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CITY OF SEBASTIAN
CITY CLERK'S OFFICE 352:
RECEIPT
Nam- .r��l . 7, t - sh
Date L2—e, , „22c? U O,S---- [4-Check# SIX
1
No. Amount Pa
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 G/ _
001501343805 Cemetery Fees %'S
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0 f._ Total Paid 93, l
P Initials
White—Dept.of Origin• Yellow—Finance •Pink•Applicant
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Block 10 Lots 1, 2, 3, 4, 1 Unit 1 0.B.
16, 17, 18, 19, 20
a/k/a Lot 2
Dr.
Rose, Mrs. Elizabeth & Schumann