Loading...
HomeMy WebLinkAbout4-28-22Name Unit Block Lot Date of Mark -out Date of Burial Time Name of Funeral Home Authorized by J, (2ilu of I*Phal3f all i 1630 O1r ' 4 nt r 1 r r jj LV [ { As NO. THIS INDENTURE MADE Thla ........ZZ........... day of .....May ._.. .................... A. D., 1898.... between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ................................... ........... Mary. .9DIlSallario................................................................ 729 Carnation Dr ............................... I.......... Sebastianr.-FE ..32958 ................ ............................................ of the County of Indian.River .. and Slate of......Flvri,da......................... as Grantee, WITNESSETH, That the Grantor for and in consideration of the sum of $ Al, Goo. •.90 ............... to it in hand paid, the receipt whereof Is herewith ac- knowledged, does by this instrument grant, bargain, sell, Intense, convey and confirm unto the Grantee her..... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: AB of Lot(s)2!1 , , Block,? ..... , 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 in Indian River County, Florida. To Have and to Hold the same forever; provided that said property shall 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 miss and regulators, ordinances and resolutions of the Gly of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requbeinenta contained in this instranent 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 such rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida W WITNESS WHEREOF, The said party of the fust part has mused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. Attest' ^....../ ........................................... CI[y LRerk Sjgned, S ed and Dcllvered I lire Bence o6 //�� •• __ __ - STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By.�. r�................... Mayor ((Qitu jgenl) I IIEIIEDY CERTIFY, That on this .22...................day of ........... my 1�8... brfore me Personally appeared ....Ruth Sullivan...,, .. ..... and Kathryn M. OI Halloran ....... ........... ........ respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the Individuals and officers described In and who executed the forcguing cuaveynnce to Mary Ann Vallario ....................................................................................................................................... ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorised; and that the Official soul of said corporation la duly affixed thereto, and the aid conveyance Is the net and deed of aid corporation. / WITNESS my signature and official seal at Sebastian, In the County of ndl n Rlver an State of Florida, the day and year last aforesaid. \ _ r 1 — MY IAMilogatl it CC 375724 !. Q,jL?r-- ............ .. ..... .... .... DIPIRFS:Jme lg'198e et a (ic, do at Large. ndedr nNaar/R'rea aam" MY cemmisdon expires, FLORIDA DEPARTMENT OF HEALT A. (TYPE) Sta f Florida, Department of Health, Vital St tics APPLICATION FOR BURIAL - TRANSIT PERMIT 3 a� uy 1. Name of First Middle Last Date Month Day Year Deceasedof 1 Mary Annr. Vallario May 1 1999 Death 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian Inst. 729 Carnation Drive 3. Name of Medical Address Phone Number Certifier N. Noor Merchant, M.D. 7744 Bay Street Medical Examiner MPhysician Sebastian, FI 561-589-0879 4. Name of Funeral Home/DiPechBisp lA M N. Central AMY Avenue Fla. Lic. No./Reg. No, Phone No. (Area Code) Establishment Strunk Funeral Home I Sebastian, FI 1228 561-589-1000 D. cnecx Appropriate Box 6. Funeral Director/ B. a. U I he medical cemhcadon has been completed and signed. A completed certificate of death accompanies this application. to. Lori was contacted on 5/3/99 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Merchant will complete and sign the medical certification of cause of death within 72 hours. c. El was contacted on sZ e of death within 72 hours. F.E. No./Reg. No. 1862 BURIAL - TRANSIT PERMIT He/she verified that Medical Examiner, will complete and sign the Permission is hereby granted to dispose of this body. Permit No.1228-99-0233 ❑ 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 rouse -of -death section of the death certificate within 72 hours. nNo extension of time for filing the death certificate has been requested. Ragiekell d Date Date Certificate Subregistrar Signature T'� � �"� Issued: 5 I 9 g Due: . (, 9 C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA Approval Number. 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 waiting period of 48 hours after death is required for all cremations. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery NEURAL FISTORAGE Date of Disposition CREMATION EJOTHER (Specify) Signature of Sexton or Person -in -Charge This permit must be endorsed by the Sexton 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. Distribution. Write cemetery or crematory OH 326, 9/97 (Obsolete, all previous editions) Yellow Funeral Directoror Direct Disposer (Stock Number 5740-0Do-0326-2) Pink Loral Registrar J.