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Home My WebLink About4-28-07Name Unit - Block Lot Date of Mark -out Date of Burial Name of Funeral Home Authorizedby I . Time / / " "- ) () z --j - /,;, ,, , Uttg At trbaBliatt -1628 i L til -G 1 -erg ..La r{ b NO. THIS INDENTURE MADE TWs ........... 2nd...... day of ............June ........................... A. D, between the City of Sebosllan, a municipal corporation existing under the laws of the State of Florida, as Grantor end Ernest Beck .............................................P:O.' ']BOX '6489...................................................................... . Vero Beach, n..3.2.96.1 of the County of .....Indian, nyer ....... and State of Florida ............................... . u Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ ..... 1,. M .00 , to it in hand paid, the receipt whereof is herewith ao- knowledgcd, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee 1118 •. • • heirs, legal representatives and assigns the following prop Ty situated In Sebastian, Indian River County, Florida, to•wit: AB of Lot(s)) §6& ✓ , Block, 28 .. , • , , UNIT 4 ............ . of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the ofBos of the Clerk of the Circuit Court of SL Lucie County of Florida; said land now lying and being in Indian Rival County, Florida. To Have and to Hold the same forever; provided that said property shag be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and ce ssimisms of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of add cemetery. The conditions, restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the fallure of the owner of any property situated within said cemetery to ob- serve end comply with inch rales, regulations, resolutions and ordinances and the conditions of the deed of convoyance thereof then the 64' of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The sold party of the first part hes caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk end its corporate seal to be hueto affixed, the day and year first above written. DA Allestr ............. ........................................ City Clerk 4,1tIllgnedenled andDellveres.. .... ..... .. ....r-`",�... ....... CITY OF SEBASTIAN, FLORIDA i By( ....................... Mayor ((QitV deal) STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this ....... 2nd............ day of ............ ........ :J117I,1E............................ bvf.re me personally appeared .... Ruth S'U1''iVan.... ............ ................... emikl;hr •'.M., O�}iB�.lOLail......... respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florid. to me known to he the Individuals and officers described In and who executed the furrgoing conveyance to Ernest Beck ................................................................................................................................... ........................................................ and severally acknowledged' -the as smelt officers thereunto duly authorised; and that the Official seal of said corporation Ii Is the net and deed of said corporation. I / WITNESS my signature and official seal at Sebastian, In the CouA last aforesaid. ley I.iNCA;!,BAILEY i �;;•Fa�j Mr GGMNISSI9rr s CC 740478 ip, 200E Nol lot2;;m't ,S :xruea mn•n•nwrax �maaiwn My to be their free act and deed eta, and the said cunveyan.e of Florida at La the day and year FLORIDA OEPARTMID OF State of Florida, Department of Health, Vital Statistics /,60 H �'-� APPLIC" _)N FOR BURIAL — TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Arlene Lou Beck DEATH Feb. 28 1998 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Vero Beach Inst. 6129 Atlantic Blvd. Q. Ivaule VI Iviwuludl 1 McOlcal rxaminer Address Phone Number Certifier Charles Fischman, M.D. 7Physiciari 1600 36th Street, Vero Beach, FI 561-569-6112 4. Name of Funeral Home/ Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Direct Disposer 1623 N. Central Ave. Strunk Funeral Home Sebastian, FI 1228 561-589-1000 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies APpro- this application. priate Box b Vicki was contacted on 3/2/98 within 72 hours after death. He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Fischman will complete and sign the medical certification of cause of death. c ❑ was contacted on . He/she verified that Medical Examiner, will complete and sign the medical certification. 8- Place of Sebastian Cemetery state cemetery/ Removal Final Disposition: ematory - na / nty: Indian River from state Donation 7. Funeral Director/lure F.E. No./Reg. No. Date Signed Diroc;ispos 62 3/2/98 B. BURIAL — TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. ❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the County in which death occurred. ❑ No extension of time for filing the death certificate requested. Regislral-or Date � � 9 Date Certif 9 Subregistrar Signature —� --1�- Issued: Due: J C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA Signature Medical Examiner Date or 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. D CEMETERY OR CREMATORY Methods of Disposition: Place of Disposition trata; BURIAL STORAGE Date of DispositionyftaPyd , /9$78 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person-in-Charge)--..�-- 4 This permit must be endorsed by the Secton or person -in -charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the County where disposition occurred. DH 326. 10196 (Replaces HRS Farm 326 which may be used) (Stock Number: 5740-000-0326-2) J.