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HomeMy WebLinkAbout4-43-08 ..t_.~_IC', -.. ';'")'..'F'."""...",.:<1!'.~."""';...,,' '{~<:;~-""~""~"'!"";' ;\,~,.T..p""Y'>~A!.'~:J:._';iI "P,W by CEMETERY Receipt No...~......... Datod..... .~J.J.J/.~?.......... t 8 " 200.00",' Blk.43, Un.4 ListPnce$"'iO(;~oo""" MaximumNO.BurialSpace..............M~.S. Chiyoko Michael t 229 Net Paid $ .................. Wonumentpennittod....................51i9 F h W .Arthur L. Michael interred utc ay 8/12/89 - Lot 8,Blk.43,Un.4 Sebastian, Fl. (Data .boy. tbII Une to, elt)' Record GAly) NO. 32958 atitt! nf t;thustiun C!!rmrtrry irrll 1229 NO. THIS INDENTURE MADE 'I1aIa .....H)..t~~....H. da)'ol .HHA-~g1;1.~.~............;..............H A. D.. 1.....~~ between the Clt)' 01 SebaatJan, a municipal corporation exlltlng undcr the lawl ot the State 01 Florid.. al Grantor and ........................... ........ ....~~.~.~.. ~~.;y.~~<?. ~~~.J:1.~~~.............................................. '" ...... ...... . . . . . ... ... ............................ 5A9. E\J, t.cb. .w'GlY.,.. .S.ebA(:l. t.:t.AJl,. ..~;J,.. ... .~4 95.6. . . . . .. . ... ..................... Indian River Florida 01 the County ot ...................................., . . . . . . . .. an'J State ot ....................................................... u Grantee, WITNESSETH I 2 00 That the Grantor for and in consideration of the sum of $ ..... ~?.. . . . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant. bargaiD. sell, release, convey and conium unto the Grantee. hex... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . . . ~. .. ,Blode,... ~.~ .. ,UNIT ..~.......... ,of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 6S of the public records in the ,office of the Clerk of the Circuit Court of St. Luc:ie County of Florida; said land now lying and being in Indian River County, Florida. Slgnw, Sealed Ilnd Dcllvered , ~,.lli' P~.t'~....,....;............ ff~a.-.{?~~~..... (QIitu ~eaJ). To Have and to Hold the same forever; provided that siid property shall be used solely and exclusively for the interment of the human dead and sha1I be used, kept and maintained at all times in accordance with the rules.and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for tho government and operation of said cemetery. The conditions, reltrictions 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 deed of conveyance thereof then the title of such owner in and to said property sha1I terminate and the same sha1I 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 fust above written. Attestl,~... .J .L.~ .,u.. In......Ofl.a.fk.~........ .f..~r."':'":'I(.~ :Clty Clerk CITY OF SEBASTIAN, FLORIDA BJ ..~~.15...~.......... MaJor STA'l'E OF FLORIDA COUN'l'Y OF INDIAN RIVER I HEllERY CERTIFY. That on tb1a . ~~~.J:1............... .day 01 ........... A':1.g~~~.............................. 18..~~ Richard B. Votapka Kathryn M. O'Halloran belore me personally appeared....... ..... ............................................... and ...... ........ ...... ...... ......... .... respectively Mayor and City Clerk 01 the City 01 ,Sebastian, . munlc1I)ll1 corporation under the laws of the State 01 Florida to me known to be the Indh'idullls llnd officers described in and who executed the fort'going coaveyanee to ........................ ..... ..... ....~!:~:.. .q?~y'<?~~. .~;.c:~~.~.~.......................................;...................... . . . . . . . . . . . . . . . . . . . . . .. . . .. .. .. .. . . .. . .. .. . .. .. .. . .. .... and aeveraUy acknowledged the execution thereol to be their Iree act and deed IS such officers thereunto duly author1&ed; and that the Ofl/cial seal 01 said.Corporation /s duly allixed thereto. and the said conveyance Is the act Ilnd deed 01 said corporation. WITNESS my ligoature and olfidal aea1 at SebaltJan. In the CoUllty 01 Indian River and State 01 Florida, the day and Jear last alort:said. ~... ... . ,. ., ot~:" .~;~..................... My coDWllaalon explrell t!otary Public. State of Floridcr My Com:ni!sion Expires Dee. 10, 1992 Bonded Thru Troy Fain a Inlurance Inc. r t, +- "- \J , , , -'..... ":., -- ~) "'." .--< h"i~";".:.l" "': I I I I j I _"_."~.J i j i I I I o CO ~ "" o 0'\ )-l N H ('f'l lJ:: u . . >,...-l m<~ P=::3 ~"lJ:: =- ..u ttl ...H-I ..-\ ~::::>.j.) <:~fI.l lJ:: ttl uO'\,o H4<Ll :s""m o \J ('f'l 44 CO E-l. H~.j.) ZHO ::::>P=lH " \0 '" CD e j:: ~ N N ...-l ~ c::l ~ ~ c::l CD Q) e 0 - J: :;, "iii 'i 0 ... " (.0 ~ "iii CD ~ ... ";:: c III :;, :E :;, II.. "P m ..- CD '0 '5 0 N ~ ';:: := 0 CD CD CD 0 C 0 '0 - - e s::. '.,"-"'b ..;? iii III III III - ..oJ Q Q Z'.: "y~ f ,.5~1,"~'~t"""._,;.~-,:F'~'~;, 0'\ CO - N ...-l - CO 'd Q.l ~ ~ <Ll .j.) s:: ..-\ ...-l <Ll ttl .c:: tJ ..-\ :s . H ~ .E .j.) ~ <: Paid by CEMETERY Receipt No...~ ?~......... . Dated. .... .~.OJI.~c)'........... ~ot 8 List Price $ ... ?~9.~ ~9. ..... Maximum No. Burial Spaces B1k. 43, Un. 4 ................. 12r.9 Net Paid $ ...~.~? :~?..... Monument permitted.................. .M~s. Chiyoko Michael G Arthur L. Michael interred 549 Futch Way 8/12/89 _ Lot 8,Blk.43,Un.4 Sebastian, Fl. 32958 (Data above dill Une tor City Rec:ord only) NO. '>;/7~,\'~'l':'1)j.;~!t?~HI~1{ :[T' ------.--------- ~ J --- ---,..,._--,-----,---..,--:-----------------._~ ~\ \ ~ ~ ..;t co ..;t . E-l~. O~Z ....;ll=Q::::> '" ';! It ~. \U ':::il V . E 0'\ N N .-I :::::::: ::.,.. - A ~ ~ A Q) e i= 0 CO ::.:: \1"1 J 0 0'\ :>-4 N , H ~ , :::r:: u . \., ~~~ \", p:l13~ cr ::E: .. :::r::Z l"') ('If .~U< ~E-lH 0;- r <::::>E-t :::r::~~ <"'l UO'\IXl '5 H..;t~ '1'" to 0 ::E:\I"IOO ~ "i ... 0;: CIS ~ :J " - (Xl .;.;. D" '0 0 .)l. () Q) Q) Q) 0 '0 ai ai e iii CIS oJ 0 C Z ~ j 0'\ '() co ~ - - N \<) .-I - - \- co "'d ~ Q) ~ ').. ~ -P Q) ~ = ..... .-I Q) as ..c:: o ..... ::E: . ....;l ~ ~ ..c:: ~ ~ < - ~ ~ ,- ~ :::C ..B c ~ .- -C ~ (' tulbyCEMEfEav _No.. ?on......... .Date4..... .~!.n/.~')...........' hot B u.t ".,. $ .. .~!!\l.: \I.I!. . . . . . __ No..-...... JIll<. 43, Un . 4 N......$ ...~~?:??..... ...._......... .............M~S. Chiyoko Michael t 229 . Arthur L. Michael interred ...................5'119 Futch Way 8/12/B9 _ Lot B,Jllk.43,Un.4 Sebastian, Fl. 3295B (Data aboye dill noe for CltJ RecOrd 0DlJ) -- ------. NO. ,:,~.-"'::;1~"'>~,,,~~:;,.,,1t!1t!fiii'1P'1",~;:'?TC'C .",':~ '''-~'f:Y'-::'t2~~~-.~:.--\;;':~ '~"iIT:VB!~;;~~'''c:'~f,tJy~,)~-t:;;~'1iiI{,~"", .:iIi;1>l:i\",~"" "C i:,:'';-,-': --- - ~~;?"~,'Jf1 ~,-1':~:~~g\"~:~~'*,',:'\c:;"'rj~ 1 . . City of Sebastian POST OFFICE BOX 780127 a SEBASTIAN. FLORIDA 32978 TELEPHONE (<407) 589-5330 August 29, 1989 Mrs. Chiyoko Michael 549 Futch Way Sebastian, Florida 32958 Dear Mrs. Michael: Enclosed is Cemetery Deed No. 1229 for Lot(s) No. 8 Block 43, Unit 4.. If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, 2145 14th Avenue, Vero,Beach, Florida. Also enclosed is a form -Return for Transfers of Interest in Florida Real Property - which must be filled out by you and com- pleted by the office of the Clerk of the Circuit Court. We are enclosing two copies of Receipt No. 573 and ask that you sign and return to us the copy marked with an "X" and' retain the other copy for your records. . A sta~ped, self-addressed envelope is provided for your convenience. Very truly yours, '1:~I\~L Elizabeth Reid Administrative Secretary LR Ene. . . . , . "'l.'., ;" '~', -r,~,- ~'~........'.... '.~.fl0~;P~D:l::i . .':_\":.' ... c. I:, :.i.:;J):: PAY TO THE .~ - "'.' . ORDER OF. x ;;,_,- ~ I ., I" ~ J t... ............. :.W.21.$T..ST...R......~.... '.................. ......... ...........................). ......1...' '. .... . .VE~8l1A~.F1ARIOA~:.H,' MtMb.. /lI7.4A'<:"i1!:!! .. .." ".. 0" ., ....,' ....._ .. ", ..'.... I.,.", ~19CJ 0751 9 $I.~cx>. 4 . 1:0 b 1008 5 1 "1:o.1.$::l'),~~,a .~ "",0 .,8u' . I . ___ ",,,-___N-:::iI'i' .. . . 51} THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: <~ ~~~ ~ e>1;oc> ~ars ($ ~o~ C)CJ ) FROM: C- 11/ 10 k 0 /'fIe-lilt-tEL 517 Fu Tefl LA/If '1 S r2-e/t5r II1/Vj F- L _ ? 2- 7 :>---;? on this II ~ day of 41) ~ (/ Sl,__19 8/ for the purchase of the following described Cemetery Lot(s) upon the terms and conditions as stated herein: Description of Property: Cemetery LOt(s)# 8 Block# 43 Unit# t{- Purchase price:~ Lu ~ t7oto Q ----rx111ars ($ ~o. 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 terms and conditions stated in the foregoing instrument: X L'4d. h1.' .r~"'Q.~ The City of Sebastian agrees to sell the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. --c~~ ~ ~'L Witness _ _ _______-.--...L____________--'- :~-''::''\:.T,::' '":0' ,::. .',....~ .- ~-""-,., -. - ~ .^ . ~ .. " ~.1lP"-,<',?:.-:~,;,{,,"?}r"'T.~~t~':1',.~':'~~~tll.;.;~B?._~::~1r':::i~~":;"-7~~~:~ [lid OEI'^ftTM~NT OF' Ht.Al.Th AND ftEHl\BtUTATlVE S€RVICES '. ,', , STATE'OF FI,..ORIDA . . . EPARTI.!~fjT llFl!EALTH &REHABILlT~E $ERVICES ' ...... .,,' ViTALSTATISTICS APPLICAT.IONF:OR. ~URIAL-TRANSIT PERMIT , :~ 'i 'oi 1. g /013 141 A. 1. Name of Deceased (Type or Print) First Middle Last DATE Month Day Year OF DEATH AUGUST 10, 1989 ART~ .i l ".' J,.;eROY, KICHAEL 2. Place of Death County BREVARD 9itv" TolIVo Qr."LQ,8!~iO/l. q MELBOURNE Name of (If O,eit~er,givestreet addrllss) Hosp. or Inst. HOLMES REGIONAL MEDICAL CENTER 3. Name of Medical , 1XI Physician Address MELBOURNE, .' Phone Number Certifier PARVESH BANSAL, M.D. '0 Medical Examiner 2202 BABCOCK STREET. FLORIDA 951-1267 4. Funeral Home/ Name '.' ..... ..... . ......., '.....< i' ,! . ,,' . ..:, Ad~r,ess Phone Number(Area Code) ~J(~Jf:X STRUNK Ft1NERAL 'HOME'!':1623' N. CENTRAI.AVE.SEBASTlAN. FLA. 407-589-1000 5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies ApprO-this applicaticm;"; lit! priate ''/ Box b 1Kl' , SHIRLEY was contacted on 8/]0/89 within 72 hours after death. He/she verified %hat this death was from natural causes, that there was no accident nor ' "'l'othllr.externa"c:a~eof death;andthat./r, DJ-- ~SAI. will complete . and sign the medical certification of ca.use of death. c 0 med ical ,certification. was contacted on . He/she verified that , Medical Examiner, will complete and sign the 6. Funeral Director/ ,Qireet QisJil9ier ~~. Fla. Lie. No./FkIS. PJ8. ~ /~7,,2. Date Signed ?V"'<:),Y/ B. BURIAL- TRANSIT.PERMIT Permission is hereby granted to diSpose ofthis'bodY. o A five day extension of time for filing the deathcertifipate (exc'usi\le ofweekerlds) has been requestec;f and granted as undue hardship would result from filing within the normal time Iim.it.lf the certifica!e c~not'b~filed within this extended time limit. a "Funeral Director/Direct Disposer Report" will be filed with the;Local Registrar Qf the County inwl;lichdeath occurred. . " I - -,'~; _ 1 .. .' ,',:, .'.,; -' " ;". .' '_' . o No extension of time for fi' g the death certificate 'requested:' \-'i, Registrar or Date 8/10/89 Subregistrar Signature Issued: Permit No. 1228-8g-~60 Date Certificate Due: C. , ',' '. .,..." , f , AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT -SEA Signature or Medical Examiner, ", Medical Examiner Date "0 " , .. . <i.m"",;,;;: ):/g~~l!authorization by telephone to '. . . ,FunllraID,irect()r/D,i,rectD,isposer. Date The Medical Examiner's approval must be obtained before dispo~J by any of the above methods. A waiting period of 48 hours after death is required for all cremations, :,.;.' " , D. 'C.EMETERY OFl,CREMATORY , Method of Disposition: fiI BURIAL 0 STORAGE o CREMATION 0 OTHER (Specify) Place of Disposition Date of Disposition SEBASTIAN CEMF.TERV AUGUST 12. 1989 Signature of Sexton ) or Person-in-Charge ) 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, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2) . ~.