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Home My WebLink About4-48-27 Deed No. 1127 - 7/17/87 ~-~aid by CEMETERY Receipt No ...... Dated Deed No. 1153 - t11/88 . 200.00 Deed #1127-Ruby Sibayan ustp~ce~ .................. ~amumNo. Bur~Spaces ...... .2. .........Lot 25 ,Blk.48,Un.4 Net ?Md $ ..... ~0/] o.0Q... Monumant p~rmitted. Deed #1153 .r..Elat..:. ...... //ames Cain,P.0.Box 143,Roselar, Neil Cain,Jr., Lot 25,Blk.48,Un.4 Lots 26 & 27,Blk.48,Un.4 interred 7/20/87 (Data abeve this line for C/ty Record ouly) /l it of ebastian leme ery Deeh NO. !153 THIS INDENTURE MADE This ........ llth ...... day et .......... January ....................... A. D., 1g..87., between the City of Sebal/tian, a municipal corporation existing under the laws of the State of Florida, .s Gruntns and ...................................... J.~m.e ~..C.ain ............................................................................... P.O. Box 143, Roselan~, Florida 32957 o, tll~ Coooty o, ....... !.n..d..i..a.n....R..iy.e..r. ................. eu-I State o, ...... .F. lo.r.i~a .................................... I~ Orunt~, WITNESSETI-h That the Grantor for and in consklerafion of the sum of $..-...-.-...-............400.00 . to it in hand paid, the receipt whereof is herewith knowledged, does by this instrument grant, balgal~, sell, release, convey and conFum unto thc Grantee . .h.~ S.., heirs, legal representatives and assigns the following propeRy situated in Sebastian, Indian River County, Florida, to-wit: ~ &27 All of Lot(s) . .~ p... , Block .... .4.~.. , UNIT ...4 .......... of Sebasrian municipal cemetery as per PL~! Number 1 thereof recolded in Plat Book 2. at pa~e $$ of the pubBc records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian Rive~ County, Florida. To Have and to HeM the same forever; prov/ded that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accotdance w/th the rules and reguhtions, ordinances and resolutions of the City of Sebastian;'Florida, herete- fore, now and bexeafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this Instrument shall be covenants running with the land. In the ~vent of the failure of the owner of any property situated within said cemetery to ob- serve and comply with iuch rules, reguhrions, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to sa/d property shall term/hate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said pazly of the first part has caused tiffs instrument to be executed in its nan~ and on its behalf by its Mayor and attesled by its City Clerk and its corporate seal to be he~eto affixed, the day and year fi~t above written. ~/ City Clerk ,qi~ned, Sealed and Dellveved in th~/~reaence oh STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLO~LIDA Name Unit Block Lot ~P ,~ Date of Mark-out / ~/~ 7",/~~/ Time" }/' ' oo 4/~ . b,,---~ J CAIN, James Deed No. 1153 Lots 26 & 27 P.O.Box 143 Blk. 48 Roseland., Fq.. 3Z957 Unit 4 See: See: Sibayan, Ruby - Deed #1127 Neil Cain interred' in Lot 25 Ella A. Cain interred - Lot 26 4/11/89 7 Deed No. 1127 - 7/17/87 Paid by C~METERY Re~ipt No....0.~..8. ......... Dated..D..~..M.d,. ?..O. :...~.~..5..3...-...~../ll / 8 8 NO. ~.ia~ce$.. 200 00 .vas ' 2 Deed #1127-Ruby Sibayan ........ : ....... Maxan o. sur~ sm~s ................. Lot 25 ,Blk.48,Un.4 ,a~*~a$ ......4.0D..0Et ~o.mmt.,mitt~a..=.F. lat~.=. Deed #1153 1 153 ........ 7ames Cain,P.O.Box 143,Roselanc Neil Cain,Jr., Lot 25,Blk.48,Un.4 Lots 26 & 27,Blk.48,Un.4 interred 7/20/87 (nat~ .~o~e m~, uae ~o, ~t~ ~e~ea o~) State of Florida, Depar~nt of Health and Rehabilitative Services, Vil~iltatistics APPLICTIfflON FOR BURIAL -- TRANSIT PERMIT (Type or Print) 1. Name of First Middle Last DATE OF Deceased Nei I Chester Cain, ST. DEATH Month Day Year 10/25/94 2. Place of Death County Clay Green Cove 3. Name of Medical Certifier Stuart Millstone, M.D. Name of Funeral Home/ Direct Disposer Strunk Funeral Homes~ P.A. 5. Check Appro- priate Box c [] City. Town or Location Name of (if neither, give street address) Hasp. or Sprin~s Inet'Vencor Hospital of N. Florida .__J Medical Examiner Address Phone Number 1893 Kingsley Ave.,, Suite C X~Physician Orange Park~ Floriaa 32073 (904)276-2044 Address Fla. Lic. No./Reg. No. Phone Number (Area Code 1623 North Central Avenue Sebast ian~ F1 32958 1228 (407)562-2325 The medical certification has been completed and signed. A corr~leted certificate of death accompames this application. was contacted on -~)../.2~¢9.4~- 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 Stuart NJ. l l stone. M.D. 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 certification. 6. Place of Sebast/an Cemetery ~ In state cemetery/,,/ Removal Final Disposition: /" [K I,¢,~matory- n, am~9//e'ounty: [ndia~ River ~ from state ~ Donation 7. Funeral Director/ ,~ / /,¢~gnature///~ ~ F.E. No./Reg. No. Date Signed OirectDisposer ,,,'~ ~ ~' / /~"~'~~tfi72 10/27/94 B. BURIAL -- TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-94-0499 [] 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 neath certificate requested. Registrar or ~ ,~ ~"~,,~ Date 'd~.~/~ Date Certificate 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: [] BURIAL [] CREMATION Signature of Sexton ) or Person-in-Charge ) [] STORAGE [] OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition -.//,,..¢.,~.,"7~;_ L/~¢,,."~.~"'-)~ ,.. 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 tocal HRS County Public Health Unit in the County where disposition occurred. HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stack NumDe~ 5740~000-0326-2)