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Home My WebLink About4-47-11Pai~ By ~mT~R¥ Eoceipt So. 12 / 5 / 8 8 ................ Dated .............................. Lot 11, ?. - 400.00 1 Blk.4?,Un.4 List ncc ~ .................. Maximum No. Burial Spaces ................. 400.00 Sadie White Net P~id $ .................. Monument mm~ted ..... ' .................. 9830 River Darrell D. NO. Dr. (Mic~co~00 White interred 12/5/88 Sebastian, Fi. (Data above ~,la line for City l~eord only) · of ebas tan leme ery Beeh NO. 1200 between the City of Sebastian, a municipal eorporaflun exlatiog under the laws of the State of Florida, ns Grantor and Sadie White 9830 River Dr. (Micco), Sebastian, FI. 32958 of the County of Indian River un-] State of Florida as Grantee, WITNESSETHI 400.00 That the Grantor for and in conskleration of the sum of $ .......................... to it in hand pa~, the receipt whereof is berewith know/ed§ed, does by this instrument grent, barpi~, sell, release, convey and confirm unto the Grantee , .h./~..~ .... hoirs, le/al representatives and assigns the following property situated in Sebastian, Indian River County, Flor/da, to-wit: AH of Lot(s)...~..]-.. , Block, .~..7. ..... UNIT . ?. ........... of Sebastian mun/~pal cemetery as pc, Plat Number 1 thereof recosded in Plat Book 2, at page 65 of the public recordz in the office of the C~Ck of the Circuit Court of St. LUcio County of Florida; ~ land now lyin§ and being in Indian River County, Florida. To Have and to Hold tho same forever; prey/dod that said propm'ty ahallbe used solaly and exclusively for the intermant of the human dead and ~mll be used, kept and m~ at all ~/raes in accordance with tho rules and regulations, osdinanees and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the gnvenunent and operation of said cemetery. The conditions, restrictions and requkemants contahed in this instrument shall be covenants running with the land. In tho event of the failure of the owner of any property situatod w/thin said cemetery to ob- se~e and comply with iuch rules, regulation% resolutions and.ordinances and the conditions of the deed of conveyance thereof than the titio of such owner in and to said property shall terminate and the ~ame shall revert to the City of Sebastian. Florida. IN WITNESS WNEP, EOF. The said 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 Ciry Clerk and its corporate seal to be hereto affixed, the day and year fus~ above written. Attestl Clerk CITY OF SEBASTIAN, FLORIDA Mayor Signed, Sealed and Delivered ~, ................. STATE OF FLORIDA COUNTY OF INDIAN RIVER, 5th December I HEREBY CE~RTIFY. That an this ........................ dar of ................................................... . IS...., before me personally appeared . ~.~..C..h.a..~..d...B..:...V..O.t...~.p..k.~ .......................... and ~a.~.h..~.Z .n...~. :....0.'..H..a.1..];..o..~..a.n... respectively Mayor and City C]erk of the City of Sebastian, a reunicipal corporation under the laws of the State of Florida to me known to be the iodividuula and officers described in and who executed the foregoing conveyance f~ ........ Sadie.. ghic.e .................................................................................... ........................................................ and sever?ly acknowledged the execution thereof to be their free act and deed as such officers theveunto duly authorized; and that the Offi?~,seal:of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corpar~Uon. WITNESS my signature and offletal seal at Sebastian, ~n~the County of Indian River and State of Plorldn* the day and year inet aforeaald. -~ , ~ · Notar~ Publl~, State of FIOrM& ~ ~ My commission ezplre~ ~ITARY PODLIC STATE OF FLORIDA NY Co##r$szoN EXP DEC 10o19~ BO#DED THRI~ GE,~RAL Unit Block Lot / t Date of Mark-out / Date of Burial Name of Funeral Home Time // O~ ~ A/"I. Name ~ A I~1.[:~ ~.{ Unit Lot \ \ Date of Mark-out Date of Burial Authorized by -:,/?-~':~ ? -7 % ..... Time Paid by CEMETERY Receipt No..~..~. ·~ .......... D'' 12/5/88 · atea .............................. Lo t 11, No. L,,~ l'~ic~ $ ........ .4..0.0. ;..0.0. .,xim.m .o. ,~,[ s.c..................1 Blk.47,Un.4 Sadie White C~C 02)0 0 NetPaJd $ 400.00 Monument permitted .... 9830 River Dr. (Mi Darrell D. White interred 12/5/88 Sebastian, Fl. (D~fa above tills line ~or City Record only) "WHITE, SADIE 9830 River Dr. Sebastian, Fl. (Micco) REC.#545 DEED #1200 'LOT 11 BLOCK 47 UNIT 4 Darrell D. White. interred 12/,5/88 City of Sebastian POST OFFICE BOX 780127 n SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 December 7, 1988 Mrs. Sadie White 9830 River Drive Sebastian, Florida 32958 Dear Mrs. White: Enclosed is Cemetery Deed No. 1200 for Lot No. 11, Block 47, 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, Vero 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. We are enclosing two copies of Receipt No. 545 and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. A stamped, self- addressed envelope is provided for your convenience. 'Very truly yours, Elizabeth Reid Administrative Secretary LR Enc. THE SEBASTIAN CE~ER¥ C~cg of Sebastian Sebastian, Florida _ FOUR HUNDRED ..... ~ ..... Dollars ($ 400.00 ) ~ Sadie White ~ · 9830 River Dr., Sebastian~ Fl.- 32958 on this St~ dag o£ e_~A~_,£1~9 ~Sfor t-J~e puxohase of the following descried C~erg ~[s$ u~n ~ =e~ ~d ~o~ as s~Ced herein: C-.~_~rg Lot(s)#. 11 al~.k~, 47 Purchase Price;FOUR HUNDRED .... Terms and'conc~'tionsof sale; - - Dollars($400.O0 ) This contract shall be binding upon bothpartles, the seller and the purchaser, when asproved hg the owne= of the propert~ above described. I, o= we, mgree'~o Purchase the AboFe described pro~ertg on the ~erms and conditions stated in the foregoing ins~rUment; · he Cit:g of Sebastian agrees ~o sell the above mentioned propertg to the above named purchaser(s) on the terms and conditions stated ~n the above instrument. STATE OF FLORIDA IT OF HEALTH & REHABI SERVICES VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT Z// A. (Type or Print) 1. Name of First Middle Last DATE Mon[h Day Year Deceased OF DARRELL D. WHITE DEATH DECEMBER 2, 1988 2, Place of Death City, Town or Location Name of (If neither, give street address} County Hosp. or INDIAN RIVER VERO BEACH Inst, INDIAN RIVER MEMORIAL HOSPITAL 3. Name of Medical [~hysician Address 562-8522 Phone Number Certifier CHA~ES CE~ANO, M.D. [] Medical Examiner 3607 15th AVENUE VERO BgACH, 4. Funeral Home/ Name Address Phone Number (Area Code) X~~ Strunk Funeral Home 1623 North Central Avenue Sebastian, Fla. 407-589-1000 5, Check Appro- priate Box 6, Funeral Director/ a [] The medical certification has been completed and signed. A completed certificate of death accompanies this application. b ~ Margaret was contacted on 12/2/88 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 Dr. Char[es Ce].ano~ I~.D. will complete and sign the medical certification of cause of death. c [] was contacted on , He/she verified that , Medical Examiner, will complete and s~gn the medical certification, -- /~Signature ~/ Fla. Lic. No./Reg. No, Date Signed B. BURIAL-TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-88-504 [] A five day extension of time for filing the death certificate (exclusi~,~ of weekends) has been requested and granted as undue hardship would result from filing within the nornlal 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 f[lino/X~e death certificate requested. Registrar or ~ /~/] '. ~ .~ ._ / Date Date Certificate Subregistrar Signature -/~J'~"("~' ~'~ ~ Issued: 12/2/88 Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telephone to Funeral Director/Direct Disooser. Date The Medicat 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. Method of Disposition: ~(~ BUR IAL [] STORAGE [] CREMATION [] OTHER (Specify) Signature of Sexton} X~") Q~, ~/~'~-.~ or Pcr~o~, in Ch;rge ) , / / / CEMETERY OR CREMATORY Place of Disposition Date of Diaposition 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. H RS Form 326, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2)