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Home My WebLink About4-48-02 eme ery Dee NO. 0 11U3 THIS INDENTURE MADE ~ ...3~d ...... day of ........ De~(~b~ ......................... A. D., 1~ between 'lhe City. of Sebastian, n municipal corporation exlating under the IRws of tbe 8tare of Florid~ nn Grantor Bennie P. Poole ....... .~ .~9~..~.~...~!~g?.,. ~ .3~9~8 .................................................................. o~ ,be ~,,t~ o~ . I~dia~.Riv2r ......................... .., st.t. ~ .. Florida ..................................... T~t the G~te~ for ~d ~ ~eca~n of ~e sum of $ . . .~ :~ ............... ~o ~t ~. ha.d pa~, the ~ipi whereof f~ herewhB ~ow~d~cd, dee~ ~F thf~ ~mtu~.t ~sant, be~g~, ~U, ze~, ~.ve~ and ~nfffm u. to ~he Grantee .. ~$~... hek% ~mf ~e~e~ntatfv~ the fo~owi~ ~op~y ~t~ ~ Seba~, fn~n R~e~ County, FMrlda, to-w/t: A~ of Lot(s) ~ .~ ,~ , B~ .... ~.~.. , U~T ...~ .......... of Seba~la. muni~ ~mete~F as ~ Pht Number 1 ~e~of re~fded in Book 2, at ~e 65 of the pubic re~rds in the o~ of ~he Clerk of tbe CircuR Ceu~ of St. Lude CountF of F~ofida; ~M had ~ow ~yf~ ~ Indf~ Rfver Co~.tF, To Have and to Hold the same forever; provided that said property shah be used solely and exclusively for the interment of the human dead and shall be usad, kept and maintained at ali times in accordance with the rules and regulations, ordinanoes and resolutions of the City of Sebastian, Florida. hereto- fore, now and hereafter adopted or pray/dod for the government and operation of said cemetery. The conditions, restrict/oas and requirements contained hm this/nstrument shell be covenants running with the {and. In the event of the failure of the owner of any property situated w/thin said cemetery to ob- nerve and comply with iuch rules, regu{ntions, resolutions and ordinances and the conditions of the deed of conveyance thereof then thc title of such owner in and to maid property shah terminate and the same shall revert to the City of Sebastian, Florida. IH WITNESS WHEREOF. The sa/d party of the first part has caused 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 afl-u/ed, the day and year first above written. ~ .. - /~_~City Clef St~ned, Sealed un~ Delivered In the I/~,e~nce of: ..... .......... STATE O~ ~LO~ID~ ~OU~T~ O~ I~DIAN CITY OF SEBASTIAN, FLORIDA By ~'~.~.. ...................... (~{t~ ~eal) I tIEREBY CERTIFY, That on this .... 3]~ .............. before me personally appeared ..L,i.G~oe.Ha=ris ................. and . Elizabeth.Reid ................ respectively Mayor and City Clerk of the City of Sehastisn. a municipal corporalion under the laws of the State of Florida to me known to be the individuals and officers deacri~d In and who executed the foregoing conveyance to ......... B~p,i~. ~,..P~ole ................................................................................................. ....................................................... and severally acknowledged the execution thereof to be their free act and deed ns such officers thereunto duly authorized~ and that the Official ~enl of said corporation is duly affixed thereto, and the ~id conveyance is thc ~ct ~nd d~d of ~id co~oration. WITNESS my signa~re and official seal at Sebastian. in t~ ~unty of Indian River ,nd State of Florida. the day and year , flotaq ~blk, State al My Commisdon Expires Od. 5. THIS INDENTURE MADE 'I'HIS 3rd Day of City of Sebastian P. O. Box 127 .~ebast'ian, Fla. 32958 December 1986, By of the County of ~ndian River Florida, as Grantor for and in consider- ation of the sum of *** Love and Affection *** , does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee Bennie P. Peele his/her heirs, legal representative and assigns the following property situated in ~ebastian, Indian River County, Florida, to - Wit: Lot 3, Block 48, Unit 4 To have and to hold the same forever, provided that said property shall be used soletg and exclusively for the interment of the dead and shall be used, kept and m~intained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian~ Florida, heretofore, now and hereafter adopted or provided for the govarnment and operation of said cemetery. The con- ditions, 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 observe and comply with such rules, regulations, resolutions and ordinances and the conditions of the deed of con- veyance 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. IN WITNESS WHEREOF, The said party of the first part has caused thins instrument to be executed the day and year first above written. Signed, Sealed and Delivered I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgments, personally appeared to me known to be the person(s) described in and who executed the foregoing instrument and_ ~__~cknowledged before me that.__~.~ executed the same. Unit Block ~/'~ Lot ~t.~ Authorized by 67 DatedAugust 26, 1976 Paid by Genernl Recehpt No ................................................. 175.00 ~ist Rice $ .................. D~scount $; ..... .- ........... Net Paid $.173.~0 ........ R&R attched Maximum No. Burial spaces "t ......... Rte 1, Box 18, Fellsmere Total are~ in square fe~ ................ (Ditch ~13) Mon~ent ~i~ ..... ~!~,~ .......... BL~K 1, LOT ~, Unit 2 (Data a~ve ~is ~ne tot Ci~ ~rd only) Rec~i t No 4~7 ......... Dated ..... .12/. ~3/~6 Paid by CEMETERY p ........................ )ts 2 & 3, Block 48, Unit 4 M.ximum No. ButYl Slm~ ...2. ............. Monument Dezm~tt~:l .... .-.~.~.a..~.-. ........... (Data above t~ls line for City H~eord only) .O. ,,-ti]3 Bennie P. Poole PO Box 152 Fellsmere, FL32948 Un. 4, Bik. 48, Lots 2 & 3 Deed No. 1103 Bennie P. Poole P. O. Box 152 Fellsmere, Fi. 32948 John Poole interred 12/4/86 - Lot 2 Cora Poole moved from Lot 14, Blk. 1, to Lot 3, Blk. 48, Un. 4 Un. 2 Four Hundred Seventg-Five and O0/lO0 .......... D~II~rS ($ FROH: P. O. Box 152 Fellsmere, Fla. 32948 475.00 on chis 3rd day ofDecember, ., 1986 for ~h~ purc~e of ~he followin~ Ceme~c~ ~(s)# 2 and 3 Blo~k# 48 V~i~# 4 P~r~hase P~ice~ Four Hundred and Seventy-five D~lla~l($ 475.00 Terms and'co.dicions of sale: S325.00 for Lot #2 $150.00 for Lot #3 (Originally paid $175. ~or Lo~ 14, Blk. 1, Unit 2 - Lots traded) This contract shall~be bindin~ #p~ b~.~h ~r£lss, £he ee~le~ and ~he p~r~ha~ex, when approved by the owner of 'l'tte Cit~ of Sebas£ian agrees t~o sell the above Paid - Check #798 12/3/86 Wi £ness U ' 298 THIS INDENTURE MADE Tt~ ..... .2f~:f~ ........... day of .......... .,~lg~u.~'.~ .......................... A. D., 19.~'.~..., between the City of Sebastian, a municipal corpor~E~n ~yisting under f~ law~ o~ate of F!or~n, as G~ranto~Zn~ .................................................................qOU~:e 7 , B0.¥18, Fe77 $i~ez'e ~.~.~..~ ^.~ .......... ~ .... ~' .............. ~ '~,~t/ A: ...... 'ki~/r'~'_~, ................. ~'-~ ....................... :: ....................................... .................... ....... 0' .... Of ~e ~unty ~f . ~.~..R~.~ ...................... ~ ~ an~ Stat~ of ..~..F~.~.... ~ ~ ...... ~ ~...~../..'4-' ~.. is be~wlth ~k~owl~ffe~ d~s b~ this ~st~ment ~, ba~g~, sell, release, eonveF an~ e~ft~ u~to the (rantee ......... heirs, legal representatives and assiffns the foUowing p~pe~F situated in ~eb~sti~, Indian River[~unty~ Florida, .~.j... of Lot J-4~-.~ik..J ..... in ~ U~. 2 .... of ~ebasBan mun[~ eeme~erF as ~e~ ~la~ ~u~ber 1 there- of ~eeo~ded in ~la~ Book 2~ s~ p~ 6~ of Ae public reco~s in the of Bee of thc Clerk of the ~ireult ~urt of St. ~ueie Coun~ of Florida. · o Have a~d to ~old the same louver; provided that said p~ shall be used so]elF aQd ~ive]~ fo~ the i~e~nt of ~e de~ and sAall be used, k~t a~d m~t~n~ at all ti~s in aeeord~lce with the rules and ~eg~latio~ ordAa~ces and r~ol~tions of the City of 8ebas~an, Florifia~ heretofo~ now and here~ff~e~ adopt~ o~ provided for the ffove~nmen~ an~ operation of said tery. ~he conditions, ~estrietions and ~quir~ents contained in this instrumen~ shall be ~ven~nts ~ ~ the land. ~n the e~en~ tbe failure of tbe owner of an~ p~ s~us~ed ~ithln said eemeterF to o~se~ye An~ comp]~ with such ~]es, ~g~ions, ~eso]~io~s and ordin~ces and the conditions of the deed of conveyance thereof then the title of such owner in and to said prope~y shall teminate and the same shall ~vert to the City of Seb~tixm Florida. IN WITNESS WHEREOF, ~e said pa~y of the first part h~ caused this instrument to be ~ecuted ~ its name and on its be- half by its Mayor and attested by~ty Oerk and its co.orate scm to be hereto affixed, the day and year first above written. CITY OF SEBASTIAN, FLORIDA Signed, Sealed and Delivered inthePresen~of:. //~ ~ ......... ..... ........ ......................... John S. Poole ...................................................................................... ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is tl, e act and deed of said corporaUon. WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year last aforesaid. Notary Public, State of Florida at Large. My commission expires: ~;0%ary Public, State of Florida at L~rge. ~.ty Commis~ion E~:,res April 18, 1980 STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this ....... 2.~.~ ........... day of ....... ~bigq/.~. .................................. , 19.~.~., before me personally ~ppeared ..... F.... l?,ugene..CJ2agq ................................ and .... ~.~.~...~.....C..a~. j?.bf..~.~. .......... respectively Mayor an~y 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 foregoing conveyance to STATE OF FLORIDA !PARTMENT OF HEALTH & REHABILITI SERVICES VITAL STATISTICS APPLICATION FOR BURIAL--TRANSIT PERMIT A. (Type or Prmt) 1. Name of Fdst Middle Last DATE Month Day Year Deceased OF JOHN SHIRLEY POOLE DEATH DECEMBER 1, 1986 2. Place of Death City, Town or Location Name of (if neither, give street address) County Hosp, or INDIAN RIVER FELLSMERE Inst. 9825 I40TH AVENUE 3. Name of Medical [] Physician Address Certifier DR. LEONARD E. WALKER, M.E. ~[Medical Examiner 4001-B VIRGINIA AVENUE, FT. PIERCE, FL 3348 4. Funeral Home/ Name Address J~JC~k~J~ STRUNK FUNERAL HOMES 734 NORTH CENTRAL AVE. SEBASTIAN, FLORIDA 32958 6. Check a [] The medical cert~fk:ation has been completed and signed. A completed certificate of death accompanies Appro- this application. pr,ate b [] was contacted on , He/she verified that Box 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 [] JOHN was contacted on 12/2/1~ . He/she verified that DR. LEDNARD R. WALl(ER; H. F,. . Medical Examiner, wilt complete and sign the medical ce~tificatmn. 6. Funeral Director/ Direct Disposer Fla. Lic. No./Reg. No. Date Signed 2088 12/2/86 BURIAL-TRANSIT PERMIT Permit No.~ Permission is hereby granted to dispose of this body E~five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted. If ~t cannot be filed within this time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the County in which death occurred. Registrar or ("'~ ~ Date DECEMBER 2, 1986 Sub~ Registrar Signatu re_ /~_~.~,A. ,~ Issued AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature Medical Examiner Date o~ 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 crematmns. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition [] BURIAL [] STORAGE Date of Disposition [] CREMATION [] OTHER ISpeci[y) Signature of Sexton ) or Person-imCharge This permit must be endorsed by the Sexton or peison-m-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department mn the County where disposition occurred. FiRS Form 326, APR. 81 (replaces previous editions which may be used.) .~-~