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HomeMy WebLinkAbout4-45-16· of' eme er§ Dee NO. THIS INDXNTUR~ ~E ~ 28th d~V o~ March 88 ~WCC~ Ibc City of Scb~a~ a m~lcJp~ ~r&t~n ~st~g ~der tho l~ws of t~ State of Florid~ a~ Gr~r ~lld Shelia R. Hunsicker ........................... 526 S W Croton Ave.~ Sebastianr. F1. 32958 th~ ~.~ of Indian River Florida Book 2, mt p~ 6~ of tho pubic ~ ~ ~.offi~ of ~ C~k of ~ Ckc~t Co~ of St. Lu~ Co~y of FIoz~; m~ ~d no~ l~g ~ hc~ To Have and to Hold tho same fo~cveri ptov/ded that said property shall ho used solely and exclus/vcly for thc interracnt of the human d~ and sha~J be use, d, kept a~d n~dntained at all thnes in accordenco with the rules and teguhtions, ordinances and resolutions of tho City of Sebastian, Florida, hexcto- fore, now and hereafter adopted et provided for tho govormnant and operation of said cemetery. Tho conditions, restrictions and ~qinrcmant$ contalncd in this instrument shuli bo covenants rung with the land. In tho event of the faille of tho own©r of any propotry situated within said c~mctcr¥ to ob- serge and comply with iuc~ ruics, regulations, resolutions and ordim~n~s and the conditions of the deed of conwyance thereof then thc title of such owner in and to said property shall terminate and tho same shall revert to the City of Sebastian, Fiorh~a. IN WITNESS WHEREOF, The said party of tho first part has ~us~d thla instrument to ho executed in its name and on its bc 'h~U' by its Mayor and attested by its City Clerk and its corporate ~al to be hereto affixed, thc ~ay and year lust above written. ~ City Clerk Si~ned, Sealed a~'*d Delivered STATE OF FI,OIIIDA COUNTY OF INDIAN RIVER CITY OF SEBA~'rlAN, FLORIDA M~yor HEREBY CERTIFY, ~t ua th~ 28th d,y ut March 88 me ~e,,on~lly appel,ed Richard B. Votapka Kathryn M. 0'Halloran respectively Mayor ami City Clerk of the City of ~eho~tian, a municilmJ corporation under the laws of the State of Florida to me known Shelia R. Hunsicker .................. ~. ..................................... and severely ~knowiedged the executlua ttwrrof to ho their free act and deed as such officer~ ther~ul~to duly uuthcr~ed; nad that the Official ~e~l of said corporation i~ duly affixed thereto, auld thc ~id conveyance HUNSICKER, SHELIA R. REC. f;510 DEED ~;1164 526 Croton Ave., S.W. . ~1165 Sebastian, FI. 32958 ~316, Blk.45, Un.4 Timothy R. Hunsicker interred Lot 16 - 3/30/88~//~ Name Unit B ock Lot / Date of Mark-out Date of Burial Name of Funeral Home Authorized by Clog of Sebastian Sebastian, Florida RECEIPT IS flEREB¥ ACKNOWLEDGED OF THE SUH Two hundred and 00/100 ................ '- .... Dollars Shelia R. Hunsicker 526 Croton, S.W., Sebastian, Fl. 32958 200.00 ,) on tkis 28th~ay of .March , 19a~or the purchase of the following described Cemeterg Lot(s) upon the terms and conditions as stated herein; Description of Property: Cemetery Lot(s)# 16 Block# .45 Uni£# 4 Purchase Price:. Two hundred and 00/100 Dollars(p200.00 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 term~ and conditions u=ated in ~l~e foregoing ln~r~-~nt~ The Cite of Sebastian agrees to sell the above mentioned property to the above na~ed purchaser(s) on the terms and conditions stated in the above instrument. A. IType or Print) STATE OF FLORIDA ~ DF HEALTH & REHABILITA'I~SERVlCES VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT 1.Deceased Name of First Middle Last DATE Month Day Year OF TTMOT~ PAUL I{b'~STCKER DEATH Z'L~d{.CH 26, 1988 2. Place of Death City, Town or Location Name of (if neither, give street add[ess) County Heap. or INDIAN RIVER ROSELAND Inst. HUMANA HOSPITAL-SRRASTIAN 3. Name of Medical ,~Physician Address Phone Number Certifier WILLIA~ RICBARDSON ICI Medical Examiner 7945 BAY STEEET SF.R~$TIAN, ~L 589-4200 4. Funeral Home/ Name O~ STRUNK FUNERAL HOME Address Phone Number (Area Code} 1623 NORTE CE~TRA~ AVENDE SRRASTIAN, FL 305-589-1000 5. Check Appro- priate Box 6, Funeral Director/ a [] The medical certification has been completed and signed. A completed certificate of deatn accompanies this application. o ~] DR. WILLI.a~,[ RIC[-[AR.DSON, D.O. was contacted on. 3/26/88 within 48 hours after death. He/she verified that this death was from natural causes, that there was no acc~aent nor will complete other external cause of death, and that HE and sign the medical certification of cause of deati~. medical certification. c [] was contacted on . He/she verified that Medical Examiner, will complete and sign the Fla. Lic. No,/Reg. No. Date Signed 8, BURIAL-TRANSIT PERMIT Permission is hereby granted to dispose of this eDDy. Permit No. -~ [] A five day extenmon of time for filing the death certificate {exclusive of weekendsl has Peen requested and granted. If it cermet be filed withir this time imit, a "Funera~ Director/Direct Disposer Report" will be filed with the ~oca~ Reg attar of the County in which death DC- currec [] No extension of time for J filing the~:~eath certificate requested. Registrar or _~___~_~ ~¢~ ~, ~.,,f~? _~..~j Date Date Certificate Sub-Registrar Signature · J , ~ssued: .,3/26/88 Due: c, AUTHORIZATION for CREMATION, DISSECTION or BURIAL--AT-SEA Signature . Medical Examiner Date or Medica~ 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. .,Oud of Disposition: RIAL [] STORAGE [] CREMATION [] OTHER(Specify) or Person-in-Charge I ~ . ! ! CEM£TE RY OR CREMATORY Place of 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)