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Home My WebLink About4-46-07Paid RY Receipt No.... 5.5 C~ ........ Dated...~./.3.]. l.~ 9. ................ ,,st ...... ..... ......... ~ ~' 000 NelP~d$ ...~.~..~ ......... Lots 6 & 7 No. Blk.46,Un.4 Mon ent pe, tted ....................... M ria Sells 1205 Franciso Solis interred P.O.Box 371 Lot 6, 2/1/89 Fellsmere, Fi. 32948 (Data above this line for City l~eeord only) (giIl! of ebasliau (gemelery Deeh NO. 1205 THIS INDI~NTUR]~ MADI/ ~ ...3..~.~.~ ............. da}' of ................ .~..~..~.1~?.?.¥. ................ t. D., 19...~.?., between the City of Sebastiar~ a municipnl corporation existing u~der the laws of the State of Florida, ns Grantor and Maria Solis, 124 S. Elm Street .................................... P.......O.,. /S~.3.7. l,..~.e..!~.~m..e..~.e..~..!.l.,... 3.2.9~ ................................... Indian River Florida of the County of ............................................. an'] State of ....................................................... aa Grantee, WIT~ESSETHt 650,00 That the Grantor for and in consideration of the sum of $ .......................... to it in hand paid, thc receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confu-m unto the Grantee . ~.1:... hairs, legal representatives and assigns thc following property situated in Sebastian, Indian Rivet County, Florida, to-wit: 6 & 7 46 4 A~ of Lot(s) ....... , Block, ......... UNIT ............. , of Seba~lan municipal cemetery as per Plat Number 1 thamo f re corded in Plat Book 2, ~t page 65 of the pubBc records in the office oftha Clerk of tha Circuit Court of St. Luci~ County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold tha sarae forever; provided that said property shah be used solely and exclusively foz the intermant of the human dead and shall be used, kept and maintained at all simcs in accordance w/th the roles and regulations, ordinances and resolutions of th~ City of Sebastian, Florida, hereto- fore, now and hereafter adopted or pro~ided for the government and operation of said cemetery, The conditions, ~e~ictions and requirements con,lined in lifts instrument shall be covanants running with tha land, In the event of the faille of thc owner of any property situated within said cemetery to ob- serve and comply with iuch ~ul~s, reguhfions, resolutions and ordinances and the conditions of the de~i of conveyance thereof then the title of such owner in and to said property shall terminate and the sam~ shall revert to thc City of Sebastian, Florida. IN WITNESS WHEREOF, Tha saki party of tim f~rst part has caused this instrurnunt to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and ils co~porate seal to be hare~ affixed, the day and year fret above written, Signed, Sealed and Delivered STATE OF FLOIIIDA CITY OF SEBASTIAN, FLORIDA Mayor Unit Block Lot "7 Date of Mark-out '7//~J/ Date of Burial ~7' / ~,3 ./~ 7 Name of Fune,~ Hom~ / :~T~b ~ ~ ~ A tho ed by ' Time State of Florida, De~lient of Health and Rehabilitative Services; API%J~T1ON~ FOR BURIAL -- TRANSIT PERMIT (Type or Pdnt) 1. Name of Deceased Fimt ~ Middle Last Maria A. Soils DATE Month Day Year OF DEATH July 19, 1997 2. Place of Death County Indian River City, Town or Locatioh Roseland 3. Name of Medical Certifier Talib Hussain, M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Home a [] 5. Check Appro- priate Box Name of (If neither, give street address) Hosp. or Inst. Sebastian River Medical Center Medical Examiner Address Phone Number X---1Phyalcian 7762 Bay Street, Sebastian, Florida 561-589-717: AddreSS, sebastian,1623 North FICentral Ave Fla. Lic.1228No./Reg. No. Phone561_589_1000Number (Area Code The medical certification has been completed and signed. A completed certificate of death accompames this application. b ~] Phyllis was contacted on 7/21/97 within72 hours after death. ,He/she verified that this death was from natural causes, that thore was no accident nor othor external cause of death, and that Dr. Hussain 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 tho medical certificatiod. 6. Place of Sebastian Cemetery~ln~te,cemetery/~'/ Final Disposition: . ',/~l~atory ~,,~am/e'/~ounty: Indian River 7. Funeral Director/ ~ [ ~gnatu~ (/~ ~ F~o./Reg. No. Removal ---]from state Donation Date~Sign~d B. BURIAL -- TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-97-0316 [] A five day extension of time for filing the death cedificate (exclusive of weekends) has been requested and granted as undue hardsh!p v,~uld 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 flied with tho Local Registrar of the County in which death occurred. [] No extension of time for filing the death certificate requested. R~ /'~ Issued: 7//~/~ '~ Date Certi~ 7 _ Due: Subregistrar Signature AUTHORIZATION 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 hours after death is required for all cremations. Methods of Disposition: ~-BURIAL [] CREMATION Signature of Sexton ) or Person-in-Charge ) [] STORAGE [] OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition Date of Disposition 7/.z~/ e 7 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-O00-0326-2)