HomeMy WebLinkAbout3-COL-28DsAName
Unit
Block LZO
Lot
Date of Mark -out
Date of Burial ` l Time �'C///— t D
Name of Funeral Home
Authorized by
Certificate No. 2410
, Y OF Si E', B A STIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Nelson B. Salazar
120 Bellamy Trail
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 28dsa
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 February, 2014.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
Interim City Manager
ATTEST:
Sally A. aio, MMC
City Clerk
Aero Beach Crematory, LLC
1830 Wilbur Avenue
Vero Beach, Florida 32960
We hereby certify that these are the cremated human remains of:
Marcia Susana Salazar
February 12, 2014
(Date of Death)
Strunk
Funeral Home & Crematory
(Funeral Home in Charge)
03462
(Cremation ID Number)
February 18, 2014
(Date of Cremation)
Sebastian, Florida
(City and State)
By:
(Cremator Signature)
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
For information contact:
Kip Kelso .Cemetery Sexton
Sebastian Municipal Cemetery
�l (772) 589-2545
City Clerk's Office
City Hall, 1225 Main Street
Sebastian, FL 32958
Office (772) 388-8215 or 388-8214
Fax: (772) 589-5570
FUNERAL HOME: Strunk Funeral Home and Crematory
ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958
PHONE#: 772-589-1000
(Check One)
OPEN BURIAL LOT
OPEN CREMAINS LOT
X OPEN COLUMBARIUM NICHE
Lot Block Unit
Lot Block Unit
Niche 28DSA Block Unit 3
N S E W
BURIAL DATE AND SERVICE TIME: Tuesday, March 4, 2014 —10:00 AM — graveside
FOR DECEASED: Marcia Susana Salazar
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
Kattya Salazar-Bandel"1 `�� ��C- 02/26/2014
Name l ignature Date
I certify that I have determined the ownership of the above described site that all site fees and administrative
fees have been paid and authorize opening of same.
NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR:
Tim Marvin
Timothy W. Marvin 02/26/2014
Name �ignature Date
Cemetery Sexton Certification:
I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's
office and that all fees hav been paid:
2 I �, Z/�- -
e etery xto Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
My Of
dLl
HOME OF ' €'ELI h ISLAND
� O
P
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
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
a4l�
Dollars ($'2600, 0 C )
on this It day of '— OD , 20 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit 3 , Block (�,D I , Lot(s)
Niche(s) a S a
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;
_ �� . L C� / W O H
Circle One
Vase and Ring for Niches (cost) Interment
Disinterment
Temporary Marker Preparation & Installation
Signature of Purchaser
1: \VVVV-DATA\Ms-Cemetery\R ECE I PT. doc
TOTAL $ Z 6)56), 6 C
46yf Sebastian
The following documents were provided as Proof of
Residency:
CITY OF SEBASTIAN
CITY CLERK'S OFFICE /, 8 /, /.
RECEIPT `+ v 4 4
Name : Ca ( G Z (, r T aryl i ❑ Cash
Date v� ` — �i YCheck #
No.
001001 208001
001501322900
001501 341920
001501 341910
001501 341930
601010 343800
001501343805
Amount Paid
Sales Tax _
Garage Sales _
Copies/Bid Specs. _
LDC/Code of Ordinances _
Election Qualifying Fees
Cemetery Lots _
Lot/Niche Block L Unit
2
Cemetery Fees
Zi
Total Paid
Initials
White - Dept. of Origin • Yellow - Finance • Pink • Applicant
4j Total Paid 1056.00
61 Initials
White — Dept. of Origin • Yellow — Finance • Pink • Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
4843
0✓1 C( &Zj— FC -M( V
Name
❑ Cash
Date
—T
IVCheck#
j
`Y
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
Lot/Niche�,Block ��''
Unit 3
001501 343805
Cemetery Fees
4j Total Paid 1056.00
61 Initials
White — Dept. of Origin • Yellow — Finance • Pink • Applicant