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Home My WebLink About4-43-33 , >ri};"~!':;"?F'\'>~'P"':rP'::"}~~,_ ,'-'- " - -:;-;~::~~~J:~'~f"lr"~'f'Y;'.""'~j,'i,' ~ Paid by CEMETERY Receipt No. ..?....... .Dated......A9.U!.t~~.......... Lot3433 4 BLK. j Un. UstPrice $. .200.. 00....... MaxJmumNo. Burial Spaces ... .1........... Sh C b aron om s Monument permitted...... .................P. O. Box 896 Roseland, Fl. NO. Net Paid $ . .2DU. 00....... Leslie D. Cook - INterred "/1181 1244 32957 (Data above tit.. Une lor Cl7 Reeord oaly) Qttty nf &,basttan <tt,m,t,ry I"b 1244 NO. THIS INDENTURE MADE ftIa 4th day 01 October A. D.. I'. .89., behnen the City 01 Sebutlan. a munlelpal eorporatlon exlatin, under the lawa 01 the State 01 Florid.. aa Grantor and Sharon Combs ....................................................................................................................................... P.O.Box 896, Roseland Fl. 32957 .... ......................................... ............................................ ... ......................................... 01 the County 01 .... Indian. .Riy.er.................... an'] State 01 .... ..:fJ~~ ~.~.~..................................... u Grantee, WITNESSETH I That the Grantor for and in eonsideration of the aum of $ .,..? R Q. '. 9.Q. . . . . . . . . . . . . to it in band paid, the receipt whereof is herewith a~ knowledged, does by this instrument pant, barpID, leU, releale, eonvey and eonfirm unto the Grantee . h ~.r. . .. heirs, Iepl repreSentatives and usigns the following property situated in Sebastian, Indian River County, Florida, to-wit: AU of Lot(s) . 33. .. ,Block,.. .43 .. ,UNIT .. {.. . . . . . . . .. ,of Sebastian municipal cemetery as per Plat Number 1 thereof reeorded in Plat Book 2, at page 6S of the pubHc reeords in theomce of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and beihg in indian River County, Florida. To Have and to Hold the same f;~re. ; provided that said property. shaD be usect solely and e.XClusivelY for the interment of the human dead and shaD be used, kept and maintained at aU time aceorc1ance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or pro for the ,ovemJnent and operation of said cemetery. The eonditions, restrictions and requirements eontaJnecl in this instrument shaD be eovenants with the land. In the event of the fallure of the owner of any property situated within said cemetery to ob- Ierve and eomply with inch rules, re,ulations, relOhations and .ordinances and the eonditions of the deled of eonveyance thereof then the title of auch owner in and to said property shaD terminate and the .me shaD revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has C1U1ed this Instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its eorporate leal to be hereto afOxed, the day and year first above written. Atteshq(~j.fn.'...Dd~ ' , , -- 'l' -, City aerk CITY OF SEBASTIAN, FLORIDA ~ I!: 1/ By................ ....... ....~..y.~I"L....... Mllfor Slgnl.'d, Sealed and Delivered ~4;:s...~.................. ~~.~.. (GIifV 'eaJ) STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on thla .....4tp...............day 01 ...........~.~.~~~.~.17.............................. 1..Ei9. bdore me personally appeared . ~;i;~.l,1.~~~. .J:l.~. .Y:<?~~p.~.~.......................... and ~~.~~:r:!.~.. ~... ..?.'.~~~.~~~~.~.. respectively Mayor and City Clerk 01 the City 01 Sebastian, a munlclllal corporation under the laws 01 thc State of Florida to me known to be the Individuals and officers described in and who executed the lor(>,oln, cORveyance to Sharon Combs .. ....................,....................................................................... .......................................... . . . . . . .. . .. .. . .. .. .. .. .. .. . .. .. .. . .. . .. . .. .. .. .. .. .. .... and severally IU!knowledged the execution thereol to be their free aet and deed as such officers thereunto duly authorl&ed. and that the Official seal of said corporation I. duly affixed thereto, and the said conveyance Is the act Bnd deed olaaJd corporation. WITNESS my algnature and oIficlal leal at Sebaatian, in the County 01 Indian River and State 01 Florid.. the day and year ,... .......... ' JA", ~ ~.?!.:..'E." ~................. Not..,. ~~~a at r...r.. My eommlulon explrellllotary PublIc, State of nortcra My Commission Expires Dee. 10, 1992 ~!~ !!!.!'OJ ~!IlA '.Io.tVIIIII$"~ .. . . 590 . 10/4/89 Lot33 Paid by CEMETERY Receipt No. . . . . . . . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 U 4 BLK . , n. List Price $. .2DQ.. 00....... Maximum No. Burial Spaces ....~........... Sh C b aron om s Net Paid $ . .2DU. 00....... Monument permitted.......................P. o. Box 896 Leslie D. Cook - Roseland, Fl. INterred t oI2l~?' :..e.. -- :f) ~,) .-, rf "'{ .... ~""~.:~CD ..~ """"~"..- ..... ."C.., ,.<.,. --> j!:' - . -. ~-""" .Je. U .2 '0 CD. ....1 'l<"'""" '" ,--; , .:!f;'!'t~':,~:!,0~~~ '5;: .'"" . . oa:, . " o "'--~' ..... " CD E j:: - e ~ 0 ii; CD ,g- ~ c: .. ';: ~ " ~ I.i.. 'C ~ m CD .... N '0 - 0 .;: 0 CD 0 CD CD E .s:::. - - - " ~". " ~ co z <( h ~<fi\?!':~t;r'~~"'f;~ " Ln 0'1 N C""l ..-t ..-t N r-I . t(.l ~ ~...or.. :E:O'I 000 .. t.) A ><z zo< O~...:l IX: .~ <000 := .0 OO~~ o z ~ ~ ~ ~ C""l ..-t..-tC""l C""l E-l. 1-t~E-l Z~O :::>~~ (Data above this Une for CJq Record oolf) 0'1 00 - 0'1 - o r-I '0 Q) I-l I-l Q) .j.J s:: 'r-! ..!:Ii: o o u . ~ Q) 'r-! r-I ro Q) ...:l NO. 1244 32957 i;:{,lli~~~4:i"Z'MNi,,~i; :i',::":TJ.ftU:l:j l~'ir;:;;~:,"~:~, ./."::,~".. . . . POST OFFICE BOX 780127 0 SEBASTIAN. FLORIDA 32978 TELEPHONE (407) 589-5330 FAX 407-589-5570 October 16, 1989 Mrs. Sharon Combs P. O. Box 896 Roseland, Florida 32957 Dear Mrs. Combs: Enclosed is Cemetery Deed No. 1244 for Lot(s) No. 33, 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 completed by the office of the Clerk of the Circuit Court. Very truly yours, -~ f)~ Elizabeth Reid Administrative fecretary If LR Ene. Jgr:-r.~ .,.,."""",,~,--!~:':;\:J.' -". "",:. ~_~___):>'::S' ;'--Sf.'!~_.......____ --~-'- .' . 1. 5""90 . ... . 'l'IIB SBIJAS'I'IAN. CBHBrBRF CJ.tf/ fjfSebastJ.an SebasUM; 1'1orJ.dll RECBIP'l' IS HBRBSF AClCNOIILBDGBD 01' !'HB SUN OFt ~ U, JA/:b? e." A-A/7) 06 /ttJO - 11011ars ($ ~o, 0-0 ) FROII: 5/+AJ? OA/ CO",? e.> f,o" eo)(..' 8 91. R D .s t; Lt1-# ":J P '- . 32-1 ;-7 , on thJ; "It-- cia, oE III c.. '" '~' : uti, tor the purchase oE the Eoll""Jng descrJ.bed Cemetery Lot(s) upon t tenns and condJ.tJ.ons as stated hereJ.n: ./ DescrJ.pUon of Property: Cemetery Lot(s)"" .11 Block' Lf..3 UnJ.t' t/- Purchase prJ.ce:~ f.l.l.......,L .J. tJ ~o/IOO - bollars($ ")..c:>o. 00) !'enns and' condJ.t1ons of sale: 'l'his contract shall be b1nd1ng upon both part1es, the seller and the purchaser, when approved by the oimer of ~heproperty above descrJ.bed. I I, or we, agree to purchase the above descrJ.bed property on the terms and condJ.t1ons stated in the foregoJ.ng .instrument, 4A~~~ ... The City of SebastJ.an agrees to seil the .bove mentJ.onecf property to the above hamed' purchaser(s) on the terms and cond1t1ons stated in the above 1nstrument. ,~,,-'<1L1\~< cJ.ty 0 Se stian . ~~~ fiJ.tness . . 'a;:"'~5;:;;;'f.:'4\:hj 1m bEPARTMF.NT OF HEALTH ANO REHARlUTATIVE SF.RVICF-5 , STATE OF FLORIDA. .EPARTMENT OF HEALTH & REHABI LI VE SERVICES VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT J. 3:3 /3 7'3 11'1 A. 1. Name of Deceased (Type or Print) First LESLIE Middle DUPUY Last COOK DATE ' Month Day Year OF DEATH OCTOBER 4; 1989 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or INDIAN RIVER VERO BEACH Inst. INDIAN RIVER MEMORIAL HOSPITAL 3. Name of Medical CD Physician Address Phone Number Certifier ARTHUR GLASER, MD. 0 Medical Examiner 2300-5TH AVE. VERO BEACH, FLA 567-7111 4. Funeral Homel Name Address Phone Number (Area Code) ~r STRUNK FUNERAL HOME 1623 N. CENTRAL AVE. SEBASTIAN. FLORIDA 32958 407-589-1000 5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. ~~:te b IXk MARGE was contacted oriO/4/89 within 72 hours after death. He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that '" DR. GT.A~F.R 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/ .Oirect Pj,~v~", Fla. Lie. No./~~ ~Io.. 111672 Date Signed 10/4/89 B. BURIAL-TRANSIT PERMIT Permit No. 1228-89-461 Permission is hereby granted to dispose of this body. o A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship would result from filing within the normal time limit. If the 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 fil' the death certificate requested. Registrar or Subregistrar Signature Date Issued: 10/4/89 Date Certificate Due: C. AUTHORIZATION for CREMATION, DISSECTioN or BURIAL-AT-SEA Signature or Medical Examiner, ,Medical Examiner Date . , galle authotizatio~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.' '" D. CEMEtERY OR CREMATORY Method of Disposition: IQJ BURIAL 0 STORAGE o CREMATION 0 OTHER (Specify) Signature of Sexton ) / . y / or Person-in-Charge) /1 ~ J' / A' 0( ~ 7-( . 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. Place of Disposition SEBASTIAN CEMETERY Date of Disposition HRS Form 326, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2) -s,