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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.
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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
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..... 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
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& 30
Un,4
NO.
114'
(Data aboYe tbla Une for Clt, Record only)
Donald E. Pinder
681 Biscayne La.
Sebastian, Fl. 32958
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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_