HomeMy WebLinkAbout4-47-33Paid by CEMETERY Receipt No.
200.
List Price $ ..................
mt,.,d S .... .2.9.O... ........
Dated 11/3/89
M~imum No. Bmial Space~ .................
Monument permitted .......................
(Dat* above ~le line fol' City Itoeord only)
Lot 33 NO.
Blk.47tUn.4
1247
Robert T. quinones
144 S, Wimbrow Dr.
Sebastian, Fi, 32958
(gitl nf ebastian
(grmrtrr l r .o. 1247
THIS INDENTURE MADE ~ ...... ~X~ ........... day of .......... N.p.y.¢.m.~.e.g ..................... A. D. 10.8..9..,
between tim City of Sebastian, a municipal eorporatlon existing under the laws of the State of Florida, as Grantor and
Robert T..~uinones
.................................. ' ..........................................................
............................................. Sabas.~ian.,..F.L ..... 3.2.95 fl ...................................................
of th, Co,.fy o, ..... .!~.d.~.a..n.,..R.i..v..e.F. .................. a.'I St,,te of .. Florida
as Grantee, WITNESSETlt*
That the Grantor lot and/il consideration of tile sum of $ ..... ~..0.0..: .0.0. ............ to it in ~n~ald, the receipt wheranf is herewith ac-
knowledged, does by this instrument grant, bal~a~, sell, release, convey and confirm unto the C~'antee ......... he~s, legal rel~eSentaflves and assigns
the following p~opetty situated tn Sebastian, Indian ~ County, Florida, to-wit:
33 47 4
of Lot(s) ....... ,Block, ........ ,UNIT ............. , of Sebastian municipal cemetery as per Plat Numher I theleof recorded in Plat
Book 2, at page 6~ of the public ~eanrds in the office of the Clerk of the Cbcuit Coult of St. Lucia County of Florida; said land now lying and being
in Indian Rivet County, Florida.
To Have and to Hold the ~'ne fo~v~'; provided that ~d prope~y ~tll be u~ ~ly and exclu~vely for the htezment of the hum~ d~d ~d ~
~ u~, kept ~ ~ed at afl ~es ~ a~n~ ~ the ales ~ r~uhflons, ord~n~s and remlutions of t~ City of Se~hn. Flofl~ he.to-
fore, now a~ hatcher ~opted o~ pro~d~ for the go.remit ~d o~raflon of ~d ~metery. T~ ~ndifions, re~fl~ns ~d ~ements ~nt~d
h t~ ~Mrumant s~H be mve~ts ~ ~th t~ ~d. In t~ e~ of the fMlme of the o~er of any pro~rty flt~t~ ~t~ ~d ~tery to ob-
oe ~d ~mp~ ~th iu~ tule~ rnguhflun~ re~6ons a~.ord~s ~d the ~Mltions of the d~d of ~n~ t~of ~un t~ fit~ of such owmr
h and W ~d prope~y s~R t~m~ate ~ the ~ ~ re~ to ~e City of ~ba~hn, FbfldL
IN ~SS ~EREOF, The smd ~y of t~ f~ p~t ~s ~u~d t~ ~ru~t to he exe~t~ M its ~ md on its he~ by Rs ~yor ~
aHe~ by its CRy Cl~k ~d Rs ~x~nte ~al to he hereto ~ed, the ~y ~ y~r ~st ahe~ written.
Signed, Sealed dud DeliverEd
COUNTY OF INDIAN RIVER
CITY OF SEBASTIAN, FLORIDA
~i~or
3rd
I HEREBY CERTIlrIF,
~ .... Richard B. Votaoka
re~tively Mayor and City Clerk of the Ci~ of ~e~tlan, a munlcllml ear.ration under the laws of ~ State of Flora ~ ~ kn~n
to ~ tbe individuals and officers descr]~ in and who ~eeutt~ the fore~ln~ eoaveyan~ to
.................................... t.. .................................................................
............. : .......................................... and severally acknowledged the execution thereof to he their free net and deed
as such officers thereunto duly author/~edt end that the Official seal of said corporation Is duly affixed thereto, and the ~ald eonveyanee
i~ the net ~nd deed of said corporation.
WITNESS m~. signature and 5fflelnl ~ ti Se~sat~a* in the County of Indian River and State o~ lqorlda* the day and ye~.r
last aforesaid.
' ....
My commission expJrce t Jqolary Public, State of Florida
My Commission Expires bK. 10, 1')92
Unit
eloc~
Lot
Date of Burial //~/ ~7//,~, ~
Name of Funeral Home
Authorized by
UNIT 4 DEED NO. 1247
BLK. 47
LOT 33 Robert Quinones
144 S. Wimbrow Dr.
Sebastian, Fi. 32958
ROBERT T. QUINONES, SR., INTERRED 11/7/89
. 593 Dat~a 11/3/89
Psi4 by CEMETERY Red'pt mo ...............................................
200.
List Pfic~ $ ..................
N~, ?aid $ 2 00.
ROBERT T. QUINONES, SR.,
interred 11/7/89
Lot 33 NO.
Blk.47,Un.4
................. 1247
Monum~t~nuitt~ ....................... Robert T. Qulnones
144 S. Wimbrow Dr.
Sebastian, Fl. 32958
(Da~ a~ve ~ ~ ~r ~ Reeo~ only)
City of Sebastian
POST OFFICE BOX 780127 r~ SEBASTIAN, FLORIDA 32978
TELEPHONE (407) $89-5330
FAX 407-58g-5570
November 9, 1989
Mr. Robert T. Quinones
144 South Wimbrow Drive
Sebastian, Florida 32958
Dear Mr. Quinones:
Enclosed is Cemetery Deed No. 1247 for Lot(s) No. 33, Block 47,
Unit 4. If you wish to have this deed recorded, you may do so
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.
ver~ truly yours,
Administrative Secretary
LR
Eno.
.00
HEALTH & REHABiLITA~ SERVICES
~PARTMENT OF STATE OF FLORIDA
VITAL STATISTICS
APPLICATION FOR BURIAL-TRANSIT PERMIT /,/'/-//
A. (Type or Print)
1. Name of First Middle Lest DATE Month Day Year
Deceased OF
DI~ATH
Robert Ouinones Oct, 30. lqSq
2. Place of Death Ciw, Town or Location Name of (If neither, ~3tve street address)
County HoSp. Or
Brevard Melbourne Inst. Holmes Regional Medical .Center
3. Name of Medical [] Physician Address 729-4304
Certifier Thomas W. Swalnt M.D. r-JMedical Examiner1351 S~ Hickory St~t Melbourne~ Fla. 32901
4. Funeral Home/ Name 1005 So. HiCkory St. Address
Direct Disposer East Coast Cremation service M~lbOurn~, Florida 3~901 407;725'6343
5. Check a [] The medical certification has been completed and signed. A completed certificate of death accompanies
Appro- this application.
~ , WdS contacted on . He/she verified that
priateBox b [] this death was from natural ~:auseS. that there WaS no accident flor other external cauSb of death, and that
cause of death.
cD
6. Funeral Director/
Direct Disposer
medical certification.
was contacted on , He/she verified that
· , M~!dic~l Ex~rfli~i~ti ~il ~b~l~i~te,~bd ~i~n the
Fla. Lic. No./Reg. No.
Date Signed
Oct. 31t 1989
B. BURiAL-TRANSIJ' PERMIT Perhiit No. KB126-5789
Permission is hereby granted to dispose of this body.
[] A five day extension of time for filing the death certificate (exclusive o~ Weekends) has been requested and
granted. If it cannot be filed within this time limit, a "Funeral Director/Direct Disposer Report" will be filed
with the Local Registrar of the County in Which death occurred.
Sub-Registrar Signature issued .
G. ~elas~et ~E6h~~ ~i ~ lqR9
AUTHORIZATION for CREMATION,' blSSECTION of BURIAL-AT'SEA
Signature , Medical Examiner Date ..... .......... ~ ,~,~ ,
or
Medical Examiner, '~ gave authorization by telephone ~6 '~ '
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiiing period o{ 48 hours after death
is required for all cremations , ~ ; ~ ,
CEMETERY ORCREMATOR¥ i.~ ' .!, .,~ ~
Method of Disposition:
[] BUR'AL [] STORAGE
[] CREMATION [] OTHER (Specify)
Signature of Sexton )
or Person-in-Charge ) .
Place of Disposition
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 County Health Department in the County where disposition occurred.
HRS Form 326, APR. 81
(replaces previous editions which may be used.)