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Home My WebLink About4-06-24Name Pr, a n Unit IW Block Lot Date of Mark -out Date of Burial 9 2- 2 v�J Name of Furneral Home se, Authorized by r CITY OF SEBASTIAN 17071 FINANCE DEPARTMENT RECEIPT IAA Ste` a t^ Name AW❑ Cash Date grL �s ACheck#555 ❑ Credit Amount Paid 001501 362150 Non -Taxable Rent 001001 220000 Security Deposit 001501 362100 Taxable Rent 001001 208001 Sales Tax 450010 369900 Airport Badge 450010 362521 AP Shade Hangar Rent 450001 208045 Airport Sales Tax 001501 347557 Community Center Revenue 001501 341920 General Fund Copies 001501 354100 Code Enforcement Fines 601010 343800 Cemetery Lot Sales 001501 343805 Cemetery Fees 480010 341920 Bldg Dept Copies PD Shop with a Cop PD COPE PD Cadets PD SRT Total Paid Initials W ite - Dept. of Origin • Yellow - Finance Dpt. • Pink - Applicant FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SE HOME OF KuH IS A D For information contact: Joseph Vergnaud - Supervisor Sebastian Municipal Cemetery (772) 589-2545 Fax(772)228-9927 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: Cox Gifford Seawinds Funeral Home J ADDRESS: 1950 20th St.Vero Beach, FL 32960 PHONE #: 772-562-2365 (Check One) OPEN BURIAL LOT V OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME: FOR DECEASED: Robin Hickey Name Lot Block Unit Lot 24 Block 6 Unit 4 Niche Block Unit N S E_W_ Friday, August 22, 2025 at 2:OOPM NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) J Melissa Daniel, Daughter / 1P&,A- Name Signature D t 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: ^ I Kristin Jewell, LFD I Zq I Name Si nature 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: Cemetery Sexton Date Seawinds Crematory 735 South Fleming Street, Sebastian, Florida (772) 589-1933 Cox Gifford Seawinds Funeral Home We certify this contains the Cremated Remains of Robin Melton Hickey who died on August 3rd, 2024 in the city of Melbourne in the County of Brevard, and the State of Florida. Your loved one was cremated on: 2024-F073377-5176 Tae#14764 Justin Silvester 08/27/2024 Crematory Operator Date of Cremation Thank you for allowing us to serve your family. Docusign Envelope ID: A078FDCA-E830-41D1-8C47-AA2FF6AE8350 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY HOM[ a xuuv ww.vn For information contact: Joseph Vergnaud - Supervisor Sebastian Municipal Cemetery (772) 589-2545 Fax (772)228-9927 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Once (772) 388-8215 or 388-8214 Fax.' (772) 589-5570 FUNERAL HOME: Cox Gifford Seawinds Funeral Home ✓ ADDRESS: 1950 20th St.Vero Beach, FL 32960 PHONE #: 772-562-2365 (Check One) _OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME: FOR DECEASED Robin Hickey Name Lot Block Unit Lot 24 Block 6 Unit 4 Niche Block Unit N_S E_W_ Friday, August 22, 2025 at 2:OOPM NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Sign" by: Melissa Daniel, Daughter 7/30/2025 Name rQ6M45 . 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 FUNERAL DIRE TOR: Kristin Jewell, LFD XW 2a 25 Name Si_ nature \ 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: metery S&Aon O Date Docusign Envelope ID: A078FDCA-E830-41D7-8C47-AA2FF6AE8350 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY Z m PnIGN 6U For information contact: Joseph Vergnaud - Supervisor Sebastian Municipal Cemetery (772) 589-2545 Fax (772)228-9927 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: Cox Gifford Seawinds Funeral Home ✓ ADDRESS: 1950 201h St.Vero Beach, FL 32960 PHONE #: 772-562-2365 (Check One) _OPEN BURIAL LOT ✓ OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME FOR DECEASED: Robin Hickey Name Lot Block Unit Lot 24 Block 6 Unit 4 Niche Block Unit N _ S _ E _ W Friday, August 22, 2025 at 2:o0PM NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Signed by T n Melissa Daniel, Daughter7/30/2025 Name rQeA7774as, 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 FUNERAL DIRECTOR: Kristin Jewell, LFD �t"� X�l Z� i5 Name Si nature 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: Cemetery Sexton Date Name Unit M Lot :p Date of Mark -out ` / /l� Date of Burial �! ( Time 'OD Name of Funeral Home Authorized by Certificate No. 2408 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Robin Hickey 105 King Fisher Way Sebastian, FL 32958 In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Block 6, Lot 24 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 6t" day of February, 2014. CITY OF SEBASTIAN, FLORIDA ATTEST: d Joseph F. Griffin Interim City Manager Sally A., aio, MMC City Clerk CM 0 -- y HOME OF PEt.i# iSLA�riiE? City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. " Name(s) ' l&J Xing FrShe-r WJ% Se-baSfi cc.ii FL- 3 7Y5S Address (- 7 7) Area Code & Phone NurT er Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: - lLii CWL tk J'AM- GJ- _ 10,52( t C ' 'r — .. Dollars ($ on this day of , 20 for the purchase of the following described Cemetery Lot(s) and /or Niche(s). Unit , Block , Lot(s) 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: '�C y Pm Corner Markers (set of 4 - $20) Opening & Closing oZ Jr U. D 0 /W O H Circle One Vase and Ring for Niches (cost) Interment Disinterment Temporary Marker Preparation & Installation TOTAL $ 61 L 1. Signature of Purchaser City of Sebastian I:1W W- DATA \Ms - Cemetery\REC E I PT.doc The following documents were provided as Proof of Residency: and Total Paid 12-5 ,00 Initials White - Dept. of Origin • Yellow - finance • Pink . Applicant CITY OF SEBASTIAN CITY CLERKS OFFICE RECEIPT 4840 P-4 b 1-4r) t L� � Name G/�l[ � ❑ Cash Date a G7 �! YCheck# No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies /Bid Specs. 001501341910 LDC /Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots G)�U.aQ / Lot/Niche'T ,Blocky, Unit 001501 343805 Cemetery Fees z 5C): 0 Total Paid 12-5 ,00 Initials White - Dept. of Origin • Yellow - finance • Pink . Applicant