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HOME OF PELiUN ISUND
Certificate # 1916
~ertificote of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
John F. and Mary K. Kasper
(name)
(name)
599 Caravan Terrace, Sebastian, F1 32958
(address)
(address)
in and for consideration of the sum of ~ 3 , 500 . oo ,has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4 ,Block 15 ,Lot(s) 36, 37, 38, 39 & 40
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 12th~y of September , 2003
' 'Y OF S ASTIAN, FLORIDA ATTEST:
t/
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Terrence R. oore Sally A. 'o, CMC
City Manager City Cl
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Lot
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Date of Burial ~ ~~ ~~~ ~ Time ~f ' ~~ ~ '
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CITY OF SEBASTIAN
CRY CLERK'S OFFICE ~ 2 0 9 9
RECEIPT
Name ^ Cash .
Date eck #~~e~~
No. Amount Paid
0010 1208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501341910 LDC/Code of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots
LoUNiche .Block .Unit
001501343805 Cemetery Fees ~ (J
/ J
Total Paid ~~r ~~
nitials r
White -Dept. of Origin • Yellow -Finance • Pink -Applicant
FUNE1tAL U1KLl: l VK', Ai'a"Llt,lf a avt~ a v a.a a a v. • ~ --- -
FOR GRAVE OPENING IN CRESTLAWN CEME'T'ERY
CITY OF VERO BEACH
~`~'`~'L- `r ~~-~- HOME
~~ ,~e ~ ~ . FUNERAL
,~-~ %~-, ~ai `,/ e ~ ADDRESS
DATE ~'
(Circle which one) Circle which one)
OPEN GRAVE: A B C D E F G H I ~J OPEN CREMAINS LOT: N or S
l
l
LOT D N BLOCK
a.m. --~
BURIAL SERVICE WILL BE HELD ~ p.m. ~~ ~ ~. ~ , 20 Cf
.._.-- r'~ ~ i - -
FOR DECEASED
GRAVE/LOT OWNERSHIP VERIFIED BY:
VIEWING OVIJNERS DEED (DEED NO. C I
CHECK WITH CITY HALL PERSONNEL. (DEED NO._~
OTHER -EXPLAIN:
I CERTIFY I HAVE DETERMINED THE OWNERSHIP OF THE LOT HEREINABOVE
DESCRIBED AND AUTHORIZE OPENING OF THE ABOVE DESCRIBED GRAVE IN TIME
FOR THE BURIAL SERVICE INDICATED. FEES FOR LO TING & RESODDING THE
GRAVE ARE IN THE AMOUNT OF $ ~BA:®8 FOR BURIAL $120.00 FOR CREMAIl~TS.
GNATURE
THE FOLLOWING IS TO BE FILLED OUT BY THE CEMETERY FOREMAN
TO FINANCE OFFICE: I HAVE CHECKED BURIAL AND FIND SAME TO BE IN
GRAVE SPACE OF LOT SECTION BLOCK
SEE DIAGRAM OF GRAVE BELOW: BY:
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