %� % ••—�' %� I l it /fit./ � . �� ( Autopsy ❑Yes XN!o Was Case Referred To Medical Examiner/ Coroner? ❑ Yes tNo Funeral Home First Assuming Custody of Body I / ` ' r V ` /I Name ?,� �1, Gl '�5 )� %l. Address f�t / f r L) Phone Name and Address of Funeral Home Handling Final Disposition if other than Funeral Home Named Above Strunk Funeral Home, 1623 North Central Avenue, Sebastian, FL 32958 Permission is hereby granted to remove this body and upon compliance with the requirements of the laws of this state to dispose of the remains. If disposal is by cremation or burial at sea, a certifieptjopy of the death certificate and, when required by law, an authorization by the medical examiner Tust be attached to .t 's permit prior ispositi n Signature of Registrar or other ethorized issuing officer Date Issued Name and Address of Cemetery or Crematory For Use Only By Corner Is uing Permit Sebastian Cemetery 1921 N. Central Avenue Was (or will) death (be) actively investigated? ❑ Yes ❑ No Sebastian, FL 32958 DHEC Form 676 (Rev. 7/90) Date f Disposition Signature of Sexton or Person in Charge �' %p/©:r> THIS COPY FOR FUNERAL DIRECTOR 00 61 ? l� 8 ' 9 /o �i ✓ /.Z / �s .. 6 v/7� �s `' 81 187 C � �o �tIV��. _ C r�Ffi 3y N S A —, 0 r^ 1< 114)