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Home My WebLink About4-47-31Monument pormktod ....................... (Data above ~h llr~ for City Eecord oaly) · of ebastian ( emetery Dee Lot 31,Blk.47,NO. Unit 4 1188 Virginia M. Horky 108 Hydrangea Ct. Barefoot Bay, F1.32958 NO. 1188 THIS INDENTURE MADE Tnb ........ 8.th .........day of ......... Sep,temba~: .................... between lite City of Sebastian, a municipal corporation existing under the laws of the State of Florid~ as Grantor and ................................. ~% ~g~..M,..Ho. rk~ ....................................................................... 108 Hydrangea Ct., Barefoot Bay, Fl. 32958 of the ~ty of ...... 1~.~..~1~.~ .................. anI St.te of .... ~!.0.~%~ .............. ~ Grantc~ WITNESSETH~ T~t the Gr~lor for ~ ~ ~ngdaragon of~e s~ of $ .... ~P.~.'.~.~ ............. ~ow~dged, does by t~s ~rument ~ant, b~g~, ~, rel~, ~nvcy ~d ~nf~m ~to thc G~tee . ~... heks, legal repre~ntativ~ ~d as~s the foBow~g property Mt~ted ~ Seba~, I~n ~ar County, Florida, to.it: ~ of Lot(s)...~ ~. , Blo~,. ~.~ ..... UNIT .. ~. .......... of ~baa~n m~ifip~ ~metexy as per Pht Number 1 ~e~o f re~rded in Pht Book 2, at p~e 65 of the pubic re~rds M the affi~ of the C~rk of the C~t Co~ of St. Lucie County of Florida; ~id ~nd now lyfi~g and bei~ ~ lndi~ River County, Finfidm To Have and to Hold the same fo~var; provided that said property shall be used ~ol~ly and exclusively for the interment of the human dead and ~hall be used, kept and maintained at all rimes in accordance with the ales and reguhtinns, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the govemmant and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shaB be covenants running with the land. In the event of the failuxe of the ownar of any property situated within said cemetery to se~e and comply with iuch rules, reguhtions, resolutions and ordinances and the conditions of the deed of conveyanc~ thereof then the title of such owner in and to said property ahab terminate and the ~me shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the First part has caused this instrument to be executed in/ts name and on its behalf by its Mayor and attested by its City Clerk and its corporate s~al to be hereto affixed, the day and year first above written. Attest .. . :, . . . .~:~}~/,-....,~. ..... ~/ City Clerk CITY OF SEBA~ITIAN, FLORIDA Mayor Signed~'~'c~led and Delivered in the ~Pre~eane of: *~ STATE OF FI~RIDA COUNTY OF INDIAN RIVER I tlEREBY CEHT1FY, T~t on th~ ...... ~ Kk ............ d.y of ........ Sep.tamb.e~ ............................ respt~ctively 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 individuals tend officers descried in and who executed the foregoing conveyance to ........... ~[~ ':. ..................................... and ~ver~ly ~knowledg~ the ~xecutinu ther~f to ~ thel, free act and deed as such officers thereunto duly authored; and that the Official acid of said corporation la duly affixed thereto, ami thc said couveyance is thc act and ~d~d' of ~id W1TNESS my signature and official a~ at ~st~n, In t~ ~unty of Indian lIivcr and State of Florida, the day and yea: last ufor~d. . ~, : '. . Nota~ PubBe~t~te of Florida at My co~lssin~cxp[rea' - ~ ' Name Un(t Block _ot 5 / Date of Mark-out Date of Burial Time Name of Funerhl Home Authorized by HORKY, VIRGINIA 108 Hydrangea Ct. Barefoot Bay, FI. DEED #1188 LOT 31 BLOCK 47 UNIT 4 Andrew J. Horky interred 9/8/88 Paid by CEMETERY Receipt No 5 3 5 Dated 9 / 8 / 8 8 List Price $,. 400.00 Net Paid $ .., .4,(]1~. I~0 ...... Andrew J. Horky Interred 9/8/88 Lot 31,Blk.47,NO. Unit 4 Maximum No. Burial Spaces ................. 1188 Monument permitted ....................... Virginia M. Horky 108 Hydrangea Ct. Barefoot Bay, F1.32958 (Data above this line for ~ity P, eeord on]y) City of Sebastian POST OFFICE BOX 780127 n SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 September 15, 1988 Mrs. Virginia M. Horky 108 Hydrangea Court Barefoot Bay, Florida 32958 Dear Mrs. Horky: Enclosed is Cemetery Deed No. 1188 for Lot No. 31, 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. 535 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 when approved b~ ~e ow~e~ Of ~a ~ro~g ~vo desc~i~d. I, or we, agm~ to P~c~e the ~vo descried P~O~rr~ on tho tor~ and above n~med purchdae~(s) on the Corme and CondiCion~ seated in Oho .bovu STATE OF FLORIDA T OF HEALTH & REHABIL VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF ANDREW JOHN HORKY DEATH SEPTEMBER 2, 1988 2, Place of Death City, Town or Location Name of Jif neither, give street address) County Heap, or BROWARD FT. LAUDERDALE Inst. NORTH BROWARD MJ~DICAL CENTER 3. Name of Medical [] Physician AddressFt· Lauderdale Phone Number Certifier FELICE DOMINGUZ, M.E. ]~XMedical Examiner 5301 S.W. 31st. Ave.Fla' 305-962-8300 4. Funeral Home,/ Name Address Phone Number (Area Code) ~~ STRUNK FUNERAL HOME,SEBASTIAN 1623 N. CENTRAL AVE. SEBASTIAN, FL 407-589--]000 5. Check a [] Appro- priate Box b [] 6. Funeral Director/ The medical certification has been completed and signed. A completed certificate of death accompanies this application, was contacted on 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, FELICE DOMINGUZ HE medical certification. was contacted on ~/6/88 He/she verified that , Medical Examiner, will complete and sign the Fla. Lic. No./~reg..-No:. Date Signed #1672 9/6/88 B. BURIAL-TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-88-408 [] A five day extension o[ time for filing the death certificate (exclusive of weekends) bas been requested and granted as undue hardship would result from filing within the normal time limit. If the cedificate 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 t)¢~ death certificate requested. .eg strar or /U - Da,e SubregistrarSignature _ VL'~L'~'~gJ ~- -~~Issued: 9/6/88 Date Certificate / / Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT--SEA Signature__ , Medical Examiner Date or Medical Exami :el', gave authorization by telephone to Funeral Director/Direct Disooser. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods, A waitin~ period of 48 hours after death is required [or all cremations. CEMETERY OR CREMATORY Method of Disposition: [~ BURIAL [] STORAGE [] CREMATION [] OTHER (Specify) Place of Disposition. Sebastian Cemetery Date of Dlspos t on__~i_ept;ember ~.._1R88 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, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2)