HomeMy WebLinkAbout4-02-29 m' OF
SETA
HOME OF PELICAN ISLAND
Certificate No. 2551
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:
Courtney Shogran
In and for consideration of the sum of $1,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 4, Block 2, Lot 29
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 24th day of October, 2017.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
z m.
anette Williams, NH tC= -
City Clerk
m OF
SEBASRAN
HOME Of PFUCAN ISLg4D
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
u1eT/v �u ,Si-�OCo2�l
Name(s)
Address
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt its acknowledged in the sum of:
O/ r--
�t 1191�f1�� ---- —Dollars ($ 1066-00)
on this day of 20 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
c
Unit , Block --9% , Lot(s) / 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
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation
y 0 10i'lAtw 0 /� 6.UdL
Signature of Pu haser 11
I:\W W-DATA\Ms-Cemetery\RECEIPT.doc
Interment
/W O H
Circle One
Disinterment
TOTAL $ 41000,06
City
The followin.- documents were provided as Proof of
Residency:
CITY OF SEBASTIAN 10935
ADMINISTRATIVE SERVICES RECEIPT
Name S;t0(; R A -/q O Cash
Date eoIA 7O? heck#
❑ Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001 218010 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
C,,n i of 0 3�-3So o Lor _' ,02 oc�
t, rr 4 A11G ,e LArF,- t -q
Total Pal (000. cd
'Initials
s
White - Dept. of Origin • Yellow - Admin. Svcs. - Pink - Applicant