The URL can be used to link to this page

Home My WebLink About4-46-01 · of ebast · eme ery Dee NO. llgg THIS INDENTURE MADE ~ .... ~.i.,B.~ ........... day of ....... .0.9.~..o.~.,r .......................... A, D., 19 ...... 08, between the City of Seb~a~ ~ m~l~p~ ~r~tion ~ht~ ~der the laws of ~e State of Finrid~ as Grantor and Clinton D. and Gloria Pease 367 Bay H~rbor T~rrace, ~astian, Fl. 32~58 of the ~unty of , Indian River an~] State of Florida ~ Orante~ WITNESSETH~ T~t the G~to~ fo~ ~d h ~n~derafion of ~e sum of $ .;... ~.0 ~ · ~ 0 ............ to it ~ ~d paid, th~ ~ipt whereof is herewith ~ow~dged, does by t~ hmu~nt ~t, b~, ~, reline, mnvey ~d mn~m ~to the Gt~teeg~eir.. ~s, le~l rep~emntatives ~d asd~s ~e foHow~ pmpe~y ~t~ted ~ ~ha~ l~n ~eI Co~ty, Fin~a, t~wit: ~ of Lot(s)~ ~ ~ ,.3, BB&, .~.~ ..... UNIT...~ ........... of Seb~ m~l ~me~ty as per Phi Number 1 ~ereof re~rded ~ Pht Book 2, at p~e 65 of the pubic te~r~ ~ the offi~ of tha Clerk of t~ ~t Cou~ of St. Lu~ County of Florida; ~ffi hnd now ly~g ~d bei~ h Indi~ Riv~ County, Flofi~. To Have and to Hold the same forever; pro~rided that said property shall be used solely and exclusively for thc interment of the human dead and shall be used, kept and maintained at all t/mos in accordance with the rules and reguhtions, ordinances and resolutions of the City of Seha~tian, Florida, hereto- fore, now and hereafter adopted or prey/dad for the government and operation of said cemetery. The conddtions, resttictions and requirements contained in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property sitmated within said cemetery to ob- serve and comply with ~uch iuins, reguhtion% resolutions andordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall term/hate and the ~ame shall revert to the City of Sebasthn, Florida. IN WITNESS WHEREOF, The Nd party of the first pa~t has cau~d thh instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate ~eal to be hereto a/freed, the day and year f~st above written. Attest: CITY OF SEBA/iTIAN, FLORIDA Mayor Signed, Sealed and Delivered in t~l~ Presence of~ - .C/' . /~ 'X ... ', .................. STATE OF I~T, ORIDA -- COUNTY OF INDIAN ltlVER I HI~REBy CERTIFY, That on thla 31st ........... aay of October lB...8,8- baler, me personally appeared . Richard B. Votapka ............ and Kathryn M. 0' Halloran respectively Mayor and City Clerk of the CRy of Sebastian, a munleipal corporation under the laws of the State of Finrida to me known Clinton D. and Gloria' Pease ....................................................... ; and. severally ~eknowiedged the execution thereof to be their free act and d~ed is the act and deed of said corporation. Unit Block Lot _ ateo, Mark-ou,- ,C' / Dateo, Bu.a, ///~'/~ ~ Name of Funeral Home ~ ~; ~ 'g ~'-' Time Neme Unit Block Lot I Date of Mark-out /,2 - /t - ~ 2.- Oate of Burial I~- ~,- ~z Time I:0o 110, ~- PEASE, CLINTON D. & GLORIA DEED NO. 1196 367 BAY HARBOR TER. SEBASTIAN, F. LOTS 1, 2, 3, BLOCK 46 UNIT 4 CONNIE PEASE. INTERRED - Lot 1 - 11/2/88, UNIT 4 BLOCK 46 LOTS 1, 2, 3 DEED NO. 1196 CLINTON D. & GLORIA PEASE 367 BAY HARBOR TERR. SEBASTIAN, FL. CONNIE PEASE INTERRED - LOT 1 - 11/2/88 N~P~d$ ...... 6D~.QO... Connie Pease interred lot 1 - 11/2/88 Maximum No. Bm/al Space~ ..... .~. .......... Monument permitted ....................... (Data above ~hls Une for C~ty Record only) Lots 1, 2, 3 NO. Blk.46,Un.4 1.198 CLINTON & GLORIA PEASE 367 Bay Harbor Ter. Sebastian, Fl. City of Sebastian POST OFFICE BOX 780127 m SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 November 10, 1988 Mr. and Mrs. Clinton D. Pease 367 Bay Harbor Terrace Sebastian, Florida 32958 Dear Mr. and Mrs. Pease: Enclosed is Cemetery Deed No. 1196 for Lots No. 1, 2, and 3, Block 46, 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, Veto 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. 542 and ask that you both 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. $~sclan, ~'lo£1da Terms and condit, ior~ of sale~ This OOncract shall be binding upon beth parties, the seller and £ho purchaser, w~en approved bE the owner of ~he prop~rtg ~b~ve described. ~ndiCions stated in thu ~or~oing dnt~um~nC~ Cit~ of ~e,~sCi.n A. (Type or Print) 1. Name of First Middle Last DATE Month Day Deceased OF AUSTIN TROY t~RDIN DEATH 12/08/92 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 .~ Medical Examiner Address Phone Number Certifier INDIAN RIVER MEMORIAL HOSPITAL JOSEPH CUSTODIO, M.D. x--]Physician VERO BEACH, FLORIDA 32960 4,DirectName of DisposerFuneral Home/ Address1623 N. CENTRAL AVE Fla. Lic. No./Reg. No. Phone Number (Area Code) STRUNK FUNERAL HOME SEBASTIAN, FLORIDA f~1228 407-589-1000 5. Check a [] The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priata Box b ~1 DR. CUSTODIA was contacted on 12/09/92 within 72 hours after death. He/sh.e verified that this death was from natural causes, that there was no accident nor other external cause of death, and that HE will complete and sign the medical certification of cause of death. c [] was contacted on. . He/she verified that ,, ... , Medical Examiner, will complete and sign the · ' medical certification. 6. Place of SEBASTIAN /~ In state cemeter.~/ SEBASTIAN CEMETERY Removal Final Disposition: CF2V~T~~'Y //?r~ cremato,ry - n~'e/county: INDIAN RIVER r-~ from state [-'] Donation 7. Funeral Director/ ~/ /// ~ Signa~re/// _,/ F.E. Uo.Al~cg. Hc..--.~ ' Date Signed B. BURIAL -- TRANSIT PERMIT Permission is 'hereby granted to dispose of this body. Permit No. ! 228-92-0552 [] A five day extension of time for filing the death certificate (exclusive of weekends) has been r~quested 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 filingJ,~e death certificate reques~d. Registrar or ,, _ _/~/¢~_~' ~ ~ Date Date Certificate Subregistrar Signature ~ · Issued: 12/09/92 Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL--AT--SEA Signature , Medical Examiner Data or Medical Examiner, , 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 [] STORAGE [] CREMATION [] OTHER (Specify) Signature of Sexton ) or Person-in-Cha~e ) ~,,~. -.. .,: '~, .~, CEMETERY OR CREMATORY 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 HRS County Public Health Unit in the County where disposition occurred. HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be used) ~% ~ Stock Number: 5740-000-0326~2) /_/ DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES VITAL STATISTICS ~//_/ APPLICATION FOR BURIAL-TRANSIT PERMIT A (Type or Print 1. Name of First Middle Last DATE Month Day Year Deceaseu OF CONNIE LYNN PEASE DEATH OCTOBER 27, 1988 2. Place of Death City, Town or Location Name of Jif neither, give street address) County Hosp. or INDIAN RIVER VERO BEACH Inst. INDIAN RIVER MEMORIAL HOSPITAL 3. Name of Medical [] Physician Addres~ 407-461-4000 Phone Number ~ FREDERICK HOBIN [][Medical Examiner 400I-B VIRGINIA AVE. FT. PIERCE, FLA 4. Funeral Home/ Name Address Phone Number ~Area Code~ Direct Disuoser 5. Check a Appro- Driate 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 mat this death was from natural causes, that there was no accident nor other external cause of death, and that wdl complete and sign the medical certification of cause of death. ~ HELEN was contacted on [0/27/88. He/she verified that FREDERICK HOBIN , Medical Examiner, will complete and s~gn the medical certification. Fla. Lic. No./Re9 No. Date Signed ;t 1672 10/27/88 B, BURIAL-TRANSIT PERMIT Permit Nc. 1228-88-468 Permission is hereby granted to dispose of this body, r-~ 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 t~xe death certificate requested. Registrar or /%~ /~,~ ' ~ ~') . - _ J Date Date Certificate Subregistrar Signature ~'~J-~/---'~-/~--J '~'" _~;,/~"~/ Issued: 10/27/88 Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telephone to .Funeral Director/Direct Dis~)oser. 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. Method of Disposition: [~ BURIAL [] STORAGE [] CREMATION [] OTHER ISpec[fy) Signature of Sexton ) or Person-in-Charge ) ' CEMETERY OR CREMATORY Place of Disposition SEBASTIAN CEMETERY Date of Disposition NOVEMBER 2, 1988