HomeMy WebLinkAbout4-08-16bCertificate No. 2367
C
ITY OF SSEBSTIANI
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
John C. &/or Anne Putman
563 Cross Creek Circle
Sebastian, FL 32958
In and for consideration of the sum of $1,500.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 8, Lots 16a, 16b & 17a
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 1St day of April, 2013.
CITY OF SEBASTIAN, FLORIDA ATTEST:
c
Minner Sally Maio, MMC
Manager City Clerk
Name
Unit
/ Aov.4 e.
Block C fi 714 � 1Z/
/1 -
Lot /
Date of Mark -out L-1 ,p %
Date of Burial
"T �l Time 'O� �C /�Y •!�
Name of Funeral Home
Authorized by
(t� E
4 .K. -LA �p � Total Paid La t
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
o
Name
L�
0 Cash
..
KCheckf!
Date
No.
Amount Paid
001001 208001
Sales Tax
001501 322900
Garage Sales
001501341920
Copies/Bid Specs.
001501 341910
LDC/Code of Ordinances
001501 341930
Election Qualifying Fees
601010 343800
Cemetery Lots
'v'
LoVNiche 1 f j Block 0
Unit
001501 343805
Cemetery Fees _ ll
+ � 60� 0
r
_3
(t� E
4 .K. -LA �p � Total Paid La t
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
mY6
HOME OF PEU01N KLAND
For information contact:
19p 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
STRUNK FUNERAL HOME & CREMATORY
FUNERAL HOME: 1623 No. Central Ave.
ADDRESS: SEBASTIAN, FL 32958
-889-4A'
PHONE #:
(Check One)
OPEN BURIAL LOT Lot Block Unit
=OPEN CREMAINS LOT Lot Block —— Unit
OPEN COLUMBARIUM NICHE Niche Block Unit�U�j�
BURIAL DATE AND SERVICE TIME:0-0 . 4-I I I IW l
FOR DECEASED: Llavl�
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership) / I
Name Si ature 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 LJICENSEQ-F{d RAL DIRECTOR:
Name ( Signature U 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 t t all fees have been paid:
��
Cem a Sexton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
Total Paid���
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT4 6 2
`S
Name _�/jj
-��8 �d ❑Cash
���-�
Date 7
Check # '
No.
Amount Paid
001001 208001
Sales Tax
001501322900
Garage Sales
001501 341920
Copies/Bid Specs.
001501 341910
LDC/Code of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots 5a)
Lot/Niche Block Unit
001501 343805
Cemetery Fees
Total Paid���
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
04/23/2013 16:44
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1673 No. Central Ave.
SEBASTIAN, FL 32958
(772) 589.JOW
04/23/2013 16:44
#2132 P 002/002