HomeMy WebLinkAbout4-02-30 ff OF
SEBAST_"
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
i,lll`aryl a 1d Cou.y- tneU shoo rare
NamA(c1
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
t't �rDi Dollars ($ /DUO. D (� )
on this day of , 20 for the purchase of the following
described Cemetery Lot(s) and/or Niche(s).
Unit _ ` _ v, Block 'Z , Lot(s) j 0 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) Interment
Disinterment
W O H
Circle One
TOTAL $
S' tune of rchas - ' y of Sebastian
Service fees are to be paid at time of need only
] :1W'w- DATAIMs- Cemetery\RECEI PT.doc
►✓" -'�- �-"T^'m Total Paid
Initials
White - Dept. of Origin • Yellow - Finance • Pink • Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
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Name
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11 Cash
Date k
—I 5 — / —1
f
;sXheek # ?q
No.
Amount Paid
001001 208001
Sales Tax
001501322900
Garage Sales
001501 341920
Copies/Bid Specs.
001501 341910
LDC /Code of Ordinances
001501 341930
Election Qualifying Fees
801010 343800
Cemetery Lots
600(-9100
LoUNiche �ts�ff 1j , Block
Unit
001501 343805
Cemetery fees
►✓" -'�- �-"T^'m Total Paid
Initials
White - Dept. of Origin • Yellow - Finance • Pink • Applicant