HomeMy WebLinkAbout4-05-19Name_,(
Unit `
Block 'J
Lot
Date of Mark -out 1� / y4 1 �5 / 1
Date of Burial L `T �/ Time
Name of Funeral Fjgme 1
Authorized
CITY OF SEBASTIAN pp
CITY CLERK'S OFFICE 4358
RECEIPT
ame �1° ❑Cash
ate XCheck C u''
o Amount Paid
01001208001 Sales Tax
01501 322900 Garage Sales
01501 341920 Copies /Bid Specs.
01501 341910 LDC /Code of Ordinances
01501 341930 Election Qualifying Fees
01010 343800 Cemetery Lots
LoUNiche rf Block Unit
)01501 343805 Cemetery Fees
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4793
RECEIPT
Name ❑ Cash
Date aC Check # CO
No. Amount Paid
001001 208001 Sales Tax
001501322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501341910 LDC /Code of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots ? ,
Lot/Niche 1Y rt - r - , Block 5 Unit
Cemetery Fees
001501 343805
Total Paid �y1 Total Paid
Initials ! Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant White -Dept. of Origin •Yellow - Finance •Pink - Applicant
Certificate No. 2365
UTY OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Rita G. Daley
139 Columbus Street
Sebastian, FL 32958
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 5, Lots 18 & 19
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 11th day of March, 2013.
CITY OF SEBASTIAN, FLORIDA ATTEST:
Minner Sally -A. Maio, MMC
Manager City Clerk
GEORGE DALEY
Mr. George Henry Daley, 76, of Sebastian, FL died March 10, 2013 at
Sebastian River Medical Center in Sebastian. He was born July 18,
1936, in Rutland, VT and moved to Sebastian over 25 years ago from
Bennington, VT.
He was a member of St. Sebastian Catholic Church, the Knights of
Columbus Council 5627 in Vero Beach, FL, served as a Correction
Officer for the Indian River County Sheriff Department, retiring after
ten years of service and served three years in the Marine Corp as a
Captain during the Korean War. Mr. Daley graduated from Poultney
High School and attended American International College in
Springfield, Massachusetts and graduated from Castleton College in
Vermont with a Bachelor of Arts Degree. He taught at the Pownal
School in Bennington, Vermont and worked for the Department of
Education in Montpelier, Vermont and Department of Social Services in
Bennington.
He was especially known for his compassion, love and dedication to his
family and friends. He extended his heart to anyone, no matter the
circumstances.
Survivors include his wife of 44 years, Rita Daley of Sebastian;
daughters, Anne Wood of Northfield, Vermont, Priscilla Osmer of
Ledyard, Connecticut, Patricia Boyce of St. Albans, Vermont and Debra
Rogers of Fellsmere; sons, George Daley of Northfield Falls, Vermont
and Shawn Daley of Sebastian; stepdaughters, Kathy Roux of Easton,
Maryland, Shirley Dunegan and Lisa Pannizzo both of Sebastian;
stepsons, Larry Roux of Greenfield, Massachusetts and Greg Roux of
Sebastian; brothers, Jim Daley of Salisbury, Vermont and Bill Daley of
Poultney, Vermont; sisters, Mary Pagliarulo of Chelsea, Massachusetts,
Kathy Frost of Shushan, New York and Nancy Darius of Plantation; 40
grandchildren and 14 great - grandchildren.
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
rnva
HOME of PELICAN KIND
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
STF..0 iC nuwm HOME & 10117— 1,,. 0 Y
FUNERAL HOME: 1691 ti, Central Ave -
ADDRESS: SEBASTIAN, FL 32958
(772) 589 11M
PHONE #:
'(Ch One) , r
OPEN BURIAL LOT Lot Imo_ Block Unit �j-
OPEN CREMAINS LOT Lot Block Unit
OPEN COLUMBARIUM NICHE Niche Block Unit
BURIAL DATE AND SERVICE TIME ! �'`'�2S N ::?>I I F E I I: 00 A
FOR DECEASED: C-8orqe, W -b attU
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
Must provide proper documentation of ownership)
+a- -bcd & Z 41 11S
Name ignature 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.
NAME AND SIGNATURE OF LICENSED FUN L RECTOR:
Hoxskcul �% s
Name Si re Date
Cemetery Sexton Certification:
certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and at all fees have been paid:
Cemetery Vexion to
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
MY Of
SIBAS1
HOME Of PELICAN ISLAND
City of Sebastian Municipal 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.
le- fa- U Do-(e-y
Name(s)
2,3g Cc)/ u_nbuS 5tr-e& (Se- WQ5tiav, F�L :32Y58
Address
Area Code & Phone Number
Name & Residence Address o ntended Occupant if her Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
Dollars ($ qW Q0, 0 L ) .
on this. / 1 day of WO-rCh , 2013 for the purchase of the following described
Cemetery Lot(s) and /or Niche(s).
Unit 4f , Block �_, Lot(s) j q 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 / W O H
Circle One
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation
Signature of Purchaser
!: \W W- DATA\Ms- Cemetery\RECEI PT.doc
Interment
Disinterment
TOTAL $ ,2-600-0()
i of Sebastian
The following documents were provided as Proof of
Residency:
j l K C Prva �no� ►� �---
q
V