HomeMy WebLinkAbout3-COL-06Certificate No. 2404
CIT
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Donald & Barbara Brown
634 Orange Avenue
Sebastian, FL 32958
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Columbarium, Niche 6dsa
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 14th day of January, 2014.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
Interim City Manager
ATTEST:
Sally A/,Aaio, MMC
City Clerk
My OFr4 r4
HOME OF PELICAN N ISLAND � J
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Name(s)
Address
(77J)5�'l -06g7
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
j
on this "4 day of �1� '1 UrA_r
Cemetery Lot(s) and/or Niche(s).
Unit , Block �() t , Lot(s)
Dollars ($ 0 C
20_L'y for the purchase of the following described
Niche(s) 6- ds Cc
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)
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation
Signature of Purchaser
Opening & Closing
Interment
/W O H
Circle One
Disinterme
TOTAL $ c),U 7g - 00
Ity of Sebastian
The following documents were provided as Proof of
Residency:
I:\WW-DATA\Ms-Cemetery\RECEIPT.doc I and
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4834
RECEIPT
Name M r -k (nPe-5
`8 rQ L)J rl ❑ Cash
Date - /' �f VCheck#
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
/�
Z)000 Al
Lot/Niche S-41ock W I
, Unit
001501 343805
Cemetery Fees
Vis z l- r 1'6 a
7q ua
/J i �ii 7!? 00
Total Paid �V
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant