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Home My WebLink About4-46-24Unit Lot Date of Mark-out Date of Burial Name of Funeral Home Authorized by Unit 4 Blk. 46 Lots 24 & 25 Deed No. 1221 Mary Lindsey 12750 Roseland Rd. Sebastian, FI. 32958 Valous R. Lindsey int.err,ed in Lot 24 - 6/8/89 Paid b¥ CEMETERY Receipt No. . . .? .6. .5 ....... :.Dated .... .6./.~./,.8.9. ................. Lots 24 & 25 NO. 200.00 2 Blk.46,Un.4 ~t ~ ~ .................. ~m~ ~o. ~'-' ~p,~, ................. 1 2 2 i Ne~P~id $ ...4..0.Q...Q.0. ...... Monumcnl mr~n~d ....................... Mary Lindsey 12750 Roseland Rd. Valous R. Lindsey interred Sebastian, Fl. 32958 Lot 24, 6/8/89 (Data above mm Une for ~ty Record oely) ~id ~ C£~-~R¥ R~ ' 5 6 5 6 retpt No ....... Dated / /89 ... Lots 24 & 25 NO. t~t Pric~ $.-................200.00 Max~nmn No. Bat,, Spaces ....... 2. ........ .B 1 k. 46, Un. 4 NctP~id$ ...4. Q.Q...Q.0. ...... Monumantpermitted ....................... Mary Lindsey 1221 Valous R. Lindsey interred 12750 Roseland Rd. Lot 24, 6/8/89 (DataahevethmlineforCa~p~cordo.¥) Sebastian, Fl. 32958 0IiIff of ebaslian · emelery Deei NO. 1221 THIS INDEN?VR]~ ~.~.Dx 'r~ ~.t..h ...... day of June ............................................. A. D., 19.8.~.., between tho City of Sebastian, a munlelpal corporation ex|sting under the laws of the State of Florida, as Granter and Mary Lindsey 12750 Roseland Rd., Sebastian, Fi. 32958 Of the County of ..... Indian River ........................................ ..'I State of Florida Sa Grantee, WITNRSaRTIti ....................................................... That the Grantor for and in consideration of the sum of $ 400, O0 ... to it in hand paid, the receipt whereof is herewith knowledged, does by this insttumant grant, ba~gai~ sell, release, convey and confirm unto the Grantee .h..e.r. .... heirs, legal representatives and assigns the following property situated in Sebasrian, Indian River County, Florida, to-wit: 25 Book 2, at page 65 of the public records in the office o f the Clerk of the Cireidt Court of St. Lucle County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; pro'dried that said property shall be used solely ami exclusively for the interment of the human dead and shall be used, kept and maintained at all thnes in aceo~dance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or presided for the government and operation of said cemetery. The conditions, res~riciions and requirements contained in this instrtuncnt shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with ~uch rules, regulations, resolutions and ordiuan~es and the conditions of the d~nd of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida. 1N WITNESS WHEREOF, The said party of tho f'~rst part has caused this instrumont to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. Signed, Sealed and Delivered STATE OF FLOIIIDA COUNTY OF INDIAN ~IVRR CITY OF SEBASTIAN, FLORIDA Ma~or I HEREBY CERTIFY, That on this _...~....~h ........ ,...day of ......... J.l, lJ?..~ ................................... , 11189, . before nm personally appeared Richard B. Votapka . Kathryn M. O'Halloran respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the b~dividuals and officers de. scrll~d in and who executt~l tbe fore~oing conveyance to Mary. Lindsey ........................................................ and severally acknowledged the exeeullen ther~f to be their free act and dead ~ts such officers there~unto duly authorized; a~d that the Official seal of said corporation is duly affixed thereto, amd the said conveyance the act a~td deed of ~qld corporation. WITNESS my.signature and official ~al at Sehastinr~ in the County of Indian River and State of Florida, the day and year last aforesaid.. .: Notary Publlj~' State of Finrtds at Large. My commission explres~ My Commission Expires ~c. I0, 1992 THE SEBASTIAN CEMETERY Cit~ of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: FROM: ___-----~ollars ($ z-}oo. ~ 0 ) on this % ~ day of J%Im'[~~ , 19~9, for the purchase of the following described Cemeterg ~t(s) u~n the te~s and ~nditions as stated h~rein: ~scription of P~rtg: Ce~terg ~t(s)~ ~ + ~ Blook~ ~ Unit~ Ter~ a~d' co, diZens of sale: This contract shall be binding upon both parties, the seller and the purchaser, when approved by the owner of the propertg above described. I, or we, agree to purchase the above described property on the terms and conditions stated in the foregoing instrument: Ths Citg of Sebastian agrees to sell the above mentioned propertg to the above named purc.haser(s) on the terms and conditions stated in the above instrument. ~ o~ ~astian A. (Type or Print) 1. Name of First Deceased Middle Last DATE Month Day Year OF 2. Place of Death VALOUS P~E LINDSEY DEATH JUNE 7, 1989 County City, Town or Location Name of (If neither, give street address) HOSO. or INDIAN RIVER HOSELAND Inst. HUMANA HOSPITAL-SEBASTiAN 3. Name of Medma~ ~] Physician Address Phone Number ~ MUHAMMAD FAROOQ, M.D. [] Medical Examiner 777-37TH. ST. VERO BEACH, FLA 567-2277 4. Funeral Home/ Name Y-] ~I~Y,~ ~ Address STRUNK FUNERAL HOME 1623 N. ~ ....... Phone Number (Area Code) ..... ~'J-'i~&L AVE. SEBASTIAN FLA. _ 5. Check a [] The medical cert' ' ' Appro- this application.. ~ pr/ate Box o ~ PAH was contacted on..6/7/89 within 48 hours after Death He/she verified that this death was from natural causes, that there was no accident nor other ex:ernal cause of death· and that_, hR. ]~AROOO wiJJ complete and sign the medical certification of cause of death. ' c [] was contacted on . He/she verified that medical certification, , Medical Examiner, will complete and sign the Fla. Lic. No,/Reg. No. Date Signed t/1672 6/7/89 STATE oF PLOR,D DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES V I TAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT 6. Funeral Director/ B. BURIAL-TRANSIT PERMIT Permission is nerepy grantea to dispose of this boc/y. Permit No.1_228-89-265 [] A five day extension of time for filing the Death certificate (exclusive of 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 tne Local Registrar of the County in which death oc- curred, [] No extension of time for filing the death certificate requested. Registrar or /~/~.~_ q~ _ ~ Date Sub-Registrar Signature ~ ~ ~ ~ssued,~ Date Certificate ' Due: ,Signature or Medical Examiner,., AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA · Medical Examiner Date , 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. Method of Disposition: ~ BURIAL [] STORAGE [] CREMATION [] OTHER (Specify) Signature of Sexton ) . - __ or Person-in-Charge )~ CEMETERY OR CREMATORY Place of Disposition_ SEBASTIAN CEMETERY Date of Disposition~IUNE If}. ] q89 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, May 86 (Replaces Apr 81 edition which may be used) lStock Number: 26-2)