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Home My WebLink About4-48-20 ~661 '01 ~ s~x~ uo~..~mo~ ~ pug lv~ ~o~t ai~qT ~ o~ l~a~ tt~ino~ oql po$~l~OU~ Xi~J~a~g, pu~ "~2 .................................................... J~uP~9 'V ~"~ ......................... X~'q~.¢.~ ............. ~o ~ ......... ~.~[ ........ ~, .o ~,~ 'xa~&uao x~.~ ~ ~AIH NVIGNI ~0 AJ, Ntq0D IOaT 'I,~' 'RoR' qa~tt' puI aoup::~D 'V 2aoqo}I IOBI 'ON ....................... po~l.nuJod motunuo]~ ................. $ P.red lan O0'O0*z O0'OOV $ ~v~t.n ld.~a~oM A~I~t~D ,iq P!~I ~ Unit Block Date of Mark-out Date of Burial Name of Funeral Home Authorized by Time GARDNER, ROBERT A. DEED NO. 1894 S. Patrick Dr. Indian Harbour Beach,F1. 32937 1201 Lot 20 Blk. 48 Un. 4 ,/ Paid by CEMETERY R,ceipt No.... ~46 ........ Dat~t .... .1..2./. .1.5./..8.8. ............. L o t 20, Li~ Price $ 400.00 400.00 Net Paid $ .................. Monument permitted ....................... 1 Maximum No. Burial Spaces ................. (Data above tltls l~ne for Clt)~ Re.rd only) Blk.48, NO. Unit 4 1201 Robert A. Gardner 1894 S.Patrick Dr. Ind. Harb. Bch.,F1. 32937 City of Sebastian POST OFFICE BOX 780127 D SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589,-5330 Mr. Robert A. Gardner 1894 South Patrick Drive Indian Harbour Beach, Florida Dear Mr. Gardner: January 5, 1989 32937 Enclosed is Cemetery Deed No.-1201 for Lot(s) No. 20, Block 48 , Unit 4 If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, 2145 14th Avenue, Veto Beach, Florida. Also enclosed is a form - Return for Transfers of Interest in Florida Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court. Very truly yours, Elizabeth Reid Administrative Secretary LR Eric. 5% THE SEBASTIAN CE~4ETERY City of Sebastian Sebastian, Florida on this I~-~ day of )~66~.19~for the purchase of the following described Cemeterg ~t(s) u~n t~ %e~ ~d ~nditions as stated herein: ~scription of P~rt~: Ce~terw ~t(s)~ ~ Bloek~ ~g Unit~ ~ RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: FROM: This contract 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 instrument: The Citg of Sebastian agrees to sell the above mentioned property to the abdve named purchaser(s) on the terms and conditions stated in the above instrument. Wi tt ci£~ of S~b~stian APPLICATION FOR BURIAL -- TRANSIT PERMIT (Type or Print) 1. Name of Deceased Fimt Middle Last DATE Month Day Year OF Hay 27, 1990 Robert _Z~ur Garc~er DEATH 2. Place of Death County Brevard City, Town or Location 3. Name of Medical Certifier John Potc~ski, D. O. 4. Name of Funeral Home/ Direct Disposer Brownlie & Maxwell Funeral Hcrne 5. Check a Appro- priate Box b Name of (If neither, give street address) Hosp. or Holmes ]~giotlal Nursing (De. nter Inst. j Medical Examiner Address Phone Number ~[Phys'~c2rt~n E. New Haven Avenue, Melbourne,Florida 32901 Address1010 E. PaLmetto Ave. Fla. Lic. No./Reg. No. Phone Number (Area Code) Melbourne,Florida 0000049 407 723-2345 [] The medical certification has been completed and signed. A completed certificate of death accompanies this application. d(X D~. Pob:xaski' s office was contacted on5/29/90 within 72 hours after death. 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 cause of death. [] was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical cer~flcation. 6. Place of Sebast±a.q Final Disposition: ~s[&~ ~ ~[a. ~ ~remator~-K~/count2: 7. Funeral Director/ Direct Disposer B. Removal ~9.r, F~ from state F~ Donation F.E. No./Reg. No, Date Signed 890 May 30, 1990 BURIAL -- TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 490CB1 [] A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the County in which death occurred. [] No extension of time for filing the death,certificate [equesJ. ed. Subregistrar Signature . _ Issued: Due: ? Signature or Medical Examiner, AUTHORIZATION for CREMATION, DISSECTION or BURIAL--AT--SEA Medical Examiner Date 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. Methods of Disposition: r~ BURIAL [] CREMATION Signature of Sexton ) or Person-in-Charge ) CEMETERY OR CREMATORY [] STORAGE [] OTHER (Specify) A Place of Disposition Sebastian ~te~'y, Sebastian Fla. Date of Disposition 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 HRS County Public Health Unit in the County where disposition occurred. HRS Form 326, Feb 89 {Replaces Oct 87 edition which may be used) {Stock Number: 5740-000-0326-2)