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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.)