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Home My WebLink About1-28-32Name if 0 - /:M446d 15/X tb / • 3/% S Unit Block Lot Date of Mark -out /y /� Date of Burial L� A, 6 ' Time /.'C, D Name of Funeral Home �it�l9 Authorized by LAUNDLE CHARLES DAMRON March 6, 1940 - October 28, 2016 Mr. Laundle Charles Damron, 76, passed away October 28, 2016 at Sebastian River Medical Center in Sebastian. Laundle was born in Huntington, West Virginia and lived in Sebastian for 31 years coming from South Point, Ohio. He served in the United States Air Force and was the Plant Operations Manager for the Devereux Foundation for 20 years. Laundle was a member of the Calvary Baptist Church in Sebastian. Survivors include his wife of 46 years Betty J. Damron of Sebastian, daughters Cathy Jean Strever (Don) of Billings, Montana, Cindy Lou Miller of Colorado Springs, Colorado and Bonnie Smith of Sebastian, sons Steven Dwain Kirtley of Richmond, Indiana and Dwight Morris Kirtley (Christine) of Milton, West Virginia, sisters Eva Powers, Frances Flesher, brothers Bill Damron, Ernie Damron, 12 Grandchildren, 17 Great Grandchildren. He was preceded in death by a brother, Carl Damron, three sisters, Norma Garrettson, Juanita Kincaid, Betty Porter. Memorial contributions in his memory can be made to Calvary Baptist Church 123 Thunderbird Drive Sebastian, FL 32958. Services: The family will receive friends from 11:00 to 1:00 PM on Wednesday November 2, 2016 with a Funeral Service beginning at 1:00 PM with the Reverend Cliff Cooley officiating at Strunk Funeral Home 1623 N. Central Avenue Sebastian. Interment will follow service at the Sebastian Cemetery Bom: March 6, 1940 Death: October 28, 2016 State of Florida, Department of Health, Bureau of Vital Statistics BURIAL TRANSIT PERMIT HEALTH DATE PRINTED: October 31, 2016 TRACKING NUMBER: 2016167187 1. DECEDENT INFORMATION Name of Deceased Date of Death LAUNDLE CHARLES DAMRON October 28, 2016 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER SEBASTIAN SEBASTIAN 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. GARY D. EVANS F065074 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: October 29, 20-5185 16 �-- Date Issued: October zs, zo16 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 Place of Disposition: SEBASTIAN CEMETERY "PA A n �/(`�, t' 4 / Method of Disposition: BURIAL Date of Disposition: 1 -4i 01 t0 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 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— SEBASTIAN ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE#: 772-589-1000 (Check One) XXXXXOPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME: FOR DECEASED: Lot-32—Block 28Unit 1 Lot—Block—Unit Niche Block Unit N S E W WEDNESDAY, 11/2/2016, 1:00 PM FUNERAL SERVICE — CHAPEL Laundle Charles Damron IV"n t NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Betty J. Damron Bettg A Tormon 10/31/2016 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: Gary D. Evans Name Gary 0. Evans 10/31/2016 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: Cemetery Sexton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. 10/31/2016 12:57 FOR FUNERALI ADDRESS: PHONE* (Check One) XXXXXOPEN BURIAL OPEN CREMAI OPEN COLUMI BURIAL DATE AND FOR DECEASED-. NAME AND SIGNAT (Must provide proper Name DIRECTOR'S REQUEST TO t . OPENING IN SEBASTIAN M For Information contact: Kip Kelso .Cemetery Sar Sebastian Municipal Cem' (772) 589.2545 City Clerk's Office City Hall, 1225 Main Sfn Sebastian, FL 32958 Ofrrce (772) 388-8215 or 381 Fax: (772) 589.5570 Funeral Home and Crematory - LOT NICHE OF SEE VAL C #6113 P.001/001 TIME: WEDNESDAY, 11/2/2016, 00 PM FUNE AIrSERVICE—CHAPEL Charles Damron OF LOT OWNER OR RI mentation of ownership) Signature I certify that I have dete coed the ownership of the above descht fees have been paid and uthorize opening of same. NAME AND SIGNATUR OF LICENSED FUNERAL DIRECTOR: Gary D. Gary 0.4 Signature Cemetery Sexton Certifition: I certify that I have check d the ownership information by viewing office and that all fees h e been paid: Cemete Sextan o Date This form to be provided o Clerk's Office by Sexton for permanent that all owner's upon 10/31/2016 Date fees and administrative 10/31/2016 Date amd confirming with Clerk's CITY OF SEBASTIAN 10393 ADMINISTRATIVE SERVICES RECEIPT Name iy4Q1A(,iiC t RCYJ JCash Date %(Check #15_1_3q u Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit 001501 362100 Taxable Rent 001501 362150 Non -Taxable Rent 450010 369900 Airport Badge 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 329200 Site Plan Review 001501 329300 Subdivision/Plat Review 001501 329100 Zoning Fees (°xpi s-01 ;143865 b IC_ 4�o ()Mrr t eALY✓ag 1i1' 3A LAW Total Paid' ritials Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant 1 ��; .riy or r, ,.a , , ... , _i_r- -J -J I-_, i .� ' .. HOME OF PELICAN ISLAND Certificate No. 2059 CC: �, . Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Betty& Charles Damron 1025 Barber Street,Sebastian,Fl 32958 (name) (address) in and for consideration of the sum of $1,400.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 1_Block_28_Lot(s)Niche(s)_32 & 33_ 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 12th day of January, 2006. CITY 'IF S A • STIAN, FLORIDA ATTEST: dl1F 1 !_ ,.! ' r; -------- i"'(i•; nner Sally Maio, MMC Manager ' City Clerk • sxcar xa--_______ :!�,44y.+.� ina.e.4_ �..,q..u4,. -_.. _• - - TERMS ..___....�. f _ CREDIT LIMIT .. .. . _..._-.... `�iF�—. "__-.- _._.___,.._ IN /A.• + . ‘l) J �/ z 5t' it's fin k,r !426. , a 14 , ` o,.a S•a r..fl 0 • 1913, '. S 1; Gar.,.,.‘'' 111111111M111=.01111MEorvm 5 6:c... a j• *--av-- t--�s,. �i(.•;r-. it .„ a.i .ri r.rif,t j P t 4 .1A.Yl•Id/'I Ati.fig •• ,�I 417, A 1 .all Ai �'10 `r !I • 5o,b _o . .ot-b 1‘ 7 , u °R y •ado &Atom.. . .»:-*1 r r t oil' ., 1 , ...14 .- ,,.•,,,-*-!".' 0 toy 11.1e. R 4.r.• �..i so. • .ill , I , '11 .,01.4 )1"' :n.n j a2 i - t.. ...., _ _ _ • • ImuuniniiIiiIiiiminitioiliiimm y N r ' ... ,a,-.r"' .�4..as : {A Yx z �f .. .. .. 74:1:.37� -.�.rt+.3. - • chi..: •","'---7} • 'T,Ir 7+1t4-7x' t. ( STATEMENT ) 123425 Date ///,/ 6 TO / / / T TERMS I I IN ACCOUNT WITH *OA/ /7. / ,^ .1., --e' / ./ g 1, Li 7e.,e AL Stock Form 25812 cri or HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, Fl 32958 Telephone(772) 589-5330—Fax (772) 589-5570 January 17, 2006 Betty& Charles Damron 1025 Barber Street Sebastian, Fl 32958 Dear Mr. &Mrs. Damron: Enclosed is City of Sebastian Certificate 2059 entitling you to full interment rights in Cemetery Lots 32 & 33, Block 28, Unit 1. Also enclosed is a copy of the receipt and the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions,please contact our office. Sincerely, Sally Maio,MMC City Clerk SAM:ar enclosure alr Cf -� . 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, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase Name(s) / /> ?5 4 i '4.r E=/ -74- - • _ Address 772 - 5?r9 Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: , Dollars ($l d- o d ) on this / day o' , 20e0' for the purchase of the following described Cemetery Lot ", and/or N' he(s). Unit / , Block 9& , Lot(s) ,�, j 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) Opening&Closing W 0 H Circle One Vase and Ring for Niches (cost) Interment Disinterment TOT Signature of Purchaser ty of Sebastian Service fees are to be paid at time of need only I:\VVW-DATA\Ms-Cemetery1RECEIPT.doc CITY OF SEBASTIAN CITY CLERK'S OFFICE 3 419 RECEIPT Name "/ 42•4ha-- ❑ Cash Date .✓ . / �� eck# Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sates 001501 341920 Copies/Bid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots &c? Lot/Nichei9 9<. ,/ ,Block P'6 ,Unit/ 001501 343805 Cemetery Fees Total Paij 1 l lnidals White-Dept.of Origin• Yellow-Finance •Pink.Applicant 01/18/2017 13:23 #6367 P.002/002 Fug 24 c^^011 1 ;33AM HP LASERJET FAX Clry o%Seba N(Tri \rhnllni f�n1WrT Pb. • II r71l.tO, 1 1'u%M11»;r111•v, Null: TAi h fnr lafnrnjAllnnal pu rpot*%rrquarain{ Alvnumr9N vl s0wilan Cel u.ItrN :\u1v 'I'Ah l fur 9lnxlr .l larAvrc undtr 2 R. �\ nrrr 1 p.(,nrr 1 R• I I�u n•J fnvldru n li mfor rrlvfo v Ciry of 9,W,rbnpry MIX 1e07llhn t'rnatltn 1011 NnrlA f•rnlrii A,n Fvuud ¢IFuI w ufY:! 329SA Allrnllun �� l'rnvlrr? S? lllfi� da 0 $L/3/ r N 11 rV,�a.�TA.r $ISP : ro Y bAo )`,t Z^O E I -D h, -FCW.'4 Hsmo P0tfo Ts: ll LiJZ.HER : t A.O.U. 1. al e t enl LO 4ppraved By ; } chichoo By E>ranlplo GUT STRUNK FUNERAL HOME & REMATORY �jr 1623 Na. CentratA SEBASTIAN, FL 329 r� fi () 589.1000