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Home My WebLink About4-28-10Name Unit Block Lot Date of Mark -out Date of Burial Name of Funeral Home Authorized by - Time J. e QMV Lit Ortialliilcu .,1. Spate trr �PP� NO. THIS INDENTURE MADE TWs .......8th.......... day of .......... May ........................... between the City of Sebastian, a municipal corporation existing under the laws of the Slate of Florida, as Grantor and 1617 9 A. D., IBS_. , ............. .................. ........... Malcolm.&..&a. Allen.............................................................. 462 Kendall Ave .............................................Sebastian, -R.32958 ................. ............. ............................... of the County of..ICIdiBO..PYer......................... and State of .... Zli?Xjda......................................... as Grantee, WITNESSETH. That the Gtantor for and in consideration of the sum of $ ..........5�t00 ....... to it in hand paid, the receipt whereof is herewith as knowkdged, docs by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee their.. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: AB of Lot(s) ...10 . , Black, 28...... UNIT 4 ............ . of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being to Indian River County, Florida. To Have and to Hold the same forever, provided that said properly shall be used solely and exclusively for the Interment of the human dead and shall be used, kept end maintained at all times In accordance with the rules and regulations, ordlnancesand resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with inch rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to sold properly shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The sold party of the fust pert has caused this Instrument to be executed in its name and on its behalf by Ila Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year fust above written. h�. off'"� Allesti.... ........ ............................... CITY OF SEBASTIAN, FLORIDA City Clerk Fign ,Sen and Delivered In m Y nee ofs /I /..-- ..................... STATE OF FLORIDA COUNTY OF INDIAN RIVER 8th I F5E1tEIIY CERTIFY, That on this ........................day of By�is+%,_ .................. Mayor (0fll �Senl) May............................... lg9S.. before rose personally appenreg'uth Sullivan ........................... . sad Kathryn M.. O'Halloran ........ ..........IJ....to........... reaprclively Mayor and City Clerk of the City off Sebebaollam a municlpol eop,orolian under the Inws of the Store of FIorn me known to be the Individuals .,,it officers described In and who executed the fatiguing Conveyance to ...........................................Malcolm.&..lata. Allen................................................................ and severally ecknowledgm lbs cseeutif to be their free act and deed as such officers thereunto duly authurisedi and that the Official seal of said cnrpureliun Is Jul affixed th oto, and the sold ranveyonce Is the net and deed of said corporation. WITNESS toy signature and official seal at Bebasl the only 4and State of Florida, the day and year last aforesaid. %1 Mr COMMISSIBB I CC 9157 f /, tilP�Bf9: Jamie, ig9e Nal gpdea ihm xanw Tkse gnkavalsn My M. Galley at PT. FROM: on this _ l' following des conditions as THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA ACKNOWLEDGED OF THE SUM OF: e A W ars i day of V I- , 19L for the purchase of the gibed Cemete Lo stated herein: upon the terms and Description of Property: Cemetery Lot Block Unit Purchase Price: Dollars ($ Terms and Condition of sale: This contract shall be`binding upon both parties, the seller and the Purchaser, when approved by the owner of the property above described. I, or we, agree to purchase the above described property on the terms and conditions stated in the foregoing instrument: The City of Sebastian agrees tos 11 the above mentioned property to the above named purchaser(s) on tFe tags Fd cpn ion.; stated in the above instrument. 1 77 witness n ... City of Sebastian 1225 MAIN STREET o SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589-5330 o FAX (561) 589-5570 May 21, 1998 Malcolm & Eva Allen 462 Kendall Ave Sebastian, FL 32958 Dear Mr. & Mrs. Allen: Enclosed is Cemetery Deed No. 1617 for Lots I& Block 28, Unit 4. Also enclosed is a form - Return for Transfers of Interest in Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded. If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, P. 0. Box 1028, Vero Beach, Florida 32960 or you may call (561) 567-8000 for more information. We are enclosing two copies of the receipt and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided for your convenience. Sincerely, Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:Img Enclosures B. BURIAL — TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-98-001 _ ❑ 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. � r'1 - n . Date 1 I if Date Date Certifica6 Subregistrar Signature A -�'-�X / Issued: Me: 9 1.92 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 Set a54 i a h C E rh e k e ® BURIAL ❑ STORAGE Date of DispositionrL- LsC R — t \'t 918 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in -Charge) U 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. OH 326, 10/86 (Replaces HRS Form 326 whiUl may be used) (Stock Number: 5740-000-0326-2) FLORIDA DFP TMEW OR AL State of Florida, Department of Health, Vital Statistics �' APPLIC. )N FOR BURIAL — TRANSIT PERMIT U 41 A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Sophia Allen DEATH Jan. 4 1998 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland Inst. Sebastian River Medical Center 3. Name of Medical X I Medical Examiner Address Phone Number Certifier Frederick Hobin, M.D., M.E. Physician 2500 S. 35th Street, Ft. Pierce, FI 561-464-7378 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 ❑ was contacted on 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 will complete and sign the medical certification of cause of death. c�1 . Helen was contacted on 1 15198 . He/she verified that /'� Dr. Hobin Medical Examiner, will complete and sign the medical certification. 6. Place of 5ebastian Cemetery s ate cemetery/ Removal Final Disposition:cre atory- naze/c my Indian River n from state n Donation 7- Funeral Director/ / 5 naVe _ F E Na/Reg. No. Date Sianed B. BURIAL — TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-98-001 _ ❑ 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. � r'1 - n . Date 1 I if Date Date Certifica6 Subregistrar Signature A -�'-�X / Issued: Me: 9 1.92 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 Set a54 i a h C E rh e k e ® BURIAL ❑ STORAGE Date of DispositionrL- LsC R — t \'t 918 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in -Charge) U 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. OH 326, 10/86 (Replaces HRS Form 326 whiUl may be used) (Stock Number: 5740-000-0326-2) A)k-), m I(Om c, Lvaq �j KgrA)) 0v� Loi )a, * voc^-k ,- , u.�144� -0/. dl-� - Paid by CEMETERY Receipt No ................. Dated .............................. List Price $ . 500' 00 Maximum No. Burial Spaces ................. Net Paid $ .500. �� Monument permitted ....................... (Data above this line for City Record only) q - z$ -ra NO. 1617