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Certificate No. 2414
CITY OF SE13ASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Patrick Schneider
382014 th Street
Micco, FL 32976
In and for consideration of the sum of $4,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 2, Lots 24 & 25
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 2nd day of April, 2014.
CITY OF SEBASTIAN, FLORIDA ATTEST:
_ ? -
r,
Joseph F. Griffin Sally A. Mai 0, MMC
Interim City Manager City Cler
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4862
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CITY OF SEBASTIAN
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-BAST F. k
HOME OF JPELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Name(s)
Address
�4_c(_D , 6: -?,2-9-76
Area Code & Phone Number
Name &Residence Address of Intended Occupant if Other Than Purchaser
Receipt is
OFFICE USE ONLY
owledged in the sum of:
t�' ✓!
Ilars ($ °'
on this day of OA , 20_1�_ for the purchase of the following described
Cemetery Lot(s) and /or Niche(s .
Unit Block 2— , 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
Signat of Purchaser
I:IW W- DATAWIs- Cemetery\RECEIPT.doc
Interment
/W O H
Circle One
Disinterme
TOTAL $ C>)000 sa
City of
The following documents were provided as Proof of
Residency:
and
FUNERAL HOME
ADDRESS:
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
(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
Strunk Funeral Home and Crematory
PHONE #: 772 -589 -1000
Flori
(Check One)
X OPEN BURIAL LOT Lot 24- Block 2 Unit 4
OPEN CREMAINS LOT Lot Block Unit
OPEN COLUMBARIUM NICHE Niche Block Unit
N S E W
BURIAL DATE AND SERVICE TIME: 3/27/2014, 11:00 AM at St. Sebastian Catholic Church
FOR DECEASED: Mary McLaughlin Schneider
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
Patrick McLaughlin Schneider
Name
3/24/2014
'gnature 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 03/24/2014
Name &Unature 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 have been paid:
Cemetery Sexton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
aTY OF
4F .
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589 -5330 Phone
(772) 589 -5570 Fax
April 3, 2014
Patrick Schneider
3820 14th Street
Micco, FL 32976
RE: Interment Rights to Unit 4, Block 2, Lots 24 and 25 Sebastian Municipal Cemetery
Dear Mr. Schneider:
Enclosed is City of Sebastian Certificate 2414 entitling you to full interment rights in Unit
4, Block 2, Lots 24 & 25.
If you have any questions, please contact our office.
Sine ly,
Sally A. aio, MMC
City Clerk
Enclosure
FUNERAL HOME:
ADDRESS: 16231
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
(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
Strunk Funeral Home and Crematory
PHONE #: 772 -589 -1000
(Check One)
X OPEN BURIAL LOT
OPEN CREMAINS LOT
A
OPEN COLUMBARIUM NICHE
BURIAL DATE AND SERVICE TIME:
Lot A Block 2 Unit 4
Lot Block Unit
Niche Block Unit
N S E W
3/27/2014,11:00 AM at St. Sebastian Catholic Church
FOR DECEASED: Mary McLaughlin Schneider
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
Patrick McLaughlin Schneider
Name
(; �) W- W,- "
3/24/2014
gnature Date
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 03/24/2014
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 have been paid:
Cemetery Sexton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.