HomeMy WebLinkAbout4-43-34
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Paid by CEMETERY Receipt No.... ........ . Dated. ..... .~9l ~9/ ~.~........
, 400.00
Ust Price S .. .. . ... .. . .. .. .. .
Net Paid S .. ..40.0...0.0.....
Willard D. Congdon
interred 10/28/89
Lot 34
Blk.43,Un.4
Mutmum No. Burial Spaces................. Mary Congdon. 1 ? 4 5
Monument permitted..................... ..617 N. Seagull Circle
Barefoot Bay, Fl. 32976
NO.
(Data aboye dd. line ior Cll7 Reeord only)
Cltttu nr l',hltJlttatt
Ittb
NO.
1245
Cttttlttttry
THIS INDENTURE MADB TIaIa
30th
October 89
day ot ............................................. A. D.. 1.......J
between the City 01 SebuUan, a lDulclpal corporation ezlatin. under the laws 01 the State 01 Florida, .s Grantor and
Mary Congdon
.... ......................................................................................... ..........................................
617 N. Seagull Circle, Barefoot Bay, Fl. 32976
. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. ............................................ .................. ~ . . . . . . . . . . . . .
. . . . . . . . . . . .
01 the Counl7 ~, ......... ..~n~J.~n. .~.t'r!H'.............. .n') State 01 ..... ..~~~~.~~~...........;........................
u Gr.ntee, WITNESSBTH I ,
That the Grantor for and In consideration of the lam of S .; .~~~. ~ ~.9..,.. ... ...... to it in hand paid, the receipt whereof Is herewith ao-
knowledged, does by this instrument pant, barpJia, leD, relesle, convey and confirm unto the Grantee. . . .~~~. hehs, legal representatlvei and a..
the following property situated In Sebastian, Indian River County, Florida, to-wit:
34 43 4 .. '. ct
AU of Lot(s) . . . . . .. , Block, . . . . . . .. , UNIT ............. , of Sebastian munidpal cemetery as per Plat Number 1 thereof recor ed in Plat
Book 2, at page 65 of the pubUc records in theomce of the Clerk of the Circult Court of St. Lude County of Florida; aid land now Iylq and bellll
Inlndlan River County, Florida.
To Have and to Hold the same forever; provided that laid property shan be used solely and exclusively for the interment of the human dead and shall
be uleCl, 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 the government and operation of said cemetery. The conditions, restrictions and requhements contained
In this instrument shan be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob-
lerve and comply with iueb rules, regulations, resolutions and .ordinances and the conditions of the deled of conveyance thereof then the title of such owner
in and to said property shall terminate and the .me shall revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of the first part has cauled this instrument to be executed in its name and on Its behalf by it. Mayor and
attested by its City Clerk and it. corporate leal to be hereto afOxed, the day and year first above written.
AtteshW~PJ....O~......
-" - /'_. C1l7 aerk
CITY OF SEBAsTIAN, FLORIDA
D, ~.4..~.:.....
M.,or
(~itV JIleld)
I'
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
I HEREBY CERTIFY. That on tbla ....3.0.th................y ot .........Q~f;..Q.1?~J::..:...............,~...........J ...~.~J
Richatd B. Votapka ,Kathryn M. O'Halloran
belore me peJ'lOnan, appeared...................... ~.. ~......................... . ....... and,.... .,..................................
re,lpt'etlvel, Mayor and City Clerk 01 the City 0; Sebastian, tl mUhlell181 eorflOratlon under the l.tVi of 'the' State 61 Florida to me known
to be the Individuals and olllan dekrlbed in and who neeuted the lor('~lnl eo.ve,ana to
.................... .."~~y.. ~Hn8.4~n............................ :....: ..';...:. .'.............;..................................
~~ . ~l;~h' ~;;~~~~. th;~~~~t~ 'ci~i~ . ~~t~~;i.'ed; ..;d '~i ~. O,~lt ae';::~l i~:b:;:~h:. e;:;~~~r:~~~~~~:h:':I;~::~t=
II the aet and dted 01 said eorporatlon. ' .
WITNBSS my slpature and oIl1clal teal at Seliiatlatl, !n th~ County 0; tndlan ttly~.. and St.te 0; Florida. t1.. ela, .nd ;tar
lut aloreaaid. -,' .
N~~~~~..............
. - Myeoiamluloa ezp.rei. .. Notary Pubbc, Stat. 0' norlda
...... My Commission Expires Dec. 10. 1992
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Paid by. CEMETERY Receipt No... :--_-. t....... Dated...... .~9/ '?9/ ~.~. ..... J;-;-;.
List Price $... .~9.9:P.~.....
Net Paid $ .. ..40.0...0.0.....
Willard D. Congdon
interred 10/28/89
Lot 34
Blk.43,Un.4
Maxbnum No. Burial Spaces... .............. Mary Congdon 1? 4 5
Monument permitted...................... .617 N. Seagull Circle
Barefoot Bay, Fl. 32976
NO.
(Data aboye thl. line for City Reeord OBI,)
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City of Sebastian
POST OFFICE BOX 780127 c S~BASTIAN. FLORIDA 32918
TELEPHONE (407) 589-5330
FAX 407-589-5570
November 3, 1989
Mrs. Mary Congdon
617 North Seagull Circle
Barefoot Bay, Florida 32976
Dear Mrs. Congdon:
Enclosed is Cemetery Deed No. 1245 for Lot(s) No. 34, Block 43,
Unit 4. If you wish to have this dead racorded, you may do S9 at
the office of tha Clerk of the Circuit Court, 2145 14th Avenue,
Vero Beach, Florida.
Also enclosed is a form - Return for Transfers of Interast in
Florida Real Property - which must ba filled out by you and
completed by the office of the Clerk of the Circuit Court.
We are enclosing two copies of Receipt No. 591 and ask that you
sign and return to us the copy marked with an "X" and retain the
other copy for your records. A stamped, self-addressed envelope
is provided for your convenience.
Very truly yours,
'f J~~ ~~j-, nv "J
Eli~;;;~;;~'"
Administrative Secretary
LR
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'l'HB SBBAS'l'IAN CBHB'l'BRY
City of Sebastian
Sebastian, Florida
RBCBIP'l' IS HBRBBY ACICNCMLBDGBD OF 'l'HB SUN OF:
!l-z>CJR JtvA/~Jte3' ~V)) 001100
-
AI:Uars ($ tf 00, 0 (;)
)
FROM:
~"A.lf
,
Co /Vcr- J)otV
6' 7 AI, S ~A-(; CJ '-'- C-l1{c L. e-
f>1)(f:.f"""ooT '&A--r p.t... ~J-~7'
, -
on this 3 I> 'II- day of d)e.-h/Jfi:!., ,1981' for the purchase of the following
described Cemetery Lot(s) upon t terms and conditions as stated herein:
, .
Description of Property:
Cemetery Lot(s)" 31f Block' '-13
Purchase Price: 7otJ( 1Iv""..Jl..e., cf 004ClO
Uni t#
1-
--
DOlla~s($ tfoo, 00 )
'l'erms and"conditions of sale:
This cont~act shall be binding upon both pa~ties, the selle~ and the pu~chase~, when
approved by the owner of the prope~tJJ above described.
I, or we, agree to purchase the above described prope~t!/ on the terms and co~di Hons
stated in the foregoing instrument:
x ~ (d~~
The City of Sebastian agrees to lIell the above mentioned prope~t!1 to the above named'
purchaser(s) on the terms and cOnditions stated in the above instrument. .
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stRUNK I=UNeltAl. itoMe i.4t.
1823 NoRTH Cl:Hf1:.1Ai. AvtNuE : ;;
seaASttAN. FL ~
841
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o Southeast Bank, N.A
I8AS1WI MNlING CINIII ,.-.
1Dt NOInI us. 1
.... /;;:::: ~~~~ ~" L. ~"'~..-"
{/ n'0008 It .lI'+ ':0 t, ~O~~ tt .0': .0'1 5 Q08 . ~. . . .. ..
.' '.~, ,. .'_ ,y' ""',, "','" ,",' ("<t- t.l ";"~'-';;''''r''' ",.>.,. .,. ,;0",/ ......... "'...... <1';..-.#'..,,#1', #....o!f!t"/l' A,ft 1'1' .,...., ...or.' ;;0 ~".#..of'...,':..
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DtiPARTMENT OF HEAUlt AND
RF.HABR.JTATM'! 5F.RVICF..5
.'. 'Ab"Th1EAaTl1~:Jl:(fijO' &g~~~~tIT.t '~~~JI!~ES
~"",l~ !t!V)r\/lfAtsT~fl:srIC!; ", I',.'
APPLltA ~'~~i ~~~t'Y~t~~;~Jn~.~.~lt PERMIT
'I. "
I- 3~
/3 /j3
tlj ,
A.
,. Name of
Deceased
(Type or Print)
First
, WILLARD ..~,
! ; ,
Middle
DAVID '.'
d I.' "'fi,'
laU ",' i,-, ..i, '., hN: t': DATE h Month Dav' Year
OF
I CONGDON 'i' bEArH OCTOBER 25. 1989
2. Place of Death City, Town or location
County
INDIAN RIVER SEBASTIAN
,jl Name of JIf neither, IIlve .treetlddress)
, l-icisp. or
Inst. HUMANA HOSPITAL.SEBASTIAN
3. Name of Medical 'I UPhvsicl6n Address' 407'"-7250.:.4500 ,Phone Number
Certifier PETER GILBERT. M.D. o Medical Examiner 200 E. .SHERIDAN ROAD. HELBOURtfE. FLA. 32958
4. Funeral Home/ Name Addrets Phone Number (Area Code)
~ STRUNK FUNERAL HOME' 1623 N.CmttRAL AVE., '~SEBASTiAN. FtAJ2958 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 a cHatS'll wascOntllcted on 10i26/89 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."'GI~BERT.....". ., ". .,,' will complete
and &igl'1 the IfIlJdld" ctttltleltlafi 6f eilutA bt 6114tfl;,,,m',,, 1,',1I ","'''dl , I "f'k' '''".' '. .
was contacted bn . He/she verified that
, Medical ~x8JTllh.t wilt complete and sign the
'!I.'''''
c 0
medical certification.
6. Funeral Director/
~r
f J' .
" ~ 11672':
'I It !
Date SlgniKt
10/26/89
Fla. lic. No./Reg. No.
B.
BURIAL-TRANSit PERMIT ,.
, ~ I ~ '. '. , ; -' ,4 .
,'.-,.:'p!
'..; ~ r.
~ei'n;'itNo.1228-89-483
Permission Is hereby gtllnted to dispose of this body. ,. 'I ,
o A five day extension of time for filing. the death certificate (exclusive of We&ketidS):h8s bMIi' reQul:iited and granted ~ tihdt.te hardShip
would resutt from filing within the I'1OI'ft1tll time limit. If the certifICate cannot be fl~ Within th~ i~ W limIt, a "Fliheral Oir9C:tor/Direct
Disposer Report" win be filed WIth N LOCal RedlStriiI' 6t N CoUnty 111 which death oc6t.itted. ., I -. , . . I.
: ' ".. .''-.. ~_ - .. ; I,: .. ' . 'II ,., H,- -'. . ;. h,., ! " , ,
o No extension ohime forfili the death certiflcatereques'd..". ;,. ' 11"1 . .
Registrar or 'baie . 10/26/89 . Data certlfii::at~
Subreglstrar Signature Issued: Due:
C.
AUT~OFUzAtlON for tREMAflb't t)1~l:ttloN o~ ~lJthAl-AT -SEA
,{';
.O!
Signature
or
Medical Examiner,
., I . .
, Medleal Examiner
bate
i J", /I'! O'vl'lUtff8flbfldlHW lelephdl18tci ' ,i ..,.. '. I "1.tUJ',H- I' ","'>1.'1.'\.'& ,
Funeral Director/Direct DisDOser. Date
The Medical Examiner's approval must be obtained before disposai by any of the above methods. A waiting period of 48 hours after
death is required for all cremations.(~n u" "~ ". ~ ~ 1;:" ~ '
D.
ceMefeftv 'offc,UEMA ToFty, .
,"
c,_ .,
": "I ,. ~ t
Method of Disposition:
iii BURIAL 0 STORAGE
o CREMATION 0 OTHER (Specify)
Signature of Sexton ) t/. J/ A_
or Person-in-Charge '-_,LJ ''I ~ / ~ 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 OCTOBER. 28. 1989
HRS Form 326, Oct 87 (Replaces May 86 edition which may be used)
(Stock Number: 5740-000-0326-2)
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