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SE�TAN
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HOME OF PELICAN ISLAND
Certificate No. 2439
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:
Gilda & William Zaleznick
1772 Sunrise Lane
Sebastian, FL 32958
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 2, Lots 36 & 37
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 27th day of October, 2014.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
41ao, MMC
City Clerk
ilY Of
f vY
HOME Or PELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
G djo -- UJ(-( Darn Za(eZnI ck
Name(s)
l-7
Address
- -7Sv
Se13c,5f-)c.n FZ- 32
CP ll
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
($ ZOGo.00
on this�� day of (i cto b 2 r 20� for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit Li , Block Z Lot(s) 3 % --1- 3 7 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:
Comer Markers (set of 4 - $20) Opening & Closing
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation
00-a A"�
Signature of Purchaser
I:%W W-DATAVAs-CemeteryVRECEIPT.doc
Interment
/W O H
Circle One
Disinterment
TOTAL$ ZOOp, OO
CAy of Sebastian
The following documents were provided as Proof of
Residency:
PrV f2 /-app Ceb,5drand
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
4943RECEIPT
Name Mr. r.y ! i n/ - Lo n a c Cash
Date 10 - 2 7- I `Y' ❑ Check #
No.
Amount Paid
001001208001
Sales Tex
001501322900
Garage Sales
001501341920
CopieslBid Specs.
001501341910
LDC/Code of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots
2 ()0U 00
Lof lche 310,3 7Bbck
Unit
001501 343805
Cemetery Fees
AJQ - /J ) Total Paid 7()60 00
Inkials
White—Dept. of Origin• Yellow — Finance • Pink - Applicant