HomeMy WebLinkAbout4-08-19aCertificate No. 2337
CITY OF .SEBSSTI N
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Oscar F. &/or Mary E. Woods
3870 101h Street
Micco, FL 32976
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 8, Lots 19a & b, 20a & b
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 20th day of June, 2012.
CITY OF SEBASTIAN, FLORIDA ATTEST:
k Al Minner
City Manager
i,
i
Sally . Maio, MMC
City Clerk
MARY ELLEN WOODS
Mrs. Mary Ellen Woods, 86, died May 17, 2013 at William Childs
Hospice House in Palm Bay. She was born December 29, 1926 in
Mounds City, IL and lived in Micco, FL coming from Delray Beach, FL
in 2000.
She was a member of St. Luke's Catholic Church, Barefoot Bay, FL
where for many years she was instrumental in the Ladies Guild,
coordinator of the Eucharist Ministers and volunteer at the St. Luke's
Catholic Church "Thrift Shop" and volunteer for Meals on Wheels.
Survivors include husband, Oscar F. Woods, Jr. of Micco; son, Jerry
Woods of Sebastian; daughter, Linda Johnson of Seville; 3
Grandchildren; 4 Great Grandchildren.
Name NIR
Unit
Block
Lot Zt - 14'
5
Date of Mark -out
Date of Burial r- y 11-5
Name of Fune
Authorized by
Time
Ulv�'A� DO
Total Paid p—
Initials
White — Dept. of Origin 9 Yellow — Finance • Pink • Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE (�
RECEIPT (J
i
Name
C ❑ Cash
Date �eck#
No.
Amount Paid
001001 208001
Sales Tax
001501322900
Garage Sales
001501341920
Copies/Bid Specs.
001501341910
LDC/Code of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots
LoMiche . Block , Unit
001501 343805
Cemetery Fees
L.nA 9'3a-
Ulv�'A� DO
Total Paid p—
Initials
White — Dept. of Origin 9 Yellow — Finance • Pink • Applicant
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
MM
17% OF PEucAN ISLAND
For information contact:
Kip Kelso - Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589-2545
City Clerk's Office
City Hall, 1225 Main Street
Sebastian, FL 32958
Office (772) 388-8215 or 388-8214
Fax_ (772) 589-5570
FUNERAL HOME: STnUNK FUNERAL HOME & CREMATORY
4623 Ne. rveatral Aves
ADDRESS: SEBASTIAN, FL 32958
(772) 589-1000
PHONE #:
(Check One)
OPEN BURIAL LOT Lot—�9--A--- Block Unit (� �� �r�
OPEN CREMAINS LOT Lot i'"� n Block Unit --4:-- v�
OPEN COLUMBARIUM NICHE Niche Block Unit y�
BURIAL DATE AND SERVICE TIME: 110 N
FOR DECEASED: NIC414 5I (P&1
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownersh'
0(0532-i:;
Name Signature Date
I certify that I have determined the ownership of the above described site, that all site fees and
administrative fees have been paid and authorize opening of same.
N E AND SIGNATURE OF LICENSED FUN L DIRECTOR:
I.til%( '
me
NaSignature Date
Cemetery Sexton Certification:
I certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and that all fees have been paid:
Z, . /, 1�;;� �� - 5-A Z�5
Ce eteryexton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion
1FLOFIDA DIISlACG1E+i rlF'�� State of Florida, Department of Health, Bureau of Vital Statistics
HEALT BURIAL TRANSIT PERMIT
DATE PRINTED: May 20, 2013 TRACKING NUMBER: 2013074616
1. DECEDENT INFORMATION
Name of Deceased Date of Death
MARY ELLEN WOODS May 17, 2013
Place of Death - County City, Town or Location Name of facility, or street address if not a facility
BREVARD PALM BAY WILLIAM CHILDS HOSPICE HOUSE
Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No./Reg. No. Phone Number
STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000
1623 N CENTRAL AVE
SEBASTIAN, FLORIDA, 32958
Funeral DirectorlDirect Disposer Fla. Lic. No./Reg. No.
TIMOTHY W. MARVIN F022789
2. 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.
�(J/ Permit Number: 2013-F041e70-5082
�+7• r Date Issued: May 20, 2013
J
Meade Grigg, State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District 18 Approval Numbeb 3. VD-- H,9
4. CEMETERY OR CREMATORY
Place of Disposition: 5 .tljr/ 4,7 r�
Method of Disposition: CREMATION Date of Disposition:
EDRS maintains all statutorily required information regarding the death record and related
burial transit permit, therefore, returning the permit to the county health department is no
longer required.
If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so.
DH 326E, 10/12
64V-1.011, Florida Administrative Code
Vero ai. 3rJ_/1j LLC - --
1830 Wilbur Avenue
Vero Beach, Florida 32960
We hereby rem that t the crenuged humon remmm pf
Mary Ellen Woods
May 17, 2013
(Date of Death)
Stew.
Funeral Home & Crematory
(Funeral Home in Charge)
031
(Cremation ID Number)
May 23, 2013
(Daae of Crem'ation')
Sebastian, Florida
(City and State)
(Cremator Signature)
CITY OF SEBASTIAN
CITY CLERK'S OFFICE /, /, 7 7
RECEIPT `+ 4 I I
Name Mar y E. Wood's od's ❑ Cash
Date &— ZO — Q a(Check N
No.
Amount Paid
001001208001
Sales Tax
001501322900
Garage Sales
001501341920
Copies/Bid Specs.
001501341910
LDC/Code of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lis
14 ayb
4/006.00
LoVNiche20n4, b. Block—, Unit
001501343805
Cemetery Fees
J• 6 ' Total Palo �GY�. 00
Initials
White - Dept. of Origin • Yellow - Finance a Pink • Applicant
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(7n) 584.1000