HomeMy WebLinkAbout4-49-32APa d by CEMETERY Rece p No Oaed 7/6/95 Lot;
u,, ]'ri,~ $ .~. 99. :.q 9. ........ M~x~,m No. ~,a~ S~ ................... Un ± t 4
500.00
Net P~id $ .................. Monumen! i~l'mltted .......................
NO,
(git~ of ~ebast~a~
eme ery Dee
NO.
',1505
7th July 95
Lucy P. Ahalt
............................ 920' 'Clair' Avarm'e .............................................
......................... ~,'.qL.B~.X 7~!.!.~ !, S~.~O.L.~.°r±da 3~778 .........................
o~ ,~, Co~.tr o~ . ~ad.!~..Ri~¢.~ .............. ..~ si.t~ o~ F.!~K$,da ....................
COUNTY OF INDIAN RIVER
7th July 95
Kathryn
M.
O'
Halloran
Linda ~. Galley
Name
Unit
Date of Mark-out
Date of Burial
Time / j" (9 0 /g- r',~'~-
500.00
N~t Paid $ ..................
......... D,ted ..... ?.(~.~P.? ................ Lot 3~
Block 49
Maxflnum No. Bum/Sm~s ................. Uni t 4
Monument per~tt~ .......................
NO.
(Data above this line for CItF Record om~)
July 12, 1995
City of Sebastian
1225 MAIN STREET rl SEBASTIAN, FLORIDA 32958
TELEPHONE (407) 589-5330 c~ FAX (407) 589-5570
Lucy P. Ahalt
P. O. Box 781151
Sebastian, Florida 32978
Dear Mrs. Ahalt:
Enclosed is Cemetery Deed No. 1505 for Lot 32, Block 49, Unit 4.
Also enclosed is a form - Return for Transfers of Interest in Real Property - which must bc Idled out by you
and completed by the office of the Clerk of tho 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. O. Box
1028, Veto Beach, Florida 32960.
We are enclosing two copies of Receipt No. 859 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'Hailoran, CMC/AAE
City Clerk
KOH:lmg
Enclosures
SEBASTIAN CEML 'ERY
CITY OF SEBASTIAN, FLORIDA
RECEIPT~IS HEREBY~ ACKNOWLEDGED OF THE SUM OF:
'~'.L.(~ ,~.~]( ~}~ ,,?~/ '/~3~h ~.i ~ Dollars ( $~.~~ )
on this ~ ) day o % , 19 ~ ~ for the purchase of the
following described Cem~ry Lot~/~upon the terms ~d
conditions as stated herein: ~
Description of Property:
Cemetery Lot ~m~-/~',~ ! ~
Purchase Price~ :J. LL'~: ,~X.'~[~}'~>~ ~
Terms and Condition of sa!e:
Block
Unit
This contrac~t 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 in~ment:
The City of Sebastian agrees to sell the above mentioned property to
the above named purchaser~ on t~e terms and conditions stated in the
above instrument.
,, ness
~;tate of Florida, Department of Health and Rehabilitative Services. Vital Statistics
APPLI(~ON FOR BURIAL -- TRANSIT PERMIT
(Type
or
Print)
1. Name of First Middle Last
Deceased Carl Secoy Ahalt
2 Place of Death
/¢ ¥?
DATE Month Day Year
OF July 1, 1995
DEATH
City, Town or Location
Name of {If neither, give street address)
Hosp, or
Inst.
County
Indian River
3. Name of Medical
Certifier
C~arlene Wilson, M,D.
Name of Funeral Home/
Direct Disposer
Zndian River Cremations,
5. Check
Appro-
priate
Box
Health South Treasure Coast
Rehabilitation Hospital
Phone Number
e []
Veto Beach
~ Medical Examiner Address
1260 37th Street
--~Phys,clan Vero Beach, Fl. 32960 407 569-2330
Address Fta, Lic, No/Re9, No~ Phone Number (Area Code.',
953 Old Di×ie B-6 . F. B0000235
Inc. Veto 3each, Fl. 32960 407 234-596i
The medical certification has been completed and signed, A completed certificate of death accom~anie~
lhis application.
was contacted on within 7£
hours after death. He/she v~rified 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,
was contacted on He/she verified tha
Medical Examiner, will comj21ete and sign the
medical certification.
6. Place of
Final Disposition:
7. Funeral Director/
Direct Disposer
In state cemetery/ Gulf Cremations Removal
,---'%, ~ crem,,c't°ry - name/c°unty~Palm Beach Cot,~t¥ ~ from state I~ Donation
~' ~ ) Si~ture ~-- F.E. No,/Reg. No, Date Signed
BURIAL -- TRANSIT PERMIT
Permission is hereby granted to dispose of this body, Permit No. 195-95-110
A five day extension of time for filing the ~ath certificate (exclusive of weekends) has been requested and granted as undue h, ardshE
would result f~m filing within the normal time limit. If t~ certificate cannot be fiJ~ within this extended time limil, a "Funeral Director/Direc:
Disposer Report" will be filed wit< the Local Registrar of the C~*nty in wh~h death occur~d.
No extension of time for filing~ death certificat~uested~
SubregistrarRegistrar or Signature ~~ ~ . Date
' ~ 2 _ Due:
AUTHORIZATION for CREMATION, DISSECTION or BURIAL--AT--SEA Cremation Authorizat~
,~o
Signature Medical Examiner Date
or
Medical Exan;mer Frederick Hobin, M.D. , gave authorization by te!ephone to Paul Goodridg'e
Funeral Director/Direct Disposer. Date Jul v 3. ~ Qq5
The Medical Examiner's approval must be obtained before disposal by any of the above method~ A Waiting period of 48 hours after
death is required for ail cremations.
Methods of Disposition:
[] BURdAL
· CREMATION
Signature of Sexton )
or Person-in-Charge ~
CEMETERY OR CREMATORY
[] STORAGE
[] OTHER (Specifyl
Place of Disposition ~,~f,c'J'.~'-.;.~',.~/ ~__~,~:,~.~/~_,~,,
Date of Disposition ¢///./?~"- /
This ¢ermit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer wnen there is no Sextcni
and returned within 10 days to the local FIRS Cc4Jnty Public Heelth Unit ie the County where disposition occurred.