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HomeMy WebLinkAbout4-44-30 "'I " Paid by CEMETERY Receipt No.' L. P' $ 200 . 00 tst nee .................. 94 11/30/87 Lots 29 . . . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . .. B1 k . 4'4 , Mll.'dmum No. Burial Spaces. .~ . . . . . . . . . . .. . . & 30 Un,4 NO. Net Paid S ..... AD.O..OO... Ellen G. Pinder J-of' interred 11/30/87 Monument permitted. . . . . . .F~ at. . . . . . .. . . 30 1146 (Data abon thla Dne for CltJr Reeord only) Donald E. Pinder 681 Biscayne La. Sebastian, Fl. 32958 atitt! Df l'fbustian Cttrmrtrry Ilrrb 1146 NO. THIS INDENTURE MADE 'I1da ..... 30.th.......... day of ........ Nov.ember....................... A. D.. 18.. .8.7.. between lhe City of Sebutlan, a municipal corporation exlltln. under the lawI of the State of Florid.. 01 Grantor alld . .. . . . .. . .. . ... ...,. .,................. .:P.Q1J.1~1d., .E.... .P.inde.r..................... .. . . . ... . .. ................................... .....,........................... ...... .6.8~ . Bi.sGay.ne. . Lana.,. . .Sebast.ian,.. .Fl...... .329-5-8........................ of the County of ...... J.x:t.4~~x:t.. ~;i;Y:~.J;.. ....... ........ an'] State of .......... ..F.l.QJ;';i,dGl............................... II Grantee, WITNESSETH. TIlIt the Grantor Cor and in consideration of the sum of S ... ~ ~ 9. ~ 9.9. .. . . . . . . . . . . . to it in hand paid, the receipt whereofis herewith ac- knowledged, does by this instrument grant, baugaiD, sell, release, convey and confum unto the Grantee. . ~.;:9. .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: .l36 AllofLot(s} ?9. .&. ,Block,. .4{;..... ,UNIT .4....... ..... ,of Sebastian municipal cemetery as per Plat Number 1 thereoCrecorded in Plat Book 2, at page 65 of the public records in theofftce of the Clerk of the Circuit Court of 81. Lucie County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; PIOvil:Iod that said property shaD be.used solely and exclusively for the interment of the hUIlJ8!1 dead and shall be used, kept and maintained at an times in accordance with the rules and rcgulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter ::dopted or provided for the government and operation or said cemetery. The conditions, restrictions and requirements contained in this inlrtrument sball be covenants running with the land. In the event or 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 deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shan revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has caused this instrument 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. "'--1L / ~. /', J..,~ AA.. _ . Attest: \-;r ;tU....{~U. /.1(..... V:~ I. ~~ . (j City Clerk Signed, Sealed und Delivered ~~l'CIlence of: ~~t(A~............... '~1.d'.2Jf~................. STATE OF ~nIDA COl'NrrV OF INDIAN RIVER (QIitv J'tn() .. ( ,.", '..J 1 \,'i --- ....,- "- ...., "-'- Q) E 0 - J: ::J ~ 0 J: 'ii Q) .>> ... ;: c: .0 as ::J ~ ::J U. "0 CD - Q) '0 '0 0 N 't:; Q) Q) Q) 0 '0 - - E .r:. as as as '5 ...J 0 0 Z <( ..... by CEMETERn_ No... !\?~......... Date<I.......... g WW! 7... ..... i~~~ 4~ ~ list Price $..... ~9.~ :.9~... MaxImum No. Burial Spaces ..~.............. Net Paid $ ..... AO.O..OO... Monument permitted...... .Fl at......... . Ellen G. Pinder interred 11/30/87 Lo t .3Q".=-=~~~----- ~ '~ ~ Q) E as z - 'c :J ~ o o 10 . I L.....__ -,~::-'~~';:~:,F' "' 'y-) J ~ 0 ('f) r.('j ..:t O'\..:t C"'l ..:t ~ 0 U)UE-I ('f) E-I 01-1 o ...:IZ +.l ...:I~::;J 0 ...:I \.0 " ..:t co ...-l - ...-l 0 ('f) . - 0 ...-l Z ...-l ~ '0 \7il OJ \7il ~ ~ ~ co OJ 0'\ +.l 1/'1 ~ 0'\ '1"'1 C"'l .OJ('f) ~ r.il .~ OJ ~ '0 ~...:I . ~ ...:I ...-l '1"'1 < OJ ~ Pot Z ~ o >> .. ~ ~~~ OJ tJ ~ ...-l .. fIl '1"'1 ...-l p:: '1"'1 +.l \7il \7il~fIl ~ ~ Z...-l,o 1-1 co OJ Pot\.OU) ,-~\ v. v "" Q) E i= ~-,--,----- & 30 Un,4 NO. 114' (Data aboYe tbla Une for Clt, Record only) Donald E. Pinder 681 Biscayne La. Sebastian, Fl. 32958 :--~;'}>:11\--rA;:;" ~!FF"f~Zf':'; ;';'%~~" _ _ _ ,..-..qp{'W';IT;if?,,$-,'<\:iiltoWi'-;;".' 'n":~l:1'1'<" ~~~:--,:~i.." ).. 30 /3 ~f !Ii ~ . STATE OF FLORID. DEPARTMENT OF HEALTH & REHABI TIVE SERVICES VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT A. 1. Name of Deceased (Type or Print) First Middle VERa BEACH Last DATE Month Day Year OF PINDER DEATH NOVEMBER 26, 1987 Name of (If neither, give street address) Hosp. or Inst. INDIAN RIVER MEMORIAL OJ Physician Address Phone Number o Medical Examiner 777-37TH STREET VERa BEACH, FL 567-2005 Address Phone Number (Area Code) 1623 NORTH CENTRAL AVENUE SEBASTIAN, FLORIDA 305-589-1000 GLADyS ELLEN 2. Place of Death County INDIAN RIVER City, Town or Location 3. Name of Medical Certifier EROL ATAMER, M.D. 4. Funeral Home/ Name ~er STRUNK FUNERAL HOME 5. Check Appro- priate Box a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b rx:J DR. SCO'I"I' was contacted on 7/n/R7 within 48 hours after death. He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that DR. ATAMER will complete and sign the medical certification of cause of death. c 0 medical certification. was contacted on . He/she verified that , Medical Examiner, will complete and sign the 6. Funeral Director/ Q,i, G"l Bi$t>e.Mi" Fla. Lie. No./Reg. No. ~ /~7..2. Date Signed /r-:~-P7 B. Permission is hereby granted to dispose of this body. o A fi" ~.y '''ten,ion of tim. for filin, th. dcath certificate I.xclu,i" of _k.nds) h" be.n r.qu."ed .nd 'tanted. If it cannot be fiI.d within this time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the County in which death oc- curred. o No extension of time for filing th Registrar or Su b- Registrar Signature BURIAL-TRANSIT PERMIT P . N 1228-87-434 ermlt o. C. Date Issued: 11/27/87 Data Certificate Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature or Medical examiner, , Medical Examiner Date , gave authorization by telephone to Funeral Director/Direct DisDoser. Date Th. M.dical E..min,,', 'ppro,,,, mu" be obtain.d before dis""",1 by .ny of th. .b,,,. m.thods. A w.itin, period of 48 hours .lter death is required for all cremations. D. CEMETERY OR CREMATORY Method of Disposition: o BURIAL 0 STORAGE o CREMATION 0 OTHER (Specify) Sign.ture of Sexton) 4- u.r. or Person-in-Charge )~ ,'~ <J'. . . ? .. Thi, pe'mh mu" be .ndorsed by the Sexton or pe,son.in"'".. 10' by th. Fun"., Di'..tor/Dir"" Disposer wh.n th.re is no Sextonl and returned within 10 days to the local County Health Department in the County where disposition Occurred. Place of Disposition Date of Disposition HRS Form 326, May 86 (Replaces Apr 81 edition which may be used) (Stock Number: 5740-000-0326:2) '1, 1_