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HOME OF PELICAN ISLAND
Certificate No. 2130
~~ ~~ ~~~~
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Charles G. Bailey & Mary Ann Mahoney 745 Schumann Dr., Sebastian, FI 32958
(name) (address)
In and for consideration of the sum of $700.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following Lot(s)/Niche(s)
Unit_4_Block_13_Lot(s)/Niche_12a & 12b_
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 11th day of May, 2007.
,~ ,~,~'
CITY O:;F SE,rrSTIAN, FLORIDA
~`~!~~ AI Minner
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%,.-~i~;y Manager
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S y A. Maio, MMC
City Clerk
FORT FIERCE CREMATORY
P.O. BUX 777
FORT PIERCE, FLORIDA 34954
We hereby certify that these are the cremains of Charles G . I3a 1leY
From Strunk Funeral Home
funeral firm
Permit No. 12 2 8- 0 7 -~ 018 5
Date of Death April 2 8, 2 0 0 7
Date of Cremation ----~.~ .ZQQ "
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the remains were received
Sebastian, Florida
city and state
Issued at Sebastian, Florida
FORT PIERCE CREMATORY
BY ~_ /"~ ~iy~yL1
cremator
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Name ~ ~ ~ ~
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Unit
Block ~ 1
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Lot t `
Date of Mark-out
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Date of Burial - -
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Name of Funeral t~tome --'~ _
Time ` ~ 'j'~ '
Authorized by , ' ~ ~~"~"h`''' "` ` "'""
~l _ ~ 13 -' ~o~~L Charles G. Ba
-ley
Charles G, Bane
Sebastian, died Y 89, of
2007,. at APril 28
Medical Celmes Regional
bourne. rater in 11ge1-
Se Ss.wa ~d n m Danvers
Bastian i °ved to
NMwLondon NH 0, fi'om
B~eY was
ter, and a member o fPen_
mo Penters Union 1n Vere
nt.
~ was of ~, Catholic
world was a veteran of
U.S. War 11 servingin the
member1Y o COrPs, and a
e~On Post #189, i~erican
an. ebas_
He is survive
daughter, d by a
Marv Ann
ni ~o Cha leneebastian; a
Allard, of M• Baile _
~~dcbiidrenT~Pa' ttivo
~eMer~dchddr na fog
held atmon~ Service was
2007, at the ~m., on MaY 5
Strum punera1
Horne, in Sebasti
dine onors fou an' Milz-
owed, con-
River ~ a Veterans Bastian
Sward. honor
a~~ Qi
~. a ~ t I ~ rt ~x~ t t i ~t r
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May l1, 2007
Charles G. Bailey &
Maryann Mahoney
P. O. Box 732
Sebastian, FI 32978
RE.• Interment Rights to Unit 4, B/ock 13, Lots 1Za & 12b Sebastian Cemetery
Dear Mr. Bailey & Ms. Mahoney:
Enclosed is City of Sebastian Certificate 2130 entitling you to full interment rights in
Unit 4, Block 13, Lots 12a & 12b.
Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal
Cemetery.
If you have any questions, please contact our office.
Si erely,
~` 7 _~ L
f ~~~
~r~
Sally A. io, MMC
City Clerk
SAM:ar
enclosures
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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
r~taaress
Area Code & Phone Number
~=G,
~ozr'7'~
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receip is acknowledged in the sum of:
i~ ~_~ ~
($ as . dd )
on this / day of __~ ' 20~ for the purchase of the following
described Cemetery Lot(s) an /o fiche(s).
Unit ~_, Block ~, Lot(s ~Q ,~ /d?6 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:
Comer Markers (set of 4 - $20) Opening 8~ Closing ~~.s: oa W O H
Circle One
Vase and Ring for Niches (cost) Interment ,.--, Disinterment
Signature of Purchaser
OTAL $ ?~S o a
Sebastian
Service fees are to be paid at time of need only
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CHARLES G BAILEY
MARYANN MAHONEY
P O Box 732
Sebastian, FL 32978
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