The URL can be used to link to this page

Home My WebLink About4-46-27 400.00 Net Paid $ .................. Patricia Cairone interred Lot 27 - 6/22/89 ......... D.ted .... 6../..2.1../.8.9 ............ Lots 26 & 27 2 Blk.46,Un.4 Maximum No. Burial Sp~ces ................. NO. Monumempexm.i~ed ....................... James G. Rogers 1056 Topsail La. Sebastian, Fl. (D~a a~ve ~ H~ ~r ~ R~-cord o~y) · iIU of ebaslian 32958 emelery THIS INDENTURE MADE between the City of Sebastian, James G. Rogers ..... 1056 ToRsail Lane~ Sebastian, Fl. 32958 et the Countr of Indian River ,n'I State ot Florida as Grantee, WITNESSETH~ That the Grantor for and in consideration of the sum of$ ........ .4.0..0.: .0..0 ......... to it in hand paid, the ~eceipt whereof is he,cwith ac- knowledged, does by this instrument grant, b~, sell, release, convey and confLrm unto the Grantee ...h. ~.s... heirs, legal representatives and assigns the following properly situated in Sebastian, Indian River County, Florida, to-wit: 27 .411 of Lot(s) .~.~.. ~ , Block, ?. ~. ..... UNIT ... ~. ......... of Sebastian munic/pal cemetery as per Pht Number 1 theseo f r~ cord~/in Plat Book 2, at p~e 6S of tho public ~rd~ in the offl~ of the Clerk of th~ Ckeuit Court of St. Lu~ Comity of Flor~; ~ ~d now 1Fing and being in Indian River County, To Have and to Hold th~ s~,ne forever; provided that said prope~y shall he used solely and exclusively for the interment of the humj deed and droll be used, kept and m~int/fined at all times in accotdance with the rules and re§ulatinns, ordinances and res~lutinns of the City of Sebastian, Flor/da, he.to. fore, now and hereafter edopted or preY/dod lot the government and opera,inn of ~/d cemetery. The cond/fions, tcstti~/ons and ~qui~ements contained in th/s instrument shall be covenants runu/ng with the hn~. In the event of the faiin~e of the owner of any property situated wifldn ~ cemetery to ob- serve and comply with ~uch rule~, regnhtions, resolutions and ord/nances and the condition~ of the deed of conveyance thereof then the title of such owner in and to sa/d property shall terminate and the ~ame shall revert to the City of Sebastian, FlOr/da. IN WITNESS WHEREOF, The s/fid par~y of the first part has caused thh instrument to be executed in/ts name and on its beheff by/ts Mayor and attested by its City Clerk and its corporate seal to be he~eto affixed, the day and yoa~ first above w~ittcn. ~/ City Clerk Signed, Sealed and Delivered ......... CITY OF SEBASTIAN, FLOI~IDA Mayor STATE OF FLORIDA Unil ~ Lot 'i. '~ Date of Burial Name of Funeral Home ,CAIRONE, Patricia - interred in Lot 27 - 6/22/89 RoGERs, JAMES G. Deed No. 1223 1056 Topsail La. Sebastian, Fl. 32958 Lots 26 &_2~ Blk. 46, Un. 4. m~WCE~mT~RyR~ipt~o...5.6..6 ........... p,t~a .... 6./..2.1./.8..9. ............... Lots 26 & 27 ~O. 200 ~amum No. ~mi~ Sm~s ...... .2. ........ .B lk. 46, Un. 4 .................. 1223 400.00 NetP~id$ .................. ~onamentpermittad ....................... James G. R~gers 1056 Topsail La. Patricia Cairone interred Sebastian, Fi. 32958 Lot 27 - 6/22/89 (Data above tb~ 11~ for Clt.v ]{~or~ only) REHABI ~ERVICES ~ ~/~ .... ^ ..................... VITAL STATISTICS ~/, ~/ ......................... APPLICATION FOR BURIAL-TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year OF Deceased PATRICIA ELLEN CAIRONE DEATH JUNE 19, 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-SFRARTIAN 3, Name of Medical [] Physician Address 464-7378 Phone Number Certifier FREDERICK HOBIN, M.E. [~ Medical Examiner 4001-B VIRGINIA AVE. FT. PIERCE,, FLA 4. Funeral Home/ Name Address Phone Number (Area Code) Direct Disposer STI{UNI(. FUNEI;~L HOME 1623 N. CENTRAL AVE. SEBASTIAN, FLA. 407-589-1000 5. Check a [] The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b [] was contacted on within 48 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 will complete and sign the medical certification of cause of death. c [] HELEN was contacted on 6/19/89. He/she verified that DR. FREDERICK HOBIN /~ medical certification. , Medical Examiner, will complete and sign the 6/19.89 B, BUR IAL-TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. ~ ~-~ 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 the Locar Registrar of the County in which death oc- curred. [] No extension of time for filin/~he de~t~h certificate requested. Registrar or ~ ~--~, ~.~Z~-~ Date Date Certificate Sub-Registrar Signature Issued: 6/19/89 Oue: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telephone to Funeral Director/Direct Disl~osar. 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 Js required for all cremations. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition SEBASTIAN CEMETERY [] BURIAL [] STORAGE Oate of Disposition ~'~' 99; )gRq [] CREMATION [] OTHER {Specify) Signature of Sexton ) ~/~.a~ ? ~ ~"~ or Person-in-Charge ) . ./ _ , 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) (Stock Number: 5740-000-0326.2)