HomeMy WebLinkAbout4-36-27
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CIlYOf
SIBA5!!AN
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HOMf OF PELICAN ISlAND
Certificate # 1961
CITY OFf SEBASiTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Lillian Shaffer and/or
Lynn Brayer
(name)
358 Concord A venue, Sebastian, Fl 32958
(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_, Niches_ 27 _
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 TIllS 21st day of May, 2004
(2'>>;
A. Maio, CMC
City Clerk
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SEBAST~
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HOME OF PELICAN ISLAND
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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
L////ai1 Shaffer ~nd/()r Lynn !3vayer
Name(~ I
35>1 Confot..{j AvetJjJfJ Sebct.<;T(.an FL 3ZQ5R
Address
Ar~ 7 Jd~~ p!on~N~nit~ 5.3 q I
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
~ ~ \. n:J{tJ-() ~Dollars($7DO.DD )
on this a I day of -=n1,~ ' 20& for the purchase of the following
described Cemetery Lot(s) and/or. e(s).
Unit tj ,Block 3(0 ' Lot(s) c11 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
W 0 H
Circle One
Vase and Ring for Niches (cost)
Interment
Disinterment
TOTAL $ 700 I OD
~J)f/lttL !;, J~fi..m/.L
C' of Sebastian
Service fees are to be paid at time of need only
I:\WW-DA T A\Ms-Cemetery\RECEIPT.doc
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
2821
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Lilli"OLn 5ha.ffu
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o Cash
)(Check # I (V"
Amount Paid
08001 Sales Tax
22900 Garage Sales
~1920 Copies/Bid Specs,
11910 LOC/Code of Ordinances
11930 Election Qualifying Fees 'tOD, CO
~3800 Cemetery Lots
LotINiche ,~'7 , Block ?io unitL
3805 Cemetery Fees
Total Paid 700.00
of Origin. Yellow - Finence . Pink. Applicent
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