The URL can be used to link to this page

Home My WebLink About4-06-08/ ��f � 4 Name S 11 1, !off . 6 �7' X iD 1,C ,(�X ,�� Unit _r Block 4 Lot Date of Mark -out Date of Burial & /%y� Time %,�, • flC7'd w G' Name of Funeral Home_ Authorized STEPHANIE G UTI ERREZ Ms. Stephanie Gutierrez, 21, passed June 1, 2014 in Vero Beach, Florida. She was born June 27, 1992 in Norwood, Massachusetts and lived in Vero Beach since 1997 coming from Walpole, Massachusetts. She was a Medical Assistant at Partners in Women's Health, Vero Beach. She was a member of St. Sebastian Catholic Church, Sebastian, Florida. Survivors include daughter, Sophie Arcila Gutierrez; parents, Luis Carlos >t Martha Gutierrez, all of Vero Beach; brothers, Andres Gutierrez and his wife, Angie Munoz of Sebastian and Victor Gutierrez of Orlando; niece, Catalina and nephew, Alexander Gutierrez Munoz; fiance, Robert Smith of Vero Beach; numerous aunts, uncles, cousins, relatives and friends. FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN R BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY 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: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian PHONE #: 772- 589 -1000 (Check One) X OPEN BURIAL LOT OPEN CREMAINS LOT Lot 8 Block 6 Unit 4 Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: Saturday June 7, 12:00 PM L ` , CY2, 14 FOR DECEASED: Stephanie Gutierrez Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Kevin Lovely /,///5/3/14 Name a 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 FUNERAL DIRECTOR: Tim Marvin June 3, 2014 Name Signature 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: e'A /_,� Q - .4 zl_� - 6 Z40 // A/ Cemetery ?rexfon Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. o i ilJ k FUNERAL HOMES City of Sebastian Cemetery 1921 North Central Avenue Sebastian, Florida 32958 To Whom It May Concern; June 3, 2014 I, Kevin Lovely, give permission to Strunk Funeral Home, to bury our cousin, Stephanie Gutierrez, in property in Sebastian Cemetery known as Unit 4, Block 6, Lot 8. Kevin Lovel 916 SEVENTEENTH STREET - VERO BEACH, FLORIDA 32960 .(772) 562 -2325 1623 N. CENTRAL AVENUE • SEBASTIAN, FLORIDA 32958 .(772) 589 -1000 NSM "uEnXE" GLENN A. STRUNK FUNERAL DIRECTOIRECTO R SEI ECE(0 ^^ 4 C�"HS CHt CEL Y °'j iNE CADFA Of iXFGOLDFN RULE Certificate No. 2385 CITY OF SSEEB SSTIA Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Kevin & Lucy Lovely Paul & Samantha Gautier 740 Barker Street Sebastian, FL 32958 In and for consideration of the sum of $5,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4, Block 6, Lots 4, 51 6, 7, & 8 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 21St day of June, 2013. CITY OF SEBASTIAN, FLORIDA � Al Minner City Manager ATTEST: Sally Maio, MMC qty Clerk State of Florida, Department of Health, Bureau of Vital Statistics BURIAL TRANSIT PERMIT HEALTH DATE PRINTED: June 3, 2014 TRACKING NUMBER: 2014081278 1. DECEDENT INFORMATION Name of Deceased Date of Death STEPHANIE GUTIERREZ June 1, 2014 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH INDIAN RIVER MEDICAL CENTER 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 Director /Direct 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. Permit Number: 2014- FO41870 -5082 Date Issued: June 3, 2014 Meade Grigg, State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District 19 Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY 'S IW I I' Method of Disposition: BURIAL 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 CITY OF SEBASTIAN CITY CLERK'S OFFICE 4886 RECEIPT Name 5 L/ rye,. l C7 U t 1'e- rre- Z❑ Cash Date 2 '4 - f Y )(Check # '702-9 No. Amount Paid 001001 208001 Sales Tax 001501322900 Garage Sales 001501341920 CopieslBid Specs. 001501341910 LDC /Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot/Niche A Block Unit 001501 343805 Cemetery Fees 256,vc, Total Paid z 5c. cc Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant Total Paid W -00 Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT /, `� 8 `+ v U ced( f ce,;,c( Name k-e y I ri L y y P l l� ❑ Cash `" e 3 Date r ❑ Check # 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 rj° � � roo 0 ' (1 00-00 601010 343800 Cemetery Lots .��' LbfflicTi� 7' Block Unit 001501 343805 Cemetery Fees Total Paid W -00 Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant 07 [)F SfOASTI - HOME Of PELICAN ISLAND 1! 1 IN •' �'� li • 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. K ► v 4 Name(s) uu '? 1 c 1 C \ A,ddre s (17 -Q 3 G 0 05q Area Code & Phone Number IA O V' Name & Residence Address of Intended Occupant if Other Than Purchaser Receipt is acknowledged in the sum of: on this. day of Cemetery Lot(s) and /or Niche(s). Unit , Block , Lot(s) Dollars ($ ) 20 for the purchase of the following described 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) Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation Signature of Purchaser Opening & Closing Interment /W O H Circle One Disinterme TlIT A t 1 V hL City of Sebastian The following documents were provided as Proof of Residency: !: \WW- DATA \Ms - Cemetery\RECEIPT.doc.. j and CULT n HOME OF PELICAN ISLAND Burial rights in the Sebastian Municipal Cemetery lots /niches purchased by me (Please print name and address of purchaser) `l (Lot/niche, block, unit description) are intended for interment of the following individuals: Please print name(s): Interment lots /niches are not to be transferred without written approval of the City of Sebastian. Interment lots /niches in the Sebastian Municipal Cemetery are allowed to be passed on to heirs but the City requires a certified copy of relevant probate or other court documents. I have read and understand the terms of this agreement. Signature Date Subscribed and sworn to before me this day of by who is personally known to me, or has produced as identification. Notary Public, State of Florida Names of Interred form Point & Pay - Create Order Thank you for your payment! This service has been provided by City of Sebastian, FL and Point & Pay. We value your business. Please keep this receipt for future reference. You have made a payment to City of Sebastian, FL . The City of Sebastian thanks you for your payment. For questions about your account, please call 772 - 589 -5330 Name: KEVIN LOVELY Address: 740 Barker St, Sebastian FL, US, 32958 Contact: 7724735808 Comments: Page 1 of 1 1 mug e.4 CU11 1U : 3:jHM HP LASERJET FAx . a VIV 31 . ____ ': ,\ ti I- Clip • of Sebastian \,na,li41, ( rillefrrY Pi M II,7)iStP, 2545 I ,\ tt Ili':' ))tt . vv2? vVlr : Thil 11 fnr la(nrnlsllonAl purpo,vs rr^carkthnq AL,nwo'ol1 rl 'cbaltl:ln ('i•nI Ur% Nutt,, Thi,hfnr \It Ic .11arLi r. ,i rlrl Cr 2 R. \ r„cr ! II(ON rr/ n.Is.1 I. ur L) (n VnJ711nn ) Y1ru.c (nurn lu carry o/ SnW,ll0rl Dry rv11x Srbactl,n ('rnutrrk /� Iv21 tinrIh r'rnlral '�%c. 1 lrUc-lt-d'Jlirrll fnr rf,) Alitnllun , ) J 1295)1 ry �ritn� dry b� 7-rigVX4. f bic,-. .-3 )( 0-1v x. 2-q •„..,• ,,,..;,„,d Babe. -2 x 1 -0 )1. D tt9 :re�K fsT oit- SizefJole TMarne dO'eto HIS : HER � D.0 cr. lqG12 Legol Descripl(lon . i Unit : _ 4. . 1,,, 0 ✓et2 Ie�e. 5)r1q 11 Bht. . (i 41lea>r e 5 1 \ , Lot : Squve FL : _ _ % /t' Z /o �Q�ir A ai,/ Approved By : /017/AT /0 r Checked By . _,k4 e 46—) . An 4 12 4:ff. 4- By °tfy _�_ (Ig X) w 2 o ✓fie � 1/ Example : c r 7A / ,`""L)I `Q.• f, ^ �I{1fi MolTit $ PD1f'�i/ 1 to S d RUNe € UNE RAL HOME & CREMATORY �N y °�,•, Ct�,H 1� f 1623 No. Central Ave. y "O, , 50, Tit Iv,/ SEBASTIAN, FL 32958 �,N) , (772) 589-1000 Lv 6 ' .)- 54f•vI Glt rv1 0"l00/7 N9 Z U ge `4c, c `l..27-41 / '9' e to/(r .. . 1 ,4vc C -1 NI Ag.1/7e. fit, 1 �� Tritf •e t_e6./ _ g A Pe764ci,�, ,,.1 (,,r we_