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Home My WebLink About4-28-11Name Unit— Block Lot Date of Mark -out Date of Burial Time Name of Funeral Home Authorized by ber 98 23rd Septem ............ A. D., 19......, Jay of .... .. ...... .. THIS INDENTURE MADE TkL:-' between the City of Sebastian, u municipal cnrparati0 — ,,haling under the laws of the State of Florida, ne Grantor and Robert H, and/or Rut�°h A. Paasch............................................................. "' 219 Cedar Street ........................................ ................................... Sebastian, FL 32958 ,,,,,,'en'1 state of Florida .... .................... .......... of the county of . -. Indian •River• • • . ' ""' •"" as Grantee, WITNESSETH, , to it in hand paid, the receipt whereof is herewith ac - That the Grantor for and in consideration of the sum of $ ....1 ��-p�• knowledged, does by this instrument grant, bargain, sell, release, convey end confirm unto the Granteet�'le1r... heirs, legal representatives and assigns the following property situated in Sebastian, sindian River County, Florida, to -wit: 11&12 Block, ........ 'UNIT , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat All of Lot(s) ...... . Book 2, at page 6s of the public records in the office of the Clerk of the Circuit Court of SL Lucie County of Florida; said lend now lying and being in Indian River County, Florida. d solely and vely r the of the human ll To Have and to Hold the same forever; accordance with the rules end regulations, rd ordinances and resolutions of the City tof Sebastian, Florida, ,hereto- fore, used, kept and maintained a t all uirements contained situated within said cemetery to ob- tore, now and hereafter adopted or provided for thu government and operation of s:Jd cemetery. The conditions, restrictions an n'A Ob - in this instrument shall be covenants running with the land. In the event of the failure of the owner . any property kth such rules, regulations, resolutions and ordinances and the conditionsofthe deed of conveyan serve and comply whall revert, to the City of Sebastian; ce thereof then the title of such owner nd in and to said property shall terminate and the same s IN WITNESS WHEREOF, The said party of the Cost put, has caused this instrument to be executed n its name and on Its behalf by Its Mayor aproperty to be hereto affixed, the day and year fust above written. attested by its City Clerk and its corporate seal CITY OF SERASTIAN, FLORIDA '7 - In t In STATE OF and DO livered)J >or7l n G ✓ By Mayor ,ffanl) COUNTY 01-1l"'M HEREBY r That on t s .• "" Kathryn M. 0 Hall I 11EIiEDY CERTII S'+ Ruth Sullivan and r ................... ......... ........... before erre Personally appeared ....... • • •' •'�f' Sebastian, a municipal corpora ice t the laws of the State of Florida to me known MfO'Ctively Mayor and City Clerk of the City A Pa85Ch to be the individuals and officers described In and nal Or eRuth he lun�gu{ng enavcYnnce to ......................... Robert H. ... ..... .....• .. " .......................... ark execution thereof to be their free act and deed :end severally t the said conveyance as sash officers Ilmreunto duly authorised; and that the Official sect of Is the incl and deed of sold corporation. WITNESS my signature and official seal at Seboatian, in t last aforesaid. ..•auk LINDAM.tia�_-,• duly affixed thereto, ane State fpr Florida, the day and year WNWAW. -- Sep 26 2008 2:45PM HP LASERJET 3200 p.l FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBASTIAN 1w 1 a rKKMIu D For informatior contact: Ki Kelso - Cemefey Seyton Se astian Municlpaf Cemetery (772) 588-2545 STRUNK FU FUNERAL HOME. 1 ADDRESS: PHONE #: (C Gk One) I1 OPEN BURIAL LOT I —OPEN CREMAINS LOT I —OPEN COL'JMBARIUM NICHE I BURIAL DATE AND SERVICP TIME: City Clerk's Olf ce Ir Hal, 1225 Main °free( Sebastian, FL 32558 772) 388-8215 or -388-8214 WAi4dWil'UREMATM 3 No. Central Ave. •1T11 .1 rl 11/.!w it » Block 28 Unit 4 ri__Block Unit fiche Block —Unit W June 6, 2009 12 p.m. — -- FOR DECEASED: Ruth Anna Paasch :NAME AND SIGNATJRE OF LOT OW 1 ER OR REPRESENTATIVE: (rausrprovide�igper dogurnenlation or wnershipj I certify tnat I have determined the own administrative fees have been paid and NAME AND SIGN/rJRE OF LICENSE Name - .---- ............................... Cemetery Sexton Certification: I certify that I have -.hacked the ovmerst with Clerk s office .-Ind that all fees have of the above described sit That all site fees and m rize opening of sae Date information by viewing the owner's deed and confirming en paid s Date This form to be provided to Clerk's Off.c� by Sexton for permanerl record upon completion. A FLORIDA DEPARTMENT OF HEALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased Ruth Anna Paasch of Death May 26 2009 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian Inst. 219 Cedar Street 3. Name of Medical Address Phone Number Certifier Nasir Rizwi, M.D 13885 U.S. #1 Sebastian, FL 772-589-6844 Medical Examiner Physician 4. Name of Funeral Home/D0eeHNspoSal jAddress Fla. Lic. No./Reg. No, Phone No. (Area Code) Establishment 1623 N. Central Ave. rank Funeral Home E Cremato Sebastian, FL 1228 772-589-1000 5. Check a. H The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b Jennifer was contacted on 5/26/09 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Rizwi will complete and sign the medical certification of cause of death within 72 hours. C. Z was contacted on He/she verified that Medical Examiner, will complete and sign the medic rtifica n cause of death within 72 hours. 6. Funeral Director/ ign ur F.E. No./Reg. No. Date Signed Dircel-2i,nnsar „ — 44048 5/26/09 B. C. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit Not 228-09-0246 F1 A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death Certificate within 72 hours. nNo extension of time for filing the death certificate has been requested. RegisRaro;r� ^ Date Date Certificate Subregistrar Signature 9MAA&-:L%S r-1 Issued: 5/26/09 Dye: 5/30/09 Approval Number: AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA Date 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 waitir required for all cremations. BMe odof Disposition: URIAL CREMATION Signature of Sexton or Person -in -Charge must cos to STORAGE OTHER (Specify) the Sexton or Health Depal period of 48 hours after death is CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition eat Id sem! in the county where disposition occurred. when there is no returned Distribution: While: Cemetery or Crematory DH 32Q &97 (Obsoleles all previous editions) Yellow: Funeral Diredoror Oired Disposer (Stock Number 5740-o00-0326-2) Pink'. Local Registrar s're ` vy„ CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Name No. 001001208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees 4526 ,$ Check #_(, 3 Amount Paid 601010 343800 Cemetery Lots LottNiche / / , Block Unit 001501 343805 Cemetery Fees Total Pald T o oitiafa White—Dal of Origin• Yellow — Finance •Pink - Applicant