HomeMy WebLinkAbout2-01-08?aid by General ReeeiptsNoS ............. . .. Dated.. May .. & April 14,. 1976
:ist Price $.35.0..00....... . Maximum No, Burial spaces ....2.......
)1scount $... :Tr ............ Total area in square feet ................
det Paid $350.00 .......... Monument permitted ....flat ...........
R &R atched (Data above this line for City Record only)
C
0
u
N
d
H
N
C
�a
E
a
4
0
W
U
r
N
E
d
1
F-
I-
WILSON, Mrs. Versie DEED #291
211 Edward Dr Route 1
Sebastian, F1
Clyde W 1-nda interred 4114176
IN LOT 8
BLOCK 1, LOTS 7 & 8 UNIT #2
State of Florida • Department of Health and Rehabilitative Services • Division of Health
Burial Permit No.._......... -. �a2.`!�. ;
B�URIAL - TRANSIT PERMIT
Full name of decease ..._..�:'� "-2-" `� >._.........
Place of death........ >a.:.� ---�` .._....... d.r/ ......Florida ................
(County) c /
Date of death ........Lf .....
`..../ .. ...........19,1~.. Color ..... Age ... lo
Method of disposal ....... ...... . :..
.! r'� sI S t� ..assrerTi
Wheth ttrla emation, transportation, storage, etc) (Cemkt rT or C
Count:' &--- t.',_. ,-. ... - ............. . . . ... State.............. _:..: ....................- _.........
/_ certificate of en_filed as required by the laws of this State, permission is hereby given
to.../ '`° License No .............. /.. `....._......._.... .................---- .-- • - - - --- _- --- -- .
tFuneral Dire r or person �ing�a/s such]
y' fir' i..c:... . . vqf
to dispose of body of said deceased as above stated.
Date issued...... .................. Signature. . r.' `/ / -- /. __... -...
(Registrar;
C TERY OR CREMATORY AUTHORITY SHALL SPACE BELOW
Body was..•
t - .. - ..- —; . 19.7 .. in .................
,State w et emate -led, stored. etc.) ` (Cemeter— or Cr ate )
Place............ ...... . . •••• ••._..................._...._.. Signature................. :._.. .....
.ta (Qariaa.e& person in charge) i
This permit must be endorsed by the Sexton (or by the Funeral Director where there is no sext(. 0 and re-
turned within 10 days to the Registrar of the district in which the burial takes place.
BLOCK 1 LOTS 7 & 8 UNIT #2
Mrs. Clyde Wilson (Versie)
211 Edwards Drive
Route 1
Whispering Palms Mobile Village
Sebastian, Fl 32958
Mr. Clyde Wilson interred in Lot 8 on April 14, 1976