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HomeMy WebLinkAbout4-08-07aCITY OF HOME OF PELICAN ISLAND Certificate No. 2420 C ITY OFSEE-B-3ASSTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: William H. Nill, Sr. 217 Periwinkle Drive Sebastian, FL 32958 In and for consideration of the sum of $500.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Block 8, Lot 7a of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 27th day of May, 2014. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: Sally A. M 'o, MMC I City Clerk �c.IC Q%md Total Paid L� Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE 4883 RECEIPT Namev� I (I(�rn� " f 1 11 Cash Date 5-27- I q / z [)(Check# .)-q-3 No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots 00,0 LoMiche -701- , Block , Unit 41 001501 343805 Cemetery Fees �c.IC Q%md Total Paid L� Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant CITY Of 1 -1\ �.' HOME Of PELICAN 'ISLAND City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. /.'j I (It 6-OAH'\Ir ( I Sv-. Name(s) Address 21-7 Fort jfnk(e.bv-, Saba-Lhc-n FL 3ZY5E qw(�/ 6&�q!� Area Code & Phone Number Name & Kesldence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: Dollars ($ 50 0. OS:) ) on this 1. 7 ,4-[' day of & , 20� for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit ! , Block & , Lot(s) -�a 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 Signature of Purchaser Interment /W O H Circle One Disinterme TOTAL $ y of Sebastian The following documents were provided as Proof of Residency: I:\WW-DATA\Ms-Cemetery\RECEIPT.doc and