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Home My WebLink About4-44-14 I Paid by CEMETERY Receipt No. . .~~ List Price $ .. . . ?~9?:. 9? . . .. Net Paid $ .... S.400..00. . .. . Lot~ 10/19/87 Bl .. .. .. . . Dated.. . . ... .. . .. .. . .. . .. .. . . . . . . Maximum No. Burial Spaces. .. . ? . .. .. .. . . . . 13 & 14 . 44, Unit 4 NO. Monument permitted. . . .. Elat .. . . . .. . . .. . Paul Klinger 643 Wimbrow Dr. Sebastian, Fl. 1140 Anne Klinger interred in Lot 13 - 10/20/87 (Dota above this Une for CiIT a..eonl ooly) 32958 muy of &tba.atian 1140 OJrmrtrry 1!1rrll NO. THIS INDENTURE MADE ThIa .....28.th........... day of ......Oc.tober............................ A. D., 19.37.., between lhe CUy ot Sebau.tlan, a municipal corporation exlatine under the lawliI of the State ot Flol'id~ aa Grantor and ........................... .....li'~1!+..!9.-mgE;!r....................... ...... ................................... ..................... ................ ..... .......... .~~.~y~.~OY1. ])r.i:'.~~..~.~~.~s.~i~.'. .!1... ...~~~?8......,............................... ..... Indian River . Florida 01 the County of ............................................. anJ State of .................,..................................... .. G,ante.. WITNESSETH. That the Grantor for and in consideration of the sum of $ . .~9~. -, 9~. . . . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ao- knowledged. does by this instrument grant, bargam. sell, release. convey and conf'wn unto the Grantee . h;~.... heirs,legalrepresentatives and assigns the fallowing property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) 13. I;. .1.'1IlOck, ..~. . .. ,UNIT ... ~. . . . . . . .. ,of Sebastian municipel cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 6S of tbe public records in the oflice of tbe Clerk of tbe CUcuit Court of St. Lucie County of Florida; said iand now lying and being in Indian River County, Florida. To Hi1ve and to Hold the same forever; provided that said property shall be-used solely and exclusively for the interment of the humap. dead and shall be wed, kept and maintained at aU times in accordance with the rules and regulations,:ordinanccs and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument 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 Such rules, regulations, resolutions and .ordinances and the conditions of the dad of conveyance thereof then the title of such owner in and to said property shall terminate and t~e same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has caused this instrwnent 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 heIeto affixed, the day and year fust above written. All..t:q(~ h..f)ld~~....... "..... tJ.-... City Clerk Rlgnl'd, Sealed ilnd DcHvered in the Presence of: ~. .6:,.tA-.~+............................ ~"/(..~"..,,.. COl'N'fY Ob' INDIAN RIVER (<IIily,$eal) Name Unit Block Lot Lj LJ t/ Date of Mark-out Date of Burial PO:;uL i !./ 3' /:1.u !,)O / f "/'1/' ~} .-l tJf> Name of Funeral me Authorize<t b~. '- J< jlf) q f'f ,I r- 0v i, 1<, ''ii, ", I I \ Time J (). (.i() f1C'V)oRlc.! t'; - J, Last )..../y' ;g9~ !I~ Month Day Year MAY 26, 2000 FLORIDA DEPARTMENT OF Sta. Florida, Department of Health, Vital SAles APPLICATION FOR BURIAL. TRANSIT PE~': (TYPE) A. 1. Name o! Deceased First Middle Date o! KLINGER Death Name of (If neither, give street address) Hasp. or Inst. 3711 SOUTH INDIAN RIVER DRIVE PAUL AUGUST 2. Place of Death County ST .WCIE 3. Name of Medical Certifier UMBRINE FATIMA MD Medical Examiner X Physician 4. Name of Funeral Home/Direct Disposal Address Establishment 7303 BI\l3aX::K STREE:l' SE FOONTAINHEAD MEMORIAL PAIM BAY FLORIDA 5. Check e. 0 The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box City, Town or location FORT PIERCE Address 1 095 NW ST. LUCIE WEST BOULEVARD PORT ST. WerE, FIDRIDA 34986 Phone Number 561 785 5570 Fla. Lie. No.lReg. No. Phone No. (Area Code) 1442 321 727 3977 b. [29 HEATHER was contacted on 5/26/00 @ 12:35PM He/she verified thatthis death was from natural causes, that there was no accident nor other external cause of death, and that FATIMA will complete and sign the medical certification of cause of death within 72 hours. c. 0 was contacted on He/she verified that I Medical Examiner, will complete and sign the ...e;,..""L L./ISpOSer - tion of cause of death within 72 hours. F.E. No.lReg. No. 3766 Date Signed 5/26/00 6. Funeral Director/ B. BURIAL. TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No.Fl:I1 442-182-00 D 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 caus&-of-death section of the death certificate within 72 hours. ~NO extension of time for filing t Registrar or Subregistrar Signature Date Issued: 5/26/00 Date Certificate Due: C. 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. OOJ3URIAL DSTORAGE CEMETERY OR CREMATORY Piace of Disposition ~ J..e. Ai;..;, -, (2 n A~ ;jIo ^ '1 Date of Disposition "i'"'<'\"'-1 3 I d.c-.:., .-. D. Method of Disposition: DCREMATION DOTHER (Specify) Signature of Sexton } orPerson-in-Charge .;$."01.;'). C/.'-_~ This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral DirectorlDirect Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the county where disposition occurred. DH 326, 8197 (Obsoletes all previous editions) (Stock Number: 574D-OQO.0326-2) Distribution: While: Cemetery or Crematory YeDow: Funeral Director or Direct Disposer Pink: Local Ragislrar j,