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HomeMy WebLinkAbout1-40-24Paid by CEMETERY Receipt No. . . 3 82. . . . . . . . . . Dated . . . , � �=� 8 � 84 . . , , , , , , , , , , NO. List Price $ . . . , 300 : 00 . . . . . . Maximum No. Puciai Spaces . . . :?.-. . . . . . . . . . . ,� r� NetPaid$ ....300_00...... Flat t �11�: ( Monument permitted . .. .. ... .. . ... .. .. . . . . • paul ine LanqZ ois Lots 23 & 24, BZock 40, Unit 1 Additional 418 Fordham St. (Data sbove ti�is line tor Gty Rernrd only) Sebastian, Florida .32958 i • i/ Name Unit ^ � ' B�o�k y� � i� �ot �-'i� �y �� fius,B� � D • Date of Mark-out l( L�/ L� � ( D � Time �� op ,e,��t� 5 I,D �../ Date of Burial _T_T Name of Funeral Home �:.. ._N " l . , Authorized by .3' W t N G � m t v � � m � s " � � T � ro m • � 5 r � v � 9 � ef d m a � � C Q 0 °o cn 0 A O � o °o o °o g o 0 o�i aZi � ° � � _°. ° � m 'o � � � � N OOD ^. O W � N O O { O O O O O � l n � o � m v o n�i d 3 � � c� �? �' °� �i, z � � � _ � �D � S- N x C� m o: c� T r c M y � � � 3 F� '�' `° _ T � N Q � y 2/i � � -.� � O c � � d . O � Q �� � � n A � � N � ? � D O o ,� c '9 "J d o: n �� mmo � y(%/� --� O y T � T s � Z m � � � � PAULINE LANGLOIS Pauline Pelletier Langlois, 76, died Oct. 25, 2012, in Melbourne. She was a former resident of Sebastian. Survivors include her daughter, Donna Langlois Ratte; sons, Michael Langlois and Richard Langlois; six grandchildren; and two great-grandchildren. She was preceded in death by her husband, Donald Langlois. vu�� � ��� � � THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: � �� �J ��� �� Dallars ($ �O �) • rl l5 I 1�i Q��- , t� a� n� e `--- � a e FROM: Y � u C,. � +., `11 �, �U p D 1-a � rn ��. �r��s��au_ ��.a 3i�s � on this )� fi� dsy of SL , Z9 ��jfor the purchase of the followinq described Cemetery Lot(s) upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)# � � ,! �-�! Block# y0 Unit# ) � )�,'�. Purchase Price: irl � tF 1�1 u�1�a t� pLN �� Dollars(S a'v o• �h J Terms and'conditions of sa1e: This contract sha11 be binding upon both parties, the seller and the pr�rchaser, when approved by� the owner of the property above described. I, or we, agree to purchase the above described property on the terms and conditions stated in the foregoing inetrument: The City of Sebastian agrees to seZ1 the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. City of Sebastian Witness CEM iex:RECORD # NEwCEM Record: Last Name Address 1 Address 2 City Deed # Unit # Lot Number Lat Number Lot Number Lat Number Comment Comment City of Sebastian, FL - Cemetery Lots Langlois First Name Pauline 418 Fordham Street Sebasdt ian 1017 Date i-A Black # 23 Interred 24 Interred Interred Interred State 09-18-84 40 F1 Amount Donald F. Langlais C�et) Zip $300 32958- Dte Interred Dte Interred 08-24-84 Dte Interred Dte Interred CE>dit CD�elete {H>ext {F>re� CR>e-search <L7abe1 CT Wednesday, Dec 29, 2004 09:45 AM CEsc> ' Georpie Depertment of Human R rces j h Vital Recorda Servica / ' �G � � (, �� �� 1 �..� ��- • P�NMIT FOR THE pISPQSITION OF HU AN REMAINS P R Name of oecaeaea � � � Q�Ur of L�th ,, Fe Qa �,.., ,, _ NO ., h.� r. 1'i�na2!j I,3n��lios� 2. '�':a1�1�R�, 3 YES ❑ P�ece pf Death (Ho�pital or �ireet No,l C?R Intar�nt C�metery City, Tuwn or LoaAtlan of De�xh Q,f� �nRprmant County of pe�tb Q!� �nterment J � 4 ':,c„�t� .�'+�t;^'t `�c�s*�ital E- . 6. ast ��'oint g Ft>> tc�n Name of Certifying Physician, Coroner or Medic�l Examiner G�rtifier's Address (Nqt Uipd For Disjoterment/Rpinpisrma�t) ' (�}Rj Used For Di$interment/Reintarment) I�� ,[��,j���,,��E��� c�� , '. . � 'r��,p� [)�cksnn �"'nronar� 8, �C�n,�qhoro,C3�. i'�23h , - Funerai Hom�a lya►r�e and AR1�1�es� - , �trunk Funera 1 rl '� Fun���% �� �.�y �r. N �, �ime � ��t.l�►nt� �nr•tu��y �erv�ce ,�.:, '�'"' � Z�31� . '��nt�al Fl�t : , � � ] a, 3;ic�rl� '' Ar,j n�t3�, �yA i�� ln7i 9 P1 �3sti=.in . ���� ` � " ~ . , � o. � . F V..��;��. ,,�.:. � Burial y�l Transport ❑ Storage ❑ Oisinterment/ '"' " � ` '� � ' � .,:, e�. r: �„-. �,�,�. , � ,.�'" ❑ . . � . r. r 11. ' Crematfon � Donation C) Other "❑ ' Relntarmen4 �Z, i N�m� a�d Addro�a of Dispq�itfq� pR Re(�ty�mant Sit�d Lac�tion of p�po�ition.Of� RelntsrmeNt �ItR , ' , , (Counry, Ci;y of-State) ' ;� L t3. ' ta. Xndi�n �iver �n�.�Sa,t-�stinx..Fl,�ric�m ' A Certificate of Death having been filed ar the requirements of the laws of Georgia having been Gompliad with, perrpiS�iQn i,� k�e�ek�y �ranted to (check only, ONE1 DISi�QS� OF C� DISINTER/R�INTER Q this k�oc�y, (Ga• Co�le 8�--1717► '°'�4` �`: L` 1 Vi�l Ra�c►r�� Flaqictr9�r na�urel �� " te Si n4d ,,�: , Q� y� � �� ��� , �,p�Q 15. � f GG� f)—�1 �f�11 16. Sexton (Or er�on In Char��— 5�6�� rel . C1stp $�Ipn�d s � . 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