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HomeMy WebLinkAbout4-46-06Paid by CEMETERY Receipt No.... 5.5 [~ ........ Dated...1/.3.~/.8 9. ................ Franciso Solis interred Lot 6, 2/1/89 Monument permitted ....................... (Data above this line for City l~rd only) /Iit of ebastian lemetery Deeh Lots 6 & 7 NO. Blk.46,Un.4 Maria Solis 1208 P.O.Box 371 Fellsmere, Fi. 32948 NO. 12O15 THIS INDENTURE MADE ~ 31st d,y of ........... ~.a.n.u.a..r..Y. ................ *. s., :g ...... , between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ................................... .............................................. .................................... P.......0.,..B~..3.!!,..~.e.!!.s.~.e..r.~.,...E!.:..' ~2.9Z~} ................................... Indian River Florida of the County of ............................................. art'] State of ....................................................... u Grantee, WITNESSETH~ 650.00 That thc Grantor for and in consideration of thc sum of $ .......................... to it in hand paid, thc receipt whereof is herewith ac- knowledged, does by tins instrument grant, bargain, sell, release, convey and confirm unto the Grantee . ~.l~... heirs, legal representatives and assigns tile following property situated in Sebastian, Indian Kiver County, Florida, to-wit: 6 & 7 46 4 ?dl of Lot(s) ....... , Block, ......... UNIT ............. , of Sebastian munle~pa! cemetery as per Plat Nombe~ 1 thereof recorded in Plat Book 2, at page 65 o f the public ~ccords in thc office of the Clark of the Circuit Court of St. Lucid County of Flotida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with thc rules and regulations, oldinanc~s and resolutions of thc City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requir=mcnts contained in this instrument shall be covenants running with the land. In the event of the failure of fha owner of any property situated within said cemetery to ob- serve and comply with iuch rules, regulations, rcsointions and ordinimces and the conditions of the dc~d of conv©yance thereof than the title of such owner in and to said property shall terminate and the same shall revert to the City of S6bastian, Florida. IH WITNESS WHEREOF, The said party of the first pa~t has caused tins instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate mnl to be harcto affixed, the day and year f~rst above written. / City Clerk Signed, Sealed mid Delivered STAT~ OF FLORIDA COUNTY OF INDIAN ~IVER CITY OF SEBASTIAN, FLORIDA M~'or I HEREBY CERTIFY, That on this ..... .3.~.S..~. ............ day of ............ ~,a..n.l~.a..r..y. .......................... , 10....,89 .¥., ~..L,'. ........... ' ................ before mc personally appeared Richard B. Votapka- . and ..a-,..b~n M. 0 I{alloran Maria Solis ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorlaed; and that the Official seal of said corporation Is duly affixed thereto, and the said conveys.ce is the act and degd of ~id ~r~ra~on. WITNESS my slgna~re a~ offi~al ~ at Se~stla~ in the ~unty of Indian River and State of Florida. the day and year last aforesaid. ................... My ~l~inn ~plres~ ~ct~r7 Puh~lq ~t~l~ of Florl~a Name Unit Block Lot ~ Date of Mark-out Date of Burial Name of Funeral Home Authorized by Time / 0 O 0 Ft , ,/~ ' .Nam~ dnit Block ~' (-~ Lot J-~ Date of Mark-out //"' ,~.~"- ~ G SOLIS', MARIA 12~ S. Elm St. F. O. Box 371 Fellsmere, Fl. REC.NO. 549 DEED NO. 32948 LOTS 6 & BLOCK 46 UNIT 4 1205 Francisco Solis int?rred Lot 6 - 2/1/89 paid by CEMETERY Reoeipt No.... 5.50. ........ Dated.. 21.3~1 l.~ 9. ................ ~t e~ $...325., O.O ...... mx~.,. ~o. ~l sp~... ~. 650.00 Net Paid $ .................. Franciso Solis interred Lot 6, 2/1/89 Lots 6 & 7 Blk.46,Un.4 1205 Maria Solis l, lonument permitted ....................... P. 0. BOX 371 Fellsmere, Fl. 32948 (Da~a above t~ls line for City Record only) THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: / described Cemetery Lot(s) upon th& terms and conditions as stated herein: Description of Propertg: Purchase Price:,~, ~ ~_ ~'~0 Dollars($ ~5~.oD Terms and' conditions of sale: This contract shall be binding upon both parties, the seller and the purchaser, when approved by the owner of the property above described. I, or we, agree to purchase the above described property on the terms and conditions stated in the foregoing instrun~nt: The Cit~ of Sebastian agrees to sell the above mentioned propert~ to the above named purchaser(s) on the terms and conditions stated in the above instrument. Cit~ of Sebastian Witness City of Sebastian POST OFFICE BOX 780127 m SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 February 15, 1989 Mrs. Maria Solis P. O. Box 371 Fellsmere, Florida 32948 Dear Mrs. Solis: Enclosed is Cemetery Deed No. 1205 for Lots No. 6 and 7, 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, 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 com- pleted by the office of the Clerk of the Circuit Court. We are enclosing two copies of Receipt No. 550 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. [mir ~ ~' ,STATE OF FLORIDA DEPAR~.~N~ O,F HEALTH & REHABILITATIVE SERVICES VITAL STATISTICS ~ APPLi'CATION FO,R BURiAL--TRANSIT PERMIT A. (Type or Print} 1. Name of First Middle Last DATE Month Day Year OF Deceased F[~CISCO CORTEZ SOLIS DEATH J,~NUAAY 28, 1989 2. Place of Death City, Town or,Location Name of (If neither, give street address) County Hosp. or INDIAN RIVER ROSELAND Inst, HUMANA HOSPITAL-SEBASTIAN 3. Name of Medical r~ Physician Address .589-4400 Phone Number ~,~¥f,~r TANER HUSAINAY, M.D. [] Medical Examiner 7762 BAY STREET, SEBASTIAN, FLA 4. Funeral Home/ Name Address Phone Number (Area Code) Y~c~W~k-~,STRUNK FIJ~F~AT, ~nt4~ 1623 N. CENTRAL AVE. SEBASTIAN. FLA 407-~Rq-]nnn 5. Check a [] The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. ariate - within 72 Box b ~ LINDA was contacted on 1/gR/R9 hours after death. He/she verified that this death was from naturm causes, that there was no acc[Qent nor other external cause of death, and that DR. HUSAINAY will complete ano sign me medical certification of cause of death. 6. Funeral Director/ _-.--;-. _. ~ c [] was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. ' Fla. Lie. No./Reg. No, Date Signed {/1672 1/28/89 B. BU RIAL-TRANSIT PERMIT Permit No. 1228-89-050 Permission is hereby granted to dispose of this boQy. [] A five day extension of time for tiling the death certificate {exclusive el weekends) nas been requested and granted as undue hardship would result from filing within the normal time limit. If the certificate cannot be tiled within this extended time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Regmtrar el the County in which death occurred. [] No extension of time for fil[ngKhe death certificate requested. Date Cert ficate Registrar or /-[,I . . ~, , ,~) '~ Date 1/28/89 Due: Subregistrar Signature ~ J/'~ ~'~,~ ,ssuea: AUTHOR IZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature . Medical Examiner Date 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 nours after death is required for all cremations, CEMETERY OR CREMATORY Method of Disposition: [~[[BU RIAL [] STORAGE r-I CREMATION [] OTHER (Specify) Signature of sexton ) or Person-in-Charge ~ Place of Disposition Date of Disposition SEBASTIAN CEMETERY FEBRUARY 1, 1989 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 Neaith Department in the County where disposition occurred. HRS Form 336, DDt 87 (Repleoe'~ Mly ~ idition whioh may be u~ed) State of Florida, Depart~of Health and Rehabilitative Services, Vital APPLICATfON FOR BURIAL -- TRANSIT PERMIT (Type or Print) 1. Name of Fimt Middle Last DATE Month Day Year Deceased OF Erasmo Vasquez, Jr. DEATH 11/22/1996 2. Place of Death County Palm Beach 3. Name of Medical C, ertifier David Yu ~ M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral FIc~es~ P,A. 5. Check a Appro- priate Box b City, Town or LocatiOn West Palm Beach ~J Medical Examiner "--~Physician Name of (If neither, give street address) Hosp. or Inst. St. Nar¥'s Hospital ~ ]'nc. Address Phone Number 901 45th Street West Palm Beach, F1 33407 (561)844-6300 Address ]Fla. Lic. No./Reg. No. Phone Number (Area Code 1623 North Central Avenue Sebastian, F1 32958 | 1228 (407)562-2325 The medical certification has been completed and signed. A completed certificate of death accompames this application. C medical certification. 6. Place of Sebastian Cemet,,e~n state ce[~e~y/ Removal Final Disposition: . / ~,~,~,/,~crema,,to,,~,~r,.................~vf~arne/county: Indian River [~ from state 7. Funeral Director/ ~w~f ///,~/ Si~ ~* F.E. No./Reg. No. ~k Laurie was contacted on ~~thin 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 Davi d Yu. H. D. will complete and sign the medical certification of cause of death. [] was contacted on . He/she verified that , Medical Examiner, will complete and sign the ~ Donation Date Signed 11 ./~./1 ¢1¢J¢i B. BURIAL -- TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-96-O541 [] 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 the death certificate requested. ~,~;~t,~, OF-~ ~ /[~, ~ Issued:Date ///~, ~,/~ ~ Date Certificate Subregistrer Signature Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL--AT--SEA Signature Medical Examiner Date or Medical Examiner, , gave authorization by talephone 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: E~BURIAL [] CREMATION Signature of Sexton ) or Person-in-Charge ) [] STORAGE [] OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition _q~',= ~ ~ =~ ~_.~_te~_~ Date of Disposition No-cem"be~' 25. 1996 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. ,I ~ HRS Form 326, Feb 89 tRe¢laces Oct 87 edition which may be usedl (Stock Number: 5740-000-0326-2)