HomeMy WebLinkAbout4-08-30bCertificate No. 2380
CITY OF SEB STIR
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Bobby Roseman
519 Lanfair Avenue
Sebastian, FL 32958
In and for consideration of the sum of $1,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 8, Lots 30 a & b
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 22nd day of May, 2013.
CITY OF SEBASTIAN, FLORIDA
/Al Minner
City Manager
ATTEST:
Sally A aio, MMC
City Clerk
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4384
RECEIPT
Name �1%"f _ ❑ Cash
Date 5f/ 2Z /�� Wl(:heck# ?9y`
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No. Amount Paid
001001 208001 Sales Tax
001501322900 Garage Sales
001501341920 Copies /Bid Specs.
001501341910 LDC /Code of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots
Lot/Niche iA ' 4
, Block Unit
001501 343805 Cemetery Fees
Total Paid 1606 o
nitials
White — Dept. of Origin • Yellow — Finance • Pink - Applicant
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HOME Of PELICAN ~ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
A i / ill .,
Name(s)
Address
331- -5b32
Area Code & Phone Number Je � / S 11M-4 (6a� IZ911M
Name & Residence Address of Intended Occupant if Other Than Purchaser 1��e f .30,E f11
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
ae- h a"j ?o Dollars ($ l00 0 �� )
on this t7224 day of , 20/:5 for the purchase of the following described
Cemetery Lot(s) and /or Niche(s).
f/
Unit 7 , Block , Lot(s) 364 '� 4-5 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 - $2
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation
Signature of Purchaser
Opening & Closing
Interment
/W O H
Circle One
Disinterment
TOTAL $
City of Sebastian
The following documents were provided as Proof of
Residency:
I: \WW- DATA \Ms - Cemetery\RECEIPT.doc
and
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STATEMENT DATE 5 ! TERMS
TO
ADDRESS
IN ACCOUNT WITH _
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