HomeMy WebLinkAbout4-43-351
~~ ` 11/9/89 i~~s 35 & 36
` Paid by CEMETERY Receipt No.....~. ~ ..Dated ........................ .
. 4 3 , Un . 4 No.
List Price S ... $ 3 2 5,, 0 ~... Maximum No. Burial Spaces .. ~ ............. .
NetPaidS .. ,. Mrs.Au uSte W81ter ~~~
• -~` 6b Q r 40• • Monument permitted ..................... g
~P.O.Box 2167
Julius Walter interred Lot 36 11/9/89 Vero Beach, Fl. 32960
(Data stave ffiIs line for City Record only)
f~i#~ ~rf ~p.btt,~#ittn
~Y ~ ~ ~ i ~ ~ ~ ~ ~ ~ ~ NO. ~ ~ J V
THIS INDENTURE MADE Title , .9.th........... day or .......... ,November A. D 19..89
~ .t
betHeen lire City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
Mrs. Auguste Walter (Residing at: 2450 53rd Ave.
..~.: b :" ~t~X "276 7 ...........................................Ve'ro' 'B'each;.. FS :....329'60............
................. Vero. Beach.,..F1.~...32,960.............................................................................
or .the Coant of ........ .Indian River Florida
y .............................. anal State ot .......................................................
w Grantee, WITNESSETHs
That the Grantor for and in consideration of the sum of S .. 6 5 Q r.Q~ .............. to it in hand paid, the receipt whereof is herewith so-
knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ,her, , , heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
All of Lot(s) 3~ ..bt 3 6Blork, ...4..3 , , ,UNIT . , , ,4. , , , , , , , , of Sebastian muni«pal cemetery as per Plat Number 1 thereof recorded in Plat
Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being
in Indian River County, Florida.
To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall
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 the government and operation of said cemetery. The conditions, restrictions 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, resohttlons 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 shall revert to the Clty of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of the first part has caused this lnstrtsment to be executed in its name and on its behalf by its Mayor and
attested by its City Clerk and its wrporate seal to be hereto affixed, the day and year first above written.
CITY OF SET3ASTIAN, FLORIDA
Attest:~ --f'IC~L/~:1 ... ~ o! :. t~ : ~~44~-G`.".t'~ ............ .
City Clerk
Signed, Scaled acrd Delivered
In the Pres of s ~ ~•-r '
r
. .
By ... .............. ~. ~~.............
Mayor
(Qlitq d$elsl)
STATE OF FT.ORIDA
COCTNTY OF INDIAN RIVER
I HEItEI3Y CERTIFY, Thst on this ..~~. th ............... .day nt .........November............................, 1989..
before me personally appeared R~.Ck1.8X't~..$....V.O.tRp~C~ ........................... and Ka.Ck1JCy.I1.. Me...O.~ ~~~.~QX:$~..
respectively Mayor anti City Clerk of the City of Sebastian, a municiial corporation under the laws of the State of Florida to me known
to be the individuals surd officers described in and who executed the foregoing conveyance to
..............Mrs. Auguste Walter.......................................................................................
•.••.•...•......• ....................................... and severally acknowledged the execution thereof to bt their free act and deed
as such officers tlsereunto duly authorised; sad that the Official seal of said corporation is duly affixed thereto, and the said conveyance
is the act and deed of said eorporatlon.
WITNESS my signature and official teal at Sebastian, In the County of Isrdian River end State of Florida, the day end year
lest aforesaid.
otary Public, S to of Florida at Large.
My commission expiren Notary Public, Sfofe of Ffot'~da
Mp Crr~:~issirn Expires Cae. 10, i99~
aond~d rhea rroy roin - Inwrana Iny
UNIT 4
BLK. 43
Lots 35 & 36
DEED ~~1250 Mrs.Auguste Walter
2450 53rd Ave.
Vero Beach_
Mailing Add: P.O.Box 2167
Vero Bch, 32960
Julius Walter interred Lot 36 11/9/89
Paid by CEMETERY Receipt No.... 5 9 8 • • . • • • • 11 / 9 / 8 9 Lots 3 5 & 3 6
. Dated ............:. .
List PriceS...$325.00 """""""' B1k.43,Un.4 No.•
............. Maximum No. Burial Spaces .. 1. , , , , , , , , ....
Net Paid S ... $ 6 S Q , 40• • • • Monument permitted , , , , , , . , • . • • ..... Mrs.. Auguste Wa 1 t e ~ ~; `
Julius Walter interred Lot 36 11/9/89 P.O.Box 2167
Vero Beach, Fl. 32960
.(Data above ffiie line for Cdty Record only)
` ~ .~ • •
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City of Sebastian
POST OFFICE BOX 780127 o SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330
FAX 407-589-5570
December 13, 1989
Mrs. Auguste Walter
P. O. Box 2167
Vero Beach, Florida 32960
Dear Mrs. Walter:
Enclosed is Cemetery Deed No. 1250 for Lots No. 35 and 36,
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.
We are enclosing two copies of Receipt No. 598 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,
'1
Eliza th Reid
Administrative Secretary
LR
Enc.
.~
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TIlE SEBASTIAN CEMETERY
City of Sebastian
3ebastlan, Florida
RECEIPT IS f1EREBY ACXNOWLEDGBD OF THE SUM OFs
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s~i ~ 1~~.~.~~ ~ ~~ r-r, y ,~-~-.~ ~a
~~$
rs S o, a v )
FROM: ~7~ .)~ • ~~ (r U s r E t~A L % ~ L fZ
on this `~~day of d U F t G' , :19 "' for the purchase of the following
described Cemetery Lot(s) upon t termer and condit.ions as stated herefn:
Description of Property:
Cemetery Lot (s) N_ 3~,5 ~3~ B1ockN ~7 Unf tN `7"
Purchase Pr~ce:~~~c.c. ~ G ,rte, Dol2ars(S 6 i~ . ~~ )
Terms and'cotjd~t~ons of sale:
This contract shall be b~nd~ng upon both partfes, 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 rind conditions
stated fn the foregoing .instrument:
x~ti~i~.
The City of Sebastian agrees to sell the above mentioned property to the above named
purchaser(s) on the terms and conditions stated ~n the above instrument.
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City of Sebastian
POST OFFICE BOX 780127 o SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330 a FAX (407) 589-5570
STATE OF FLORIDA )
COUNTY OF INDIAN RIVER )
CITY OF SEBASTIAN
I, Sally A. Maio, Deputy City Clerk of the City of Sebastian,
Florida, do hereby certify that the attached are true and
correct copies of Sebastian Cemetery Deed #1250 in the name of
Mrs. Auguste Walter, letter from City of Sebastian to Mrs.
Auguste Walter dated 12/13/89, Cemetery receipt #598, and check
#864 from Strunk Funeral Home.
IN WITNESS WHEREOF, I hereunto set my hand and affix the Seal of
the City of Sebastian, Florida, this 24th day of September, A.D.,
1991.
c~ ~.1 ~2 ~~..
Sally A. Maio
Deputy City Clerk
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Date of Ma[k-out~~~ ~~
,~ i~ c^~ - Time 1(/ ,scat? l~''"~ 7 t ~.,
Date of Buriaf
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Name of Funeral Home
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Authorized by ~ '¢'f/~ ~ ~ ~
11305 21 C ~ Bran[hpay®1-(800)444.6899 Arrottler eaMCe of Oelco Informetbn NetworK, Irlc. torso rravne, mrv ~ ~.~~......
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Florida Memorial Funeral Home'(4467) 01! ~ 6 6 ®6 3 5 8 ?
P O Box 1776 Gelco Check Number 116 6 0 6 3 5 ' ~ J
COCOA FL 329231776 ~~_' ustRlD ~ IssuED`a~ ~;','i
~wrighten1/12/2007 ~~
NOT VALID AFTER SIR (S) MONTHS FROM 15SUE DATE
PAY TO THE
~ oROEROP City. of Sebastian. ~ ~~r^I"
~ 1921 N. Central Ave. ~'~~`°~
`Sebastian FL -'-32958-
Seventy Five Dollars And No Cents******************************************* $***75.00 ("
NOT VALID FOR-0VER 55,000 NOT REDEEMABLE FOR CASH BV DRAWER'S AUTHORIZED REPRESENTATIVE ~'r^
~.~
SIpNATURE OF DRAWERS AUTHORIZED REPRESENTATIVE
i'J~
PAYABLE THROUGH Er1C DanlelS ;'~
FI-6t PREMIER Bank ~ 9~ 8y ~yq Wa IIISUUrlen6 Ure canAmre that tNs F~sWlnent has 4ean drawn In accwdence wish the authairy beued M (moo Infolmellal Network, Inc. tl nny ~ `
SIOUX FALLS, SD s(atemenf helek~ be ulAnle, wee the a , agree ro pay Iha drexer Igarl delnahd the ernomt d ihls InsWment end ell expenses entl demepesarWlg hom auctr mlestetemenL ~ '~
ii'0 L ~ 6 60 6 3 S~ii' ~:0 9 L 408 58 5~: 2 500000 6 5 5ii'
$,~,I~ Eric Daniels USER ID wrighten
1660635
DESCRIPTION
City of Sebastian
1921 N. Central Ave.
Sebastian FL 32958
DATE LOCATION NUMBER OL CODES CONTRACT NUMBER NAME /DESCRIPTION AMOUNT
1/12/200 4467 8405-0 446701000412 Walter/Cemetery $********75.00
FLORID DEPARTME f OF
HEALT
A. (TYPE)
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
1. Name of First Middle Cast Date Month Day Year
Deceased of
Auguste Walter Death January 12,-2007
2. Place of Death City, Town or location Name of (If neither, give street address)
County Brevard West Melbourne Hosp. or Indian River Center
Inst.
3. Name of Medical John J. Potomski, DO Address 720 E. New Haven Ave. , ~~11 Phone Number
Certifier West Melbourne, FL 32901 321-724-4545
Medical Examiner x Physirtian
4. Name of Funeral Home/Dired Disposal Address Fla. iic. No./Reg. No. Phone No. (Area Code)
Establishment 5950 S. Hwy.l
lorida Memorial Funeral Home Rockled a FL 2 5 1 2
5. Check a. ~ The medical certfication has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. Qx Lynn .was con#aded on 1 / 12 / 2007
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that John J. Potomski, DO will complete and sgn the medical
certification of cause of death within 72 hours.
c. ~ was contacted on
medical certification of cause of death within 72 hours.
6. Funeral Director/ Signature k F.E. No./Reg. No. Date Signed
Direct Disposer ~Q,L,~,R / ~ FED ~ ~ o ~- /a. ' p ']
B. BURIAL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. .Permit Na 1332-6665
A five (5) day extension of time for filing the death oertificate (exclusive of weekends) has been requested and granted since the physician has
been ~ntaded by the funeral director and will not be able to complete the medical osrtification of cause-of~Jeath section of the death certificate within
72 hours.
~No extension of time for the deaf cEtfCtficate has been requested.
Reg'IStrar or Date /~ _ ~ ~ Date Certificate
Subregistrer Signature Issued: _ Due:
C. AUTHORIZATION for CREMI4TION, DISSECTION, or BURIAL AT-SEA
Approval Number. Date
Medical Examiner, ,gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiners approval must be obtained before disposal by any of the above methods. Awaiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY ~„
Method of Disposition: Place of Disposition ,~ ,~ .
URIAC STORAGE Date of Disposition j~j (a /p~
CREMATION OTHER (Spet~fy)
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.
Distribution: White: Cemetery or Crematory
DH 326, 8/97 (Obsobtea all prevaus ediUona) Yelbw: Funxal Director a Direct Disposer ~y `~ ~
(Stock Number. 5740.000-0326-2) Pirdc: Loeal Registrar
He/she verified that
Medical Examiner, will complete and sign the