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Home My WebLink About4-48-07$ ........ Do,ca 4/6/87 NO. ..................................... · ttl Manimum No. SErial Spa~ ....... 2. ........ Georgia Allen 8120 130th St.,Box 249 Monument permitted ....................... Roseland, FI. 32957 Lloyd Allen interred (ha+- aheve mt, une tot City n~ord oaly) 4 / 7 / 87 - LO t 7 (Iii{I{ of t)ebasIiau ( emelery leeh NO. 1111 THIS INDENTURE MADE T~ .... 1.4.th ........... day of ................ April ....................z,. D., ~S. 87.., between the City of Sebastian, a municipal uarporatinn e~lsting under the laws of the State of Florida, ns Grantor and Georgia Allen ........................................ fi120.. 130.th..St...,..R .O., Box.. 249,, · Rosel and.,..Fi.,.. 3 Z9.5.7 ......... cf the County of . Indian River anI State of Florida ~ Grantee, WITNESSETH~ That the Grantor for and in con~/deration of the sum of$...................40 0.0 0 ....... to it in hand paid, the rcceipt wh~eof is herewith ac- knowled§ed, docs by this instrument grant, bax~, ~ell, release, convey and confirm unto the GIantcc .... .h.~.r. heirs, legal representatives and assigns thc following property situated in Sebastian, Indian R/vet County, Florida, to-wit: All of Lot(s) .7...~...8, Block,...~.~. .... UNIT .... ?. ........ of Sebastian municipal cemetery as per Phi Number 1 thereof i~corded in Phi Book 2, at pagc 65 of the public records in the office of thc Clerk of the C/tcuit Court of St. Lude County of Florida; sa/d land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; provided that said proper~y mheB be used solely and exclusively for the interment of the human dead and ~ be used, kcpt and maintained at all fimcs in acooxdance with the rules and reguhtions, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provid~ for thc government and operation of ~ cemetery. The conditions, resUictions and tequkements contained in this instrument shall be covenants ntuning with the land. In the cvent of the fallutc of the owner of any property situated within said cemetery to ob- serve and comply with/ach rule% xegula~ons, resolu~on~ and o~dinances and the conditions of thc deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the Chy of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has censed this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above wdtten. Signed, Sealed and Delivered In the Presence of: STATE OF FLORIDA COUNTY OF INDIAN' RIVER ! HRRESY CEETIP'¥, That on this ........ .1.4..t..h. ......... day of ........... .A. l?.r.$-.! ............................... , lB. 8..7, before me ~ersanally ippenved --L. Gene Harris and ~t~" ~en~J~T~ 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 indivldu~ls and officers described In and who executed tile foregoing conveyance to Georgia Allen ........... .. ;.. ·..- ...................................... and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorizedi and that the Official seal of said corporation is duly affixed thereto, and the ssid conveyance is the act and deed of said corporation. WITNESS my signature and official ~ at 8ebuathn, in the County of Indian River and State of Florida, the day and year last aforet~id. Notary PubUe, Stub'of Florida at Large. ' My commission explreo~ ~OT~R¥ PIIBLIC STATE OF FLORIDI Name Unit Lot 7 Date of Mark-out "//~ Dete of Burial '~/'~ /~ r' Time Name of. Funeral Home Authorized by Allen, Georgia 8120 130th St., P.O.Box Roseland, Fi. 32957 249 DEED NO. 1111 Lots 7 & 8, Blk. 48, Unit 4 Lloyd Allen Interred - 4/7/87 Lot 7 u,t ~ $ ....... ~20~.D0 M~dm~. No. B~ Sm~, ....... 2 ..... .... Georgia Allen N~ Paid $ ........~ .4.O .0., .0. Q Lots 7 & 8, Blk. 48, Monument ~r~dtted ....................... Unit 4 (Data above this line fo~' City Record only') 8120 130th St.,Box 249 Roseland, Fi. 32957 Lloyd Allen interred 4/7/87 - Lot 7 RECEZPT Z$ ~R~B¥ AC~IO~r~Ix;ED OF ~fi£ SUN OF: This contract shall be binding upon both parties, the seller and the purchaser, when approved b~ the owner of the propert~ above described. I, or we, agree to purchase the above described propertg on the terms and ~onditions stated in the £oregoing lntr~---nt~ above ~m~d purchaser(s) on the terms and conditions s£~ted in the above ins£rus~nt. Witness /~. Cit~ of S~stian L. Gene Herl'lm Mayor City of Sebastian POST OFFICE BOX 780127 [] SEBASTIAN, FLORIDA 32978-0127 TELEPHONE (305) 589-5330 Keth~n M. Benjamin City Clerk April 28, 1987 Mrs. Georgia Allen P. O. Box 249 Roseland, Florida 32957 Dear Mrs. Allen: Enclosed please find Cemetery Deed No. 1111 for the purchase of Lots 7 and 8, Block 48, Unit 4, Sebastian Municipal Cemetery. If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circui. t Court, 2145 14th Avenue, Veto Beach. We are also enclosing a form - Return for Transfers of Interest in Florida Real Property - which must be fuilled out by you and completed by the Clerk of the Circuit Court's office. ~~truly yours, Elizabeth Reid Deputy C±ty Clerk LR Enc. A. (Type or Print) STATE OF FLORIDA PARTMENT OF HEALTH & REHABILITatE SERVICES VITAL STATISTICS ~ APPLICATION FOR BURIAL-TRANSIT PERMIT 1, Name of First Middle Last Deceased Lloyd Allen DATE Month Day Year OF DEATH April 4, 1987 2. Place of Death City, Town or Location Name of (if neither, give street address) County Hosp. or Indian River Veto Beach Inst. Indian River Memorial Hospital 3. Name of Medical [~hysician Address Certifier Paul Borgmeier, M.D. (-IMedical Examiner 2300 5'ch Avenue Vero Beach, Fla. 32960 4. Funeral Home/ Name Address ~~ Porringer & Son Funeral Home 1200 S. Indian River Dr. Sebastian Florida 32958 5. Check Appro- priate Box a :~ The medical certification has been completed and signed. A completed certificate of death accompanies this application. b [] was contacted on . 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 was contacted on . He/she verified that , Medical Examiner, will complete and sign the ~1770 cause of death. -~ /; ~-')..~ .__~_.me._d.~;~J_cert~icatiorl~ 6. FunerarOire6t~/' ~/ - ~ SignOre Fla. Lic. No./Reg. No. April 4, 1987 Date Signed B. BURIAL-TRANSIT PERMIT Permit No. 759- 722 Permission is hereby granted to dispose of this body~ [] A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted. If it 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. Sub-Registrar Signature . Issued ~ C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT--SEA Signature , Medical Examiner Date or Medical Examiner, gave authorization by telephone tn 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. _ CEMETERY OR CREMATORY Method of Disposition: [] BURIAL [] STORAGE [] CREMATION [] OTHER {Specify) Signature of Sexton ) or Person-in-Charge ) Sebastian Cemetery Place of Disposition Date of Disposition April '7~ 1987 This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sextonl and returned within 10 days to the local County Health Department in the County where disposition occurred. HRS Form 326, APR. 81 (replaces previous editions which may be used.)