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HomeMy WebLinkAbout4-02-11Name Unit_ Block Lot Date of Mark -out �. I //1? S ' / Date of Burial 26,3//5— • Time Name of Funeral Home Authorized by cnvof z!W HOME OF PELICAN ISLAND Certificate No. 2450 CITY OF SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Dennis T. Heaney 1212 Iroquois Drive Barefoot Bay, FL 32976 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 lot: Unit 4, Block 2, Lot 11 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 4th day of February, 2015. CITY OF SEBASTIAN, FLORIDA �J Joseph F. Griffin City Manager ATTEST: Sally A. Nj io, MMC City Clerk LYN ETTE M. H EAN EY Mrs. Lynette M. Heaney, 65, died February 7, 2015 at VNA Hospice House in Vero Beach, FL. She was born January 4, 1950 in Brooklyn, NY and lived in Levittown, NY prior to moving to Barefoot Bay, FL in 2011. Lynette was the Vice Chairman of the real estate firm of Dennis Heaney & Associates and was a Master Gardener for Indian River County. She attended St. Sebastian Catholic Church, Sebastian, FL. Survivors include husband, Dennis T. Heaney of Barefoot Bay, FL; son, Dennis Heaney and his wife, Ann Marie of Wantagh, NY; daughter, Katherine Heaney of East Northport, NY and granddaughters, Nicole and Madison Heaney of Wantagh, NY. CITY OF SEBASTIAN CITY CLERK'S OFFICE /, O O i RECEIPT 4 7 7 1 Name -J I ' ,L `'FAL CAVA" ❑Cash Date �J �(J ��� %Check# No. Amount Paid 001001 208001 Sales Tax 001501322900 Garage Sales 001501341920 Cop'les/Bld Specs. 001501341910 LDC/Code of Ordinances 001501341930 Election Qualifying Fees 601010343800 Cemetery Lots LotfNiche . Block Unit 001501343805 Cemetery Fees D/c, /5p.00 <Q w�Total Paid InBials White- Dept. of Origin • Yellow - Finance • Pink - Applicant State of Florida, Department of Health, Bureau of Vital Statistics Hfl BURIAL TRANSIT PERMIT ������ff�lLLZ�dd DATE PRINTED: February 10, 2015 TRACKING NUMBER: 2015022243 1. DECEDENT INFORMATION Name of Deceased Date of Death LYNETTE MARGUERITE HEANEY February 7, 2015 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH VNA HOSPICE HOUSE Name and Address of Funeral HomelDirect Disposal Establishment Fla. Lie. No.IReg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 Funeral Director/Direct Disposer Fla. Lie. NoJReg. No. TIMOTHY W. MARVIN F022789 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2015-Fo41870-5020 Date Issued: February 9, 2015 State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY h" Z �� I'S of Disposition: BURIAL Date of Disposition: 3 EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10/12 64V-1.011, Florida Administrative Code 02/10/2015 14:52 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Kip Kelso .Cemetery Sexfon Sebastian Municipal Cemotery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Stmet Sebastian, FL 32958 Office (772) 388-8215 or 388-8294 Fax: (772) 589-3570 FUNERAL HOME: Strunk Funeral Home and Crematory - SEBASTIAN ADDRESS: 1623 North Central Avenue. Sebastian, Florida. 32955 RHONE#: 72-589alQ00 iCheck One) AN OPEN BURIAL LOT OPEN CREMAINS LOT _OPEN COLUM13ARIUM NICHE Lot -1 1 -.___.Block 2 Unit 4 tot_Slock_Unit Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: FRIDAY 7/13/2015, 11:00 AM • CHURCH FOR DECEASED: Lynette M. Heaney Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE_ (Must provide proper documentation of ownership) #14102 P.001/001 Dennis Heaneype uy&ff 2/1012015 Name Signature Date I certify that I have determined the ownership of the above described site that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: Tim Marvin Name ri 4/!LC/ 1 y V. w.a"in 2/10/2015 a Signature Date Cemetery Sexton Certification: certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: Ce at ry Se on Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. ary Of N2, J rIk HOME OF PELICAN ISLAND dU 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) &yo /r ��- 3971 Address -77z 202- y13y Area Code & Phone Number L vvo-rE .UFv7AiE-y Name & Residence A( of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: JLM t1C iii-• . 0 D. 00 .0 on this q 4k day of Fe -,b 20 IS for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit q_, Block Z , Lot(s) l 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 Vase and Ring for Niches (cost) Marker Preparation & Installation I:kV W-DATAWIs-Cemetery\RECEIPT.doc Interment /W O H Circle One Disinterment TOTAL $ 2000.00 _,i -L J-4-'- - Ply of Sebastian The following documents were provided as Proof of Residency: CITY OF SEBASTIAN CITY CLERK'S OFFICE 4987 . ('1 p RECEIPT 4 7 U Name ! " t r/ / H e i Y1 l % ❑ Cash Date Z- �7 - �CheckA No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 CopieslBid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots LolMiche/ I Block 2- 001501343805 001501343805 Cemetery Fees UUU o0 Unfl_q__ �YYI'� Total Paid 2LIli 'CC.�,�_ Initials White - Dept. of Origin•Yellow - Finance. Pink - Applicant City of Sebastian Sebastian Cemetery Ph. # 1(772) i89 - 2545 Fax # 1(772) 228 - 9927 Note : This is for Informational purposes reguarding Monuments at Sebastian Cemetery . Note : Please return to Sebastian Cemetery 1921 North Central Ave. oundatlon onured--- 32958 v : everraas Ing ! jamle Attention Cemetery Sexton date : / D `�/_/_ stone installed 3 CO by : everlasting /Jamie ,_stendnrg.stray r date Size : Names & Dates : His: f-��fi/i / S Her: Legal Description Unit Blk. Lot: Approved By: Checked By: Date: By: Example D.O.B.�J✓Y/ 7 D.0.6. D.O.D. c' L I D.O.D. I� K.G.K. K.G.K. everlasting stone works 0-/0 2 -Le LYNE TE JAN. 4, WO FEB. leo 2M EUROSTMG STOn WORKS M353 2-6 X O—W X �-6 RPPRC ED DATE DENNIS 5—B—MS