HomeMy WebLinkAbout3-COL-10crrY or
HOME OF PELICAN ISLAND
Certificate No. 2434
CITU OF SE-BASSTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Rachel Cannon
1504 Eagles Circle
Sebastian, FL 32958
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Columbarium, Niche 10dsa
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 16th day of September, 2014.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
'Y�--
Sally A. Mai , MMC
City Clerk
CITY OF SEBASTIAN I
CITY CLERK'S OFFICE 4923
RECEIPT
creel t
Name p�(3L Lh e I CCAn o n ❑ Cash
IDate j ❑ Check #
No.
001001208001
001501322900
001501341920
001501 341910
001501 341930
601010 343800
001501343805
Amount Paid
Sales Tax
Garage Sales
Copies/Bid Specs.
LDC/Code of Ordinances
Election Qualifying Fees
Cemetery Lots
ZOCC.0°
Q., Block �' , Unites
Cemetery Fees
Total Paid ZyW .
Initials
White - Dept. of Drigin • Yellow - Finance • Pink • Applicant
CM Of
�.
HOME Of 41 PELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Name(s)
(-Z a C h e. ( (f Cc h o
/5v
les C(rdc Se-
Addressj
C�7)-
Area Code & Phone Number
g-5h'c,vi P& 3ZY5J
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
,J4M -G ftp(. �n Dollars ($
on this. 64�\ day of S e Pt 20j�j for the purchase of the following described
Cemetery Lot(s) and/or Niche
Unit 3_, Block C� , Lot(s)
Niche(s) 10 C(S 0.
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_
Interment
/W O H
Circle One
Disinterment
TOTAL $ ',ZU U 0 '00
(-1JJ
Ca of Sebastian
The following documents were provided as Proof of
Residency:
l:\WW-DATA\Ms-Cemetery\RFCEIPT.doc j and