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Home My WebLink About4-48-26?aid by CEMETERY Receipt No.. ..... Net Paid $ ..... .4.0~ o.00, ... Nell Cain,Jr., Lot interred 7/20/87 Deed No. 1127 - 7/17/87 Dated Deed No. 1153 7111/88 NO ........................ ~'" '~'Deed #l127-Ruby Si~ayan M~amm, No. B~ Sm~ ................. Lot 25,Blk.48,Un.4 Monnme.tmr~tted...-..Elat..:-.. Deed #1153 I 153 ..... James Cain,P.0.Box 143,Roseland 25,Blk.48,Un.4 Lots 26 & 27,Blk.48,Un.4 (Dz~ ~ve ~ ~ne for ~t~ ~ o~y) of ebas ian leme ery Deeh NO. 153 THIS INDENTURE MADE T~M ........ llt.h ....... day of .......... January ....................... A. D~ be/ween lime City of Sebt~tlnn, a m~lclp~ eo~rat~a ~ist~g ~der the laws of the State of Florid~ ea Gr~r and ...................................... J.om~ ~..C.ain ............................................................................... P. O. Box 143, Roseland, Florida 32957 ot tbe ~u.~ of ..... Indian River ........................................ ~ st~e of ...... ~Qr~da .................................... u Gr~ WITN~SS~, ~ow~cd, does by t~s ~mant gr~t, b~, ~U, rcl~. ~nvey ~d ~nf~ ~to t~ Gr~tee . .h~ B... he~s, I~l re~e~nta~v~ ~d as~s ~e foUow~ p~p~y ~t~tcd ~ ~baa~, In~ ~ver Co~ty, Ho~a, t~it: ~ of ~t(s) . .~ p... , B~ ...... Q.. , UNIT ...~ .......... of Seb~ mu~p~ ~mcte~ as ~: P~t Number l ~f m~rd~ ~ P~t Book 2, at p~e 65 of ~ pub~ ~r~ ~ ~e offl~ of ~c C~rk of t~ Ck~t Co~ of SL Lu~ ~unty of Fior~a; ~ ~d now l~g ~d he~ ~ In~ R~er Co~ty, Flogd~ To Have and to Hold the same forever; provided that said property shall be nsed ~olely and exclus/vely for th~ intern'~nt of the human dead and shall be used, kept and maintained at aU/frees in accordance with the rule~ and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of ~aid cemetery. The conditions, restrictions and requirements contained in this instzument shah be covenants running with the had. In the event of the failure of the owner of any property situated withh said cemetery to ob- serve and comply with ~uch rulo% ~egulations. re~olutions and ordinances and the conditions of the deed of conveyance thereof then the titl~ of such owner in and to said property shall term/hate and the same shall revert to the City of Sebas~hn. Florida. IN WITNESS WHEREOF. The said party of the first part has caused tkis instrument to be executed in/ts name and on its behalf by its Mayor and attested by its City Clerk and its corporate ~ to be hereto affbied, the day and yea~ first above written. ~,/ City Clerk ~//// M~vor Signed, Sealed ami Delivered STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEEEB¥ CERTIFY. That on thi~ 11th .d~y of January 88 .......................................................................... , 19...., before me personally apPeared ..... T,....L... Gene..Harria... ~,d Kathr.yn..R... 0 respectively Mayor and City Clerk of the City of Scbastiaa, s muaici]ml corporation under the laws of the State of Florida to me known to be tl~e indi¥idu~]s aud officers de~criL~:d in and who executed the foregoing cu~veyanea to James Cain ........................................................ and severaBy acknowledged the execution thereof ~o he their free act and deed as sucl~ officers thereunto duly author~ed; ~nd that the Official sc#l of said corporation is duly affixed thereto, and the ~ald convey~lee is thc act and deed of said corporation. WITNESS my signature and official seal mt Scbastion. in the County of India! River and St#re oI Florida, the day and I.st .forespJd. N ary Public, Stat&of Florida at Lar~. My commiasion expires~ #01AI{Y PtI~LIC ST/III (IF FL§RIDI THE SEBASTIAN CEHETER~ Citg of Sebastian Sebastian, Florida RECEIPT Z$ ~ERE~ ACKNOWLEDGED OF THE SUN FRON: Jo '~ ' ' ' '~ · ' ~0 ~,,. /~ · £2q3-7 ~scription of · ~r~ ~d condiCl~ of ~ale~ ~ ~ 7 This contrac, snell ~ bindln~ ~n ~th ~es, the seller and the purchaser, whe~ ~pp~ved bg the owner of the pro~rtg ~ve described. I, or we, agree to purchase the above described proI~rtg on the terms and condieior, m ~at~u' ':,u =I~ foregoing lntrummnt ~ The Cit~ of Sebastian agrees to sell the above mentioned prOperty.to the above named purchaser(s) on the terms and conditions stated in the above instrumsnt. ~t~ o£ ~bastian / ' Neme Unit Date of Mark-out Date of Burial Ti~e Name of Funeral Home ~ ~'"'~ Pt /-/Id. Authorized by , UNIT 4 BLOCK 48 Lots 26 & 27 Ella A. DEED NO. 1153 See: Sibayan, Ruby ~~ Nail Cain interred Lot 25-7/20/87 JAMES CAIN P.O.BOX 143 ROSELAND, FL.' 3~957 Cain - Interred Lot 26 - 4/11/89 Deed No. 1127 - 7/17/87 Paid by CEMETERY Receipt No....0.1. .8. ......... Dsted...D..e..e.d., .N..o. :.. ,1.1. .5..3...-...1, ./11 / 8 8 NO. 200.00 Deed #11Z7-Ruby Sibayan u,~H~$ .................. ~mamN..~Sm~, ...... .2. ......... Lot 25 ,Blk.48,Un.4 .o..me., ' tted Elat Deed #1153 N.t~.mS .....~OQ.~OQ ......... : .... :-. ...... James Cain,P.O.Box 143,Rosela Nail Cain,~r., Lot. Z~,Blk.48,Un.4 Lots 26 & 27,Blk.48,Un.4 interred 7/20/87 ~ (Da~ .~,e m~ ,,,, ~., ~t~ ~,a L. Gene Harrl- Mayor City of Sebastian POST OFFICE BOX 780127 [] SEBASTIAN, FLORIDA 32978-0127 TELEPHONE (305) 589-5330 Kathryn M. O'Halloran City Clerk January 12, 1988 Mr. James Cain P. O. Box 143 Roseland, Florida 32957 Dear Mr. Cain: Enclosed is Cemetery Deed No.1153 for Lot(s) No. 26 & 27 Block4~,Unit4 . 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. 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, Administrative Secretary LR Ene. ~ STATE OF FLORIDAi~II DEPARTMENT OF HEALTH & REHABiLi~. iVE SERVICES VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased ELLA ANN CAIN OF DEATH APEIL 8, 1989 2. Place of Death City Town or Location Name of Ill neither, give street address) County Hosp. or INDIAN RIVER RosELAND Inst. HUMANA HOSPITAL~SEBASTIAN 3. Name of Medical ~[ Physician Address Phone Number Certifier FARHAT KHAWAJA, M.D. [] Medical Examiner 7754 BAY ST. SEBASTIAN, FLA 589-3000 4. Funeral Home/ Name Address Phone Number (Area Code) ~ STRUNK FUNERAL HOME 1623 N. CENTRAL AVE. SFBASTIAN, FLA 407-589-1000 5. Check a r-~ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate 8OX b [] PA3~ was contacted on 4/8/89 within 48 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 DR, KI~WAJA will complete and sign the medical certification of C~use of death. ' c [] was contacted on . He/she verified that medical certification. , Medical Examiner, will complete and sign the 6. Funeral Director/ / //~/j~gna! __.t~1672 ' 4/8/89 8. BURIAL-TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No.1228-89-173 [] A five day extension of time for filing the death certificate exc us ve of weekends) has bee · within this time limit, a "Funeral Director/Direct Dist~oser Renort" ,.,m h~ ~...~ ..,:.~ .L . n r,e..que~ted and granted. If jr ca,not be hied curred, r ,- .. ..,,, ,~..,,=u w~L. L.e LOCal ~egmtrar of the County in which death oc- J-'l No extension of time for filing, the death certificate requested. '. Registrar or /~ )~/).//, ~ .'~ Sub-Registrar Signature /t_~ ~, ¢:~.~ Date 4/8/89 Date Certificate Issued: ~ Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT--SEA Signature , or , Medical Examiner Date, Medical Examiner, , gave authorization by te(ephone to,, Funeral Director/Direct Disooser. 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: Place of Disposition SEBASTIAN CEMETERY [] BURIAL ~ STORAGE Dateof Disposition 4/11/89 [] CREMATION [] OTHER (Specify) Signature °f sext°n ) ,~. 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. HRS Form 326, May 86 (Replaces Apr 81 edition which may be used) (Stock Number: 5740-000-0326-2)