HomeMy WebLinkAbout1-29-13 CoC3 (rQ4:-
MY OF
SLDASTLAN
I
HOME OF PELICAN ISLAND
Certificate# 1976
C1 _! _ 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:
Karen Lohse O'Brien 11536 Indian River Drive, Sebastian, Fl 32958
(name) (address)
in and for consideration of the sum of $3.800.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plots:
Unit_ 1_Block_29_Lot(s)_13, 14, 15 & 16_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 28th day of July, 2004.
C OF SEB:. TIAN, FLORIDA A ST:
)2- 4
Terrenq X. Moore Sally A. Maio, CMC
City Manager / City Clerk
Co) /
CITY OF
SEPASTIAN
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian,Fl 32958
Telephone (772) 589-5330—Fax (772) 589-5570
July 28, 2004
Ms. Karen Lohse O'Brien
11536 Indian River Drive
Sebastian, Fl 32958
Dear Ms. O'Brien:
Enclosed is City of Sebastian Certificate 1976 for the purchase of Cemetery Lots 13, 14, 15 &
16, Block 29, Unit 1. Also enclosed is a copy of your receipt and the Rules and Regulations
governing the Sebastian Municipal Cemetery.
If you have any questions, please contact our office.
Sinc- -1 ,
ti
Sally A. aio, CMC
City Clerk
SAM:ar
enclosure
MY OF
SLDASTAN
HOME OF PELICAN ISLAND
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
A
4 /3 ti EN] Ldtf5E 0 BR ENI
Name(s)
llS3 (o _LNd /9 it/ /?/VEX' P/c%V' g
Address
sE,3,9 s l= L 3 a q -6-6
Area Code & Phone Number
(-7 702) 38' 8
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
/!�
04.4--444104' i .� � Dollars ($, ,80 . DO )
on this "gal day of , 20.01 for the purchase of the following
described Cemetery Lot(s nd/ Niche(s).
Unit / , Blocka0P' , Lot(sy.5 /} /S/6 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 i Disinterment
T• A $5 /60 Od
Si nature of Purchaser 'ity of Se•astian
Service fees are to be paid at time of need only
I:\W W-DATA\Ms-Cemetery\RECEI PT.doc
Lon0
ITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
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/ � '� h-�..) ❑ Cash
�/ of d° ! Amount Paid
208001 Sales Tax 322900 Garage Sales 341920 Copies/Bid Specs.341910 LDC/Code of Ordinances 341930 Election Qualifying Fees 343800 Cemetery Lots •eV LotNich4'1%z Block�9 Unit 343805 Cemetery Fees i Total Paid f dd •E•r,°/niba'
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