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Home My WebLink About4-36-11 @ @) HOME Of PELICAN ISLAND Certificate No. 2006 CITY Off SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Mary Beth Oliver (name) POBox 780580, Sebastian, Fl 32978 (address) in and for consideration of the sum of $700.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 4 Block 36 - - Lot_ll_ of the Sebastian Municipal Cemetery, as maintained on file in the records ofthe ~ity Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 24th day of February, 2005. CITY OF SEBASTIAN, FLORIDA James A. Davis Interim City Manager I. // \ /) -- y" 1//1 @) @) 84 Treasure Coast Newspapers Mary Elaine Brock, Sebastian . Mary Elaine Brock, 74, died Feb. .19, 2005, at Sebas- tian River Medical Center in Roseland. She was born in Saginaw, Mich., and lived in Sebastian since 1968, coming from White Sands, N.M. She was a physical thera- pist. She worked for 20 years at Sebastian River Medical Center 'as a sterilizing and surgical technician, and as an.aide at Indian River Me- morial Hospital, Vera Beach. She was a'member of St. Sepastian Catholic Church and its choir, the American Legion Auxiliary and the Ea- gles, all of Sebastian. Survivors include a son; Charles Brock of Sebastian; daughters, Linda Trantham and Mary Beth Oliver, both of Sebastian; sister, Betty Ro- tunio of Aurora, Colo.; six grandchildren; and five great-grandchildren. ? ~he was preceded in death l}yp.er husband,OllinBrock; ahlt a son, James Brock. ;;SERVICES: Visitation will b€Pfrom 5 to 7 p.m. Feb; 24 at ilig Strunk Funeral Home, Sebastian. A Mass of Chris- tiIDl Burial will be celebrated attiLI a.m. Feb;25 at Sf, Sebas~ tiRm Catholic Church. Burial will be in Sebastian Ceme' te.liW, Sebastian. 8(1;..-... ::,\ CJlYOf SEBAS!!AN ~ HOME OF PWCAN JSI.ANl) l225 Main Street, Sebastian, Fl 32958 Telephone (772) 589-5330 - Fax (772) 589-5570 February 25,2005 Ms. Mary Beth Oliver POBox 780580 Sebastian, FI 32978 Dear Ms. Oliver: Enclosed is City of Sebastian Certificate 2006 for the purchase of Cemetery Lot 11, Block 36, Unit 4. Also enclosed is a copy of your receipt and the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Sincerely, Sally A. Maio, MMC City Clerk SAM:ar enclosure ff';'~h 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, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase ~~t/ g.E~ t:J/"'t/E~ Name( 6) p. t::J. 4 7FtJ ~"t:> / ..) dA5(7AA,- 77. J.297t3 Address Area Code & Phone Number 0; Residence Address of Intended Occu Office Use Only Rec~t is acknowledged in the sum~ ~~ L_~ ~ 7&6 on this otyd day of ;t:~~~Rr' described Cemetery Lot(s) and/or Nic e(s). Unit 1-, Block J~ , Lot(s) / / Dollars (~~. "lJ ) , 2~for the purchase of the following 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 & Closin~~: ,,(j (WJ 0 H Circle One Vase and Ring for Niches (cost) Interment Disinterment L $ ~ /'5': ~ lJ Signature of Purchaser Service fees are to be paid at time of need only I:\WW-DAT A\Ms-Cemetery\RECEIPT .doc CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT 3271 ~;"~-'.$-.._:z;. ~%..z Amount Paid ~ P~. t\A.IS ~ -- \'<1~.~. ~~ - 2.12sJo~" 8001 Sales Tax ~ ~l ~II" 3to, loT l( 2900 Garage Sales 1920 CopIeslBId Specs. 1910 LDCICode of Ordinances ?~qu~t. .Mo-..J. ~4.~: 1930 Election Qualifying Fees 1800 Cemetery Lots LolINiche / / Block j(, ZD.- liD , . unit$- ?:f:t? {) ~~~~-r t.... ..~ P. o. l'1c", , g () S ~ 0 ~~~ I FL '?> 2.."78 1805 Cemetery Fees (J~C!.. -~ ~~~ "'~~~' ~ ?z IUlIa ' TOYI;i' 7751'11} . ., i c::::: ,~ _ ~""""'" S~i3 '-, .-\ C ""7 ~Srl"; """:':-'1'''''' "1lf'>..~... .............. .' E<);;:'~ J::t Fi ve, ".t'bfJ'J:t -~!000~9Sa .--""""'"" White - oept. af Origin. Y"law - Flnence . Pink. Applicant . . .. . . .' .STRUNK'FUNERAl.;H()MES~.P';A. .. CASH'ADVANCEACCOUNT~SEBASTIAN' 91617THST. VERa BEACH,FL 32960 PH,772~562"2325 I!Se cu r it'- en hano'edOC,li m;.e-n,t,. See'b-t! c'k or d.e Ln..; I s.m DATE ~\~3fos. . 1$ 63-12051870 01 . I 4952 PAY ~ .... 6~ci~~ OF L ~ ~ .' Q ~%..S~~...,; '..~l'~,. t~..d.A.Wt. ~...~ . I ~e... .Q),! )C1e 17~ 00 '1' fl'. ".'~r.i"nOfft... . "-'-. ." ,''''.c, 95112DlhPf8o. .' ...:'-,iiL'ii='.:;;;' V.........,FI32960 ~ ~ .. ~ ~ ~~.... -......-.....-..-..........-. ...........................................-.-....-..- ..-. .'...-.................. ----,-!!!. ; " ',,' ',',,','. '",- ',," --'>" ,," -,".',,', ," ,,-,., (l20 1;12 5 Oi 118 .. '-;': . "'~"u.. H I:Ob?Oi20 5'71: Name PI 14 i'- i , 1 b. fC' }' /) ;t'PG ~ . II X 1!., '3.t)i1dS Unit Block 7L.' J~ Lot II Date of Burial "/1-- 7.-/0 ~-- ~/1-. ~-/{) ~-. Time I' ., I . Cd) 17 . / \ l....- ,,- t'. ;" '/ L J; j;':' . . 7 .'"2 t,-_.-" I / Date of Mark-out ..,.>'} Name of FuneraIH9J'1''8')}i/iu .....J.. ( (' '. ,I 1: ./ r l.r' " "'-;." . /71 Authorized by \~,. ....7 ./// -' / . c ,I /' /,<:~:::";~^.,t('~,,,_'J~!.,,~/- '1- J~-I/ FLORIDA DEPARTMENT OF State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT A. 1 . Name of Deceased (TYPE) First Middle Last Date of Death (If neither, give street address) Month Day Year Mary Elaine Brock Feb. 19 2( 2, Place of Death County I ndian River City, Town or Location Roseland Name of Hosp. or Inst. Sebastian River Medical Center 3, Name of Medical Certifier Richard T. Address y, M.D. 8005 83rd Avenue Sebastian, FL Phone Number Medical Examiner 4, Name of Funeral Home/Direet Oi51'6661 Establishment Strunk Funeral 5, Check a, Appropriate Box Physician Address 772-581-9977 Fla. Lic. NoJReg. No. Phone No. (Area Code) 1623 N. Central Ave. Home Sebastian FL 1228 772-589-1000 o The medical certification has been completed and signed. A completed certificate of death accompanies this application. b. [ii was contacted on He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Penly will complete and sign the medical certification of cause of death within 72 hours. Sara 2/21/05 c,D was contacted on He/she verified that , Medical Examiner, will complete and sign the eil <.'..",,[ EJ;;:)IJU;)Cr ause of death within 72 hours, F.E. NoJReg, No, 1862 Date Signed 2/19/05 6, Funeral Director/ B, BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body, o A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within 72 hours, ONo extension of time for filing the death certificate has been requested, 4le!l)i5trer sr Permit No,1228-05-o075 Date Subregistrar Signature tv... Issued: 2/19/05 Date Certificate Due: 2/211/05 ~ J, AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA Approval Number: Date Medical Examiner, , gave authorization by telephone to Funeral Director/Direct Disposer. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods, A waiting period of 48 hours after death is required for all cremations, Methoq of Disposition: ~BURIAL DCREMATION Signature of Sexton or Person-in-Charge CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery ). DSTORAGE Date of Disposition ;( /;1, ,- /0'5>--: r , DOTHER (Specify) } ,;Ii' <} f~~?, "his permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned IIthin 10 days to the local County Health Department in the county where disposition occurred.