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HomeMy WebLinkAbout4-45-03Paid by CEMETERY Receip List :.0..°. ..... Net Paid $ ... ~.5~ ,.O0. ..... Mar±e Farre11 interred Lot. 4, Blk.45, Un.4 Maximum No. Burial Spaces ................. Lots 3 & 4 Blk.45,Un.4 Monument permitted ....................... Thomas Farrell P.O.Box 952 (Data above mis line for City Record only) Roseland, F1. NO. i149 32957 (llitl! of ebastian emelery Deei NO. . Z49 THIS INDENTURE MADE ~ .... 15th .......... day of ........... No.v.emhe.r .................... A. D. 1g..8.9., between Ibe City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ..................... .T.h.p.m..a.~...F..a.~..r~.! !.. (.R~.s. id.ing..s.C..Lo.t.. 3 ,...Palme.r~. C.o.u~ ~ .......................... P.O.Box 952 11330 U.S. 1, Sebastian, Fi.) ........................ Ro~ e land.,..F.1 ...... 32957 ......................................................................... of tb~ con,fy of ......l.p.~.n..~.v.~.V .................hi Stale of .F.l~Ki.d~ ......................................... · s Grantee, WITNESSETH~ That the Grantor fo, and in consideration of the sum of $ ..~.O. ?.0. :.0..0. .............. to it in hand paid, the ,eceipt whereof is herewith ac~ knowiedgad, does by this instrument grant, bargain, sell, mlea se, convey and confirm unto the Giantee . .h..i.s.... heirs, legal mpresantatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit; All of Lot(s) .3...~...~, Block, .~.~. ...... UNIT .. ~ .......... of Sebastian raunic/pal ceraete~y as per Plat Number 1 lhereof recorded in Plat Book 2, at pete 65 of the public records in the office of the Clerk of the Ckcuit Court of St. Lucie County of Florida; 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 u~xl, kept and maintained at all times in accordance with the rules and ieguhtions, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted o! provided for the government and operation of said cemetery. The conditions, restrictions and mqukements contained in this instrument shall be covenants running with the land. tn the event of the failure of the owner of any property situated within said cemetery to ob- seiwe and comply with iuch rules, regulations, resolutions and oldinances and the conditions of the deed 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. IN WITNESS WHEREOF, The said party of the first pa~t has c~used this instrument to be executed in its name and on its behaff by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. Attest: City Clerk CITY OF SEBASTIAN, FLORIDA ,, .............. Mayor Signed, Sealed and Delivered In the Price of: /// STAT~, OF FLORIDA COUNTY OF INDIAN RIVER 5 th November to be the individuals and officers deserted In and who executed thc ton'going conveyance to ........................................................ and severally acknowledged the execution thereof to he their free act and deed as such officers ti~ereunto duly authorized; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance is thc act and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year last aforesaid. Notary Publ[ff, State of Florida at Larse. My commission expires: Holnry Publk, State of florida My (ommlsfi:m E::~ir~s ~c. 10, 1992. FARRELL, THOMAS DEED #1249 Lot 3,. Palmer Court 11330 U.S. 1 Sebastian, Fi. Mailing Add.: P.O,Box 952 Roseland, Fl. 32957 Lots 3 Blk. 45 Un. 4 Marie Farrell interred Lot 4 11/16/89 11- 7 7- 1 L ..... 325.00 NetP~dS ...fiSD.OQ ..... Marie Farrell interred Lot. 4, Blk.45, Un.4 Lots 3 & 4 NO, 2 Blk.45,Un.4 Maximum No. Buzial Spaces ................. Monument ~erm~tted ................. ~ ~ 4 ~ ...... Thomas FarreI1 P.O.Box 952 (Data above t~l. line for C~ty Record only) Roseland, F1. 32957 CITY OF SEBASTIAN crrY CLERK'S OFFICE RECEIPT 001501 369400 001501 369400 680~0 220681 680800 22(}682 Sales Tax Garage Sales Copies/Bid Specs LDC/~ode of Ordinances Communiiy Cenler Renl Yachl Club Renl Non Taxable Renl Cernele~y Lots Cemelery Lois Lot/Niche Block Inlerment Fee Weekend Service Yacht C~b Securily Oepesil Community Center Securily Oepo~it Riverview Park ~ecu~ty Dep~Jl 0211 O &lsh A~ount Pak Unil Total Paid White- DeC. of Origin · Yellow- Fbmne* · Pink- Appliunt City of Sebastian POST OFFICE BOX 780127 a SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 FAX 407-589-5570 December 14, 1989 Mr. Thomas J. Farrell 431 South Papaya Circle Barefoot Bay, Florida 32976 Dear Mr. Farrell: Thank you for your prompt return of Receipt No. 597 with your signature. I am returning the other copy to you for your records. I am also returning to you the form - Return for Transfers of Interest in Florida Real Property - which must be recorded along with Deed No. 1249, previously sent to you, in the office of the Clerk of the Circuit Court, 2145 14th Avenue, Vero Beach, Florida. ve~truly yours, /? -,..-./ ,"2 "/ E-~(abe(h Reid Administrative Secretary LR Enc. City of Sebastian POST OFFICE BOX 780127 ~ SEBASTIAN. FLORIDA 32978 TELEPHONE (407) 589-5330 FAX 407-589-5570 December 11, 1989 Mr. Thomas Farrell P. O. Box 952 Roseland, Florida 32957 Dear Mr. Farrell: Enclosed is Cemetery Deed No. 1249 for Lot(s) No. 3 and 4, Block 45, Unit 4. If you wish to have this deed recorded, may do so at the office of the Clerk of the Circuit Court, 14th Avenue, Vero Beach, Florida. you 2145 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. 597 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. THE SEBASTZAN CB~TERY Ctt~ of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: FROM: R~× hundred fiftv and 00/100 Thomas Farrell (Residing at Lot 3, S=b~ti~,i, Fl.) P.O.Box 952 Dollars ($650.00 ) Palmer Court, 11330 U.S. Roseland, Fi. 32957 on this 15th da~ of November , 19 89for the purchase of the following described Cemeterg Lot(s) upon the terms and conditions as stated herein: Description of Fropert~: ' Cemeter~ Lot(s)# 3 & 4 Block# 45 Unit# 4 Purchase Frice~ Three hundred twenty-fiveDollars($ Terms and'conditions of sale: 325.ea.) This contract shall he binding upon both parties, the seller and the purchaser, when approved b~ the owner of the propert~ above described. I, or we, agree to purchase the above described propert~ on the terms and conditions stated in the foregoing instrument: 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. 'Cltg of S~basttan State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT A. (TYPE) 1.DeceasedName of First Middle Last Do°~thDate Month Day Thomas J. Farrell Nov. 13 Year 2001 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland nst. Sebastian River Medical Center 3. Name of Medical Address Phone Number Certifier Muhammad Siddi~.~., M.D. 937 Barefoot Blvd. i--']Medical Examiner I'~ IPhysician Barefoot Bay, FL 561-664-4349 4. Name of Funeral Home/Direct Disposal Establishment Strunk Funeral Home 5. Check a. [] Appropriate Address1623 N. Central Ave, Fla. Lic. No./Reg. No. Phone No. (Area Code) Sebastan, FL 1228 561-589-1000 The medical certification has been completed and signed. A completed certificate of death accompanies this application. ? medical.e~i~catio~, of ceuse~.ef de.within 77 hours. 6. Funeral Director/ ~~ Si at .~ ~_~.~ ?~..~.~ F.E. No./Re~.. Direct Disposer ,~ , .~ ~ ,~ 1862 BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Martha was contacted on 11 / 13/01 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Siddiqui will complete and sign the medical certification of cause of death within 72 hours. c. [] was contacted on He/she verified that , Medical Examiner, will complete and sign the Date Signed 11/13/01 Permit No. 1228-01-0546 [] A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death cer[ificate within 72 hours. [] No extension of time for filing the death certificate has been requested. 1~ ~ ~ Date Date Celtificate S u bregistrar Signature /~ Issued: J*//~3/O~ Due: ,/ /[~/OJ AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA Approval Number: Date 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. Method of Disposition: ~]BURIAL E-]CREMATION Signature of Sexton or Person-in-Charge [~STORAGE F-"~OTHER (Spec~) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery 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 County Health Department in the county where dispos tion occurred. (Stock Number: 5740-000-O326.2) Pink Local Regis(fa'