HomeMy WebLinkAbout4-43-15
/
p..ws by CEMETERY Receipt No. .
List Price $ . .. 200 ...on .. ... .
. 400.00 .
NotPaid.$ ..................
;79 . 8/17/89 Lots 14 & 15
. .. . ..... .. .. Dated............. ... .. . . . . ... ... .... Blk . 43, Un. 4
Maximum No. Burial Spacea.. ... ........ "naris E. Graeme
Monument permitted..................... .9.5 6 Benedic tine
interred: Sebastian, Fl.
. (Data above th111IAe for QtJ' JI.ecord 0Db')
NO.
. Richard M. Graeme
Lot 15 - 8/18/89
1-234-
Terr.
32958
mitD nf &rbastfan
<1trmrtrry
Ilrrll
1234"
NO.
THIS INDENTURE MADE TWI .....~!1:.J:l........... day 01 ...........A~gv..~~....................... A. D.. 18~9....
between the Clly 01 Sebaatlan, a mUDiclpal eorporatloll exlatins UDder the lawaol the State 01 Florid.. 8a Grantor and
Doris E. Graeme
.......................................................................................................................................
656 Benedictine Terr., Sebastian, Fl.
32958
.............................................. ...............,.............................. . ...........................................
Indian River Florida
01 the Count, of ............................................. aid State 01 .......................................................
u Grantee, WITNESSETH I 400 00
That the Grantor for and in consideration of the sum of $ .,.....:.................. to it in band paid, the receipt whereof is herewith ac-
knowledged, d~es by this instrument grant, barpiD. seD, release, convey and commn unto the Grantee .. . h~ k. heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River COUDty, Florida, to-wit:
14 &l;' 43 4
All of Lot(s) . . . . . .. ,BIock,........ ,UNIT ............. ,of Sebastian munic:ipsl cemetery as per Plat Number 1 thereof recorded in Plat
Book 2, at page 65 of the public records in the .omce of the Clerk of the Circuit Court of St. Lucie CoUDty of Florida; said land now lying and being
in Indian River COUDty, Florida. ..
To Have and to Hold the same forever; provided that said property shall be.usedlOlely and exclusively for the interment of the human dead and shaD
be used, kept and maintained at aU times in accordance with the ru1esand regulations.on:Unances and resolutions of the City of Sebastian, Florida, hereto.
fore, now and hmeafter adopted or provided for the govmunent and operation of said cemetery. The conditions, restrictions and requirements contained
in this instrument shaD 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 .ordinancesand the conditions of the deed of conveyance thereof then the title of such owner
in and to said property shaD terminate and the same shaD 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
atteJted by its City Clerk and its corporate seal to be hereto affixed, the day and year fust above written.
CITY OF SEBASTIAN, FLORIDA
Attest~41L 11JJ...Otl.~.~........ -"" "1-' City Clerk
B1 ....~.~.~.....:.....
Mqor
~~~.."":..~............
/9V. ·
:r"~~r.cr.~.~.......
STATE OF Fr..oRlDA
COUN'fY OF INDIAN RIVER
(QIitv $~al)
Y '1.:I"D'D'DnV I"'''D'D'''Y'DV ""-...... _ ...LI__
__17th
.1__. -M
August
.a.
89
I
I
I
I
F
I
I
/
I
I
I
1$...-\
^,
)0
c.
-
=s-
o
~
N
CD
Q.
!i
,^
;J
"
~.
,~
~
z 0 0-
III a III
3 CD iD
CD a a
0
.,... OJ ~
"TI c: III
C ::2. ~
;:, !!!. ~
CD
i 0
c:
-
::t
0
3
CD
-i
3'
CD
),,)
'j
~
~
.....
'-- -'-- ----- ------- ---..-.---
r- OJ c:: Z <.
S; . g:.o"".""i"""'""", I,.:;.
~ "CD
"-... ~
'--"\. LA:
.,
(,
" ....
.~
::-t
"':.
......
......
'>
.~
....,.,
(:\
(?)
~
'Di.~"~
Ot.l'l\l1.rMLNl Ill' lil,"\1.111 1\.","0
IU::tl^hll..tTAi'iYt_ st:.HYICES
" ,STATE OF FLORIDA.
.' "EPARJMENT Of HEALTH & REHABILI E SERVICES
VITAL STATISTICS
APPLICATION FOR BlJRIAL- TRANSIT PERMIT
/../
/j '13
vi
A.
1. Name of
Deceased
(Type or Print)
First
RICHARD
Middle
MCCARTY
Last
DATE Month Day Year
OF
DEATH AUGUST 16, 1989
GRAEME
2. Place of Death
County
City, Town or LOCation
Name of (If neither, give street address)
Hosp. or
BREVARD MELBOURNE Inst. HOLMES REGIONAL MEDICAL CENTER
3. Name of Medical [JPhysician Address 725-4500 Phone Number
Certifier ROBERT C. UFFERMAN,M.D. 0 Medical Examiner 200 E. SHERIDAN ROAD, MELBOURNE, FLORIDA
4. Funeral Home/ ' Name " ." " , ,"" Address Phone Number (Area Code)
~r STRUNK FUNERAL HOME)623~. CElfTRALAVE. SEBASTIAN, FLA. 407-589-1000
5. Check a 0 The me,dical certification has been completed and signed. A completed certificate of death accompanies
Appro- this application:, ",
~~:te b KI ',' BARBARA was contacted on 8/16/89 within 72
hours after death. He/she verified that this death was from natural causes, that there was no accident nor
other external,cause.ofdeath, a",cl'lhat DR. ROBERT C. UFFERMAN. M.D. will complete
"and signthemedi~l,certification'pH:ause of death. ,,, ,',c, ." ' ;'
c 0
medical certification.
was contacted on, ' . He/she verified that
, Medical Examiner, will c~mplete and sign the
6. Funeral Director/
Direet D:...~o...er-
r
Fla. Lic. No./Res_ NQ..
#1672
Date Signed
8/16/89
B.
BURIAL-TRANSIT PERMIT
Permit No. 1228-89-373
Permission is hereby granted to dispose of this body.
o A five day extension of tim", for' filing the death, certificate (exclusive of. weekends) has been requested and granted as undue hardship
would result from filing within the normartime limit. If th(;! certificate cannot be,filed within this extended time limit, a "Funeral Director/Direct
Disposer Report" will be filed with the Local Registrar of the County in' which death occurred.
o No extension of time for fir the death certificate requested. . I
Registrar or
Subregistrar Signature
tJ
Date
Issued:
8/16/89
Date Certificate
Due:
C.
J'
AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT -SEA
Signature , Medical Examiner Date
or
Medical Examiner, , !lave authorization by telephone to
, , ' "" ", '... fUl)itral [)irectqrlDirect PisDoser., p.a~e ,
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. ' . .,
D.
CEMETERY OR CREMATORY
Method of Disposition:
fi BURIAL 0 STORAGE
o CREMATION 0 OTHER (Specify)
Signa,"," of Sexton I .t::.. ~ ~ ~
or Person-in-Charge ) , ~ ., .. . .
Place of Disposition
Date of Disposition
SEBASTIAN CEMETERY
AUGUST 18. 1989
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)
I