The URL can be used to link to this page

Home My WebLink About4-06-26 Name 3 /M. M. ui fiat biG ()Aft, Unit f Block (o Lot V&:, • 1 Date of Mark-out W it // . Date of Burial /Z // JA._ Time oD • 6.4011 r- Name of Funeral Home 1/ / ,� [o ri t.•• qatio-e-14 �, . Authorized by I CHYOF SS !lNEB HOME OF PELICAN ISLAND Certificate No. 2398 CITY 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: Joseph Grant Devine 8265 Fleming Grant Road Micco, FL 32976 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 lot: Unit 4, Block 6, Lot 26 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 December, 2013. CITY OF SEBASTIAN, FLORIDA ATTEST: / , Al Minner Sally . Maio, MMC City Manager ity Clerk JILL MARIE LAFAVE DEVINE Sept. 13, 1956 December 10, 2013 Mrs. Jill Devine, 57, passed away December 10, 2013 at William Childs Hospice House in Palm Bay. Jill attended school, lived in Westbrook, Connecticut, and attended Yale University. She moved to Fort Lauderdale, FL in 1987 and in 1998, with husband Pat, moved aboard the yacht Paradise. She later moved to Micco to live in their retirement home. Jill enjoyed Greek history, visiting Athens with Pat, and having dogs and cats for company. She joined TNT Reality with Jack Timmons in Fort Lauderdale as a Real Estate Associate. Jill also volunteered with Red Cross, the Human Society and Broward General Hospital in Fort Lauderdale, FL. Survivors include her husband of 22 years, Pat Devine of Micco; brother, Rick Lafave of Micco; sister, Janie Liejeski and her husband, Roger; sister, Renee Conger of New York and nephews, Paul & David Liejeski and their families. 11(N ‘* 6Iccv CCU t r /L L__Dt 2 (40 nti-x\rAloc, i\lbc(6L mic_co Ft CITY OF SEBASTIAN CITY CLERK'S OFFICE 4/, 82 /, RECEIPT 4 Name 3s)h !/C. vi n e_ ❑ Cash Date /e2,/e2,-/ /- /3 xCheck# 14 &0 No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees //�yyyy�� 601010 343800 Cemetery Lots / a�L�C/ UC Lot/Niche Z(0 ,Block (D ,Unit Li 001501 343805 Cemetery Fees 4 WtY�{L,t,r,(,�'Y Total Paid �Q1.41 Initials White-Dept.of Origin• Yellow-Finance •Pink•Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE /, 823 RECEIPT �+ Name 5fr yi k/j2 V I n e_ H Cash Date I 0 - 11- 13 k Check# CO3 I t. No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot/Niche ,Block ,Unit 001501 343805 Cemetery Fees ®/C /S .Do 4(/ ,, Total Paid 150.00 Initials White-Dept.of Origin• Yellow-Finance •Pink•Applicant • • - FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR 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, Florida, 32958 PHONE#: 772-589-1000 (Check One) yy OPEN BURIAL LOT Lot 26 Block 6 Unit 4 OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: Monday, December 16, 2013 at 1:00 pm CHAPEL FOR DECEASED: Jill Marie LaFave Devine Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) • YoseQv Gck-1L ,: 121l ( � i3 Name Signnattare 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: Tim Marvin S M blhn U MCL100 t'if�/!AVL _ 1211 1 I i 3 Name ignature 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 en paid: fe /2//, Cemetery xton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR 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, Florida,32958 PHONE#: 772-589-1000 €--•-lif (Check One) up 1L l 6--.-r xx OPEN BURIAL LOT Lot 26 Block 6 Unit 4 OPEN CREMAINS LOT Lot Block Unit \j K-lt:■0—Q-- OPEN COLUMBARIUM NICHE Niche Block Unit N S E W t V BURIAL DATE AND SERVICE TIME: Monday,December 16,2013 at 1:00 pm CHAPEL I �/ �l� FOR DECEASED: Jill Marie LaFave Devine \S � 1, /��v Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) • ause�Jh GirCu t-t- �J t,li 1 Y-,.�., O�Jc.2�) c -la( AAS- i21 i < I I3 Name Signature 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: Tim Marvin T MUtli 0. U tJl( _��__ ./ 12-1 I I 3 Name ignature ' 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 end that all fees av een paid: • /0Z///43 Ce teryxto Date . This form to be provided to Cler ' Office by Sexton for permanent record upon completion. 6312 STRUNK FUNERAL HOMES&CREMATORY MARINE BANK&TRUST 611424 670 CASH ADVANCE ACCOUNT-SEBASTIAN VERO BEACH,FL 32960 DATE 12/11/2013 1623 N CENTRAL AVE SEBASTIAN,FL 32958 AMOUNT One Hundred Fifty and 00/100 $ 150.00 PAY TO THE City of Sebastian ORDER OF: 1228-13618 Devine F1UR1DA ARC OF'. State of Florida, Department of Health, Bureau of Vital Statistics HEART BURIAL TRANSIT PERMIT DATE PRINTED:December 10,2013 TRACKING NUMBER: 2013174441 1. DECEDENT INFORMATION Name of Deceased Date of Death JILL MARIE LAFAVE DEVINE December 10,2013 Place of Death-County City,Town or Location Name of facility,or street address if not a facility BREVARD PALM BAY WILLIAM CHILDS HOSPICE HOUSE 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: 2013-F041870-5160 . /L4 . Q/ � t Date Issued: December 10,2013 Meade Grigg,State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY 1 Place of Disposition: SEBASTIAN CEMETERY i1 ' 1 1 12 Method of Disposition: BURIAL Date of Disposition: ll It ey 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