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HomeMy WebLinkAbout4-03-12aName Unit_ Block_ Lot Date of Mark -out - Date of Burial ! / L 6 ��� Time v v 'ME Name of Funeral Home Authorized CITY �X SEBAST HOME OF PELICAN ISLAND Certificate No. 2467 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: Darla Quinn 410 Easy Street Sebastian, FL 32958 In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Block 3, Lot 12a of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 14th day of July, 2015. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: Sally A.'m4io, MMC City Clerk SEAWINDS CREMATORY Sebastian, Florida 735 Fleming Street • Sebastian, Florida 32958 www.seawindsfh.com (772) 589-1933 We hereby certify that these are the remains of MICHAEL E. VOLPICELLI 4t -6 , The remains were received from SEAWINDS FUNERAL HOME & CREMATORY Cremation Permit No. 15-73380-5165 Issued at BREVARD COUNTY Date of Death JUN�Er 277,, 2015 Date of Cremation ` — / 5 By oo� rL7� C-femator My OF c. HOME Of PELICAN ISLAND City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Name(s) y(0 Address IW(0'1) 110 1)7 Area Code & Phone Number MIC-hao, VojatCe(l/ Name & Residence Address of Intended Occupant If Other Than Purc OFFICE USE ONLY Receipt is acknowledged in the sum of: 6W JA'ii{,[JW W � ollars ($ 0 0 ) on this )41 dayof JLktV 20_L5 for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit_ / , Block 3 , Lot(s) / Za 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 - $20) Opening & Closing 0 • D 0 _/W O H %-16-1,j burtq(CircleOne Vase and Ring for Niches (cost) Interment Disinterment Temporary Marker Preparation & Installation Signature of Purchaser I:\W W-DATA\M s-Cemetery\RE CE I PT.doc pTpOTAL$_[ 050,00 �.c,EX-�Gc-yt1,0 ty of Sebastian The following documents were provided as Proof of Residency: CITY OF SEBASTIAN FINANCE DEPARTMENT RECEIPT 0/914 Name 00-0 "f n n t,t Cash _ Date 7-114-13 ❑ Check # ❑ Credit Amount Paid 001001 208001 001001 220000 Sales Tax Security Deposit - 001501 362100 Taxable Rent - 001501 362150 Non -Taxable Rent - 450010 369900 Airport Badge 001501 329500 Alarm Permits 001001 218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 369900 Miscellaneous Revenue 001501 359000 Other Fines/Forfeitures 001501 351140 Parking Citation 001501 342100 Police Security Services 401010 3y39-0 t7 /J-111A.-Qo U 4 B 3 L 12q cs o tfo � 3Y 3805 50.00 K --5m Total Paid Initials White - Dept. of Origin - Yellow - Finance • Pink - Applicant