HomeMy WebLinkAbout4-43-39
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NO.
(>1858
THIS INDENTURE MADE TIIlI . ~ ?~.~....... " ".., day 01 ....... AV.Gq~'t........................... A. D..JlJ. ~).) @
between the City 01 Sebutlan, a municipal corporation exlltln, undcr the lawI 01 the State 01 Florida, al Grantor and
CLEO WOODWARD
. . . , . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . p ~ '(J" ~ . . B()'X' . 9 z' 2' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
............................................. SE.BASTI!N,.. .FL QRIDA. .3.2.9.5. 7... ."..............................;..........
01 the County of ... ..INDIAN.. RIY.ER................... an'J State of .... .Fl ORI.DA.................... ..................
u Grantee, WITNESSETH.
That the Grantor for and in consideration of the sum of S ...7. QQ .-. O.Q . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bugaiD, seD, release, convey and confirm unto the Grantee ... . . . . .. heirs. legal representatives and uslgns
the following property situated in Sebastian,lndian River County, Florida, to-wit:
All of Lot(s) . . ~ 9. .. ,Block,.. 4 ~ . .. ,UNIT .~........... ,of Sebastian municipal 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, resolutions and ,ordinances and the conditions of the de'ed of conveyance thereof then the title of such owner
, ,
in and to said property shall terminate and the same shall 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.
CITY OF SEBASTIAN, FLORIDA
Attest:
/7 f71 '
.U":..............................
City Clerk
B, .\u.~.W..~..........~.....
Mayor
(CIlitv ~eal)
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
I HEU.EBY CERTIFY, That on this ..... ..?.?.~h......... .day of .......... A~g\l.fiI.t;... .......................... .,x1t..2.Q02
"
before me personally appeared.....;... W~J.~~~. Yr-.. .~.~.:r;n~~....................,. and .S.~lly.. A... ..M~iQ...............
respectively Mayor and City Clerk of the City of Sebaltlln, a municipal corporation under the lawI of tbe State of Florida to me known
to be the Indlviduall Ilnd ofllcers deserlbed In and who exeeutl-d the fOfegolng cORveyanee to
Cleo Woodward
............................................... ...... ......................................... .........................................
. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . : . . .. .. . .. . .. .. . . . . . . . . .. and severally acknowledged the execution thereof to be their free aet and deed
IS such officers thereunto duly authorized; and that the Official seal of '-said corporation Is duly affixed thereto, and the said conveyanee
Is the aet and deed 01 said corporation.
WITNESS my signature and offlelal ae.J at Sebastian, In the County of Indian River and State of Florida, the day and ,ear
last aforesaid. /
(I): ., MY~~~ flI.... ....8(~~.. ' . ..................
. EXPIRES: April 30, 2006 No Public, State of Florida at LarF.
II Ilcr1dIdlhruNalllyPldcIblBnwtln M mmlulon expires.
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....
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3,{~.
Name
w ~ I iJ.. ~ AI'")
BloCk
1
13
. C;
J ...
Unit
Lot
fj!'A"A .IO.'~
Date of Mark-out
Date of Burial 6/:;''5'/0 ?/'
Sr/JUd Ie.
. Name of Funeral.Home - -
:A~';;~' .iil~i1JihA~
I \ ,'.
Time
;? / D D /0 .
.
__J.._ -- i";i';~\L~:________;...~.______.___~~~~_~~_,,_____._,_.~~___.':-~,-,-,-,--,____c.._~'_._;,-.,'___~ ~ --- .---- - ----
Ct
CLEO WOODWARD
Paid by CEMETERY Receipt No.... .Q9.9A...... Dated.......& /.~ 7.L ~9.Q7..........
List Price $...... .?~Q... 9.Q.. Maximum No. Burial Spaces.................
Net Paid $ ...... .'ZQQ... 9.Q.. Monument permitted.......................
NO.
f!1858
LOT 39. BLOCK 41. TTNT1' b.
HOME OF PELICAN ISlAND
August 29, 2002
Cleo Woodward
P.O. Box 922
Sebastian, Florida 32957
Dear Ms. Woodward:
Enclosed is City of Sebastian Deed number 1858 for Cemetery lot 39, Block 43, Unit 4. Also
enclosed is a copy of your receipt.
If you have any questions, please contact our office.
.~.~-
SAM:js
enclosure
E:j
Goldman Sachs Funds
(liE () j(J &;,oUfIf.(l /:J
/ ,-,:,10. J3tJ)( 9'cJ~ ~
~/1 8cJ~7 rf' ~{r
/ \~\~\
U4 /343 L3c;
7 tv',1J6
1 (800) 292-4726
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The Sebastian Cemetery
City of Sebastian, Florida
JV. ;f ~~
Receipt is acknowledged in th~ sum of:
d4&A - r%A(~/~
(! Ace> lVt3o.D ttJ';J"e ~
/l1. J3tJ)( '7dd..
-5 ~J3 d-.5-71 A A,} I F;t. c ~ /XJ /l- 3r:;;21..6- 7
on this .!l zt;t day of ~.I;C ,20 tJ,J for the purchase of the following
described Cemetery Lot(s)/Ni (s) upon the terms and conditions as stated herein:
Dollars ($ 7 d-tJ ' tl'"tJ
)
From:
Description of Property:
Cemetery Lot(s)/Niche(s) .31 Block '13 Unit /(.
Purchase Price: cy:;, //.e" J Cl-'~!t.. ~j Dollars ($ 7 hf, t1 tJ
Terms and Condition 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:
Purchaser signature
Purchaser signature
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.
/)- L
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{---City of Sebastian
V'
Witness
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CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
0964
Name
o Cash
~Checkt :.25/7
AmountPald
Date
~/27/0J..
001001 208001 Sales Tax
001501322900 Garage Sales
001501 341920 CopieslBid Specs.
001501 341910 LDClCode of Orcinances
001501362100 Community Center Rent
001501 362100 Yacht Club Rent
001501 362150 Non Taxable Rent
001501343800 Cemetery Lots
601010343800 Cemetery Lois 700, DO
LolINiche .. ~9 . Block '13 Unit~
001501369400 Interment Fee
001501369400 Weekend SeMce
680800 220681 Yacht Club Security Deposit
680800 220682 Community Center Security Deposit
680800 220683 Riverview Park Security Deposit
,go) T.......
Initials
Whitl- Dept. of Origin. YIII_ - Fl.... . Pink. Applicant
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o DILUXI ...
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001501 341920
001501341910
001501 362100
001501 362100
001501 362150
001501 343800
601010 343800
001501369400
001501369400
680800 220681
680800 22lI682
68Olioo ~.,
t.~
Garage Sales
c~Specs.
LDClCode of Qrdnances
Community Center Rent
Yacht Cloo Rent
Non Taxable Rent
Cemetery Lots
Cemetery Lots
Lot/Niche
. Block
Unit_
Interment Fee -
Weekend Service
Yacht Cloo Security Deposit
Community Center Security Deposit
, ~iVeMeWM:~1y Deposit
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'Total'Plkf'75?~ . ',~
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Name
Date
001001 208llO1
001501 322900
001501341920
001501 341910
001501 362100
001501 362100
001501362150
001501 343800
601010 343800
. 001501 369400
001501369400
680800 220681
680800 220682
680800 220683
/
J
crrv OF SEBASTIAN
crrv CLERK'S OFFICE
RECEIPT
0961
~~
AmountPald
Sales Tax
Garage Sales
CopieslBid Specs.
LDClCode of Ordinances
Community Center Rent
Yacht Club Rent
Non Taxable Rent
Cemetery Lots
Cemetery Lots
LotINiche
, Block
,Unit_
Interment Fee _
Weekend Service
Yacht Club Security Deposit
Community Center Security Deposit
Riverview Park Security Deposit
c;hfI!N($' ".CI~".:vc;,.
('(v/df1LJ{;~'"
tl7S'~
Total Paid 25:n
,
Initials
White - Dept. Df Origin. Y IIlew - Fi.._ . Pink. Applicant
f_p_37
.. ...-i':7r:"';~~~~;i~~':;.?'~i;:;.. _,;~::/~:":",,,';_"C,<
tAL{ B 43 L 3q
FLORIDA DEPARTMENT OF
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
A.
1. Name of
Deceased
(TYPE)
First
Middle
Last
Month
Day
Year
Melbourne
Date
of
Woodward Death
Name of (If neither, give street address)
Hosp. or
Inst.
Aug.
21
2002
2. Place of Death
County
Brevard
3. Name of Medical
Certifier Peter Marzano, M.D.
Medical Examiner Physician
4. Name of Funeral Home/Oire81 Bial'aaal' Address
Establishment 1623 N. Central Avenue
Strunk Funeral Home Sebastian, FL 1228 772-589-1000
5. Check a. D The medical certificatiQn has been comple~ed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
William Howard
City, Town or Location
290 Michigan Avenue
Melbourne, FL
Holmes R ional Medical Center
Phone Number
Address
321-727-0911
Fla. Lic. No.lReg. No. Phone No. (Area Code)
b. ~
Barbara was contacted on 8/21/02
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Marzano will complete and sign the medical
certification of cause of death within 72 hours.
c. D
was contacted on
He/she verified that
, Medical Examiner, will complete and sign the
DiNl;t Dilp~eer
f death within 72 hours.
F.E. No.lReg. No.
62
Date Signed
8/21/02
6. Funeral Director/
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-02-0352
o A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within
72 hours.
ONO extension of time for filing the death certificate has been requested.
~l1illtllllr QL.."
Subregistrar Signature
Date
8/21/02
Date Certificate
Due: 8/26/02
Issued:
C.
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT -SEA
Approval Number:
Date
Medical Examiner, , gave authorization 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.
tethod of Disposition:
I!lBURIAL DSTORAGE
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
Date of Disposition
s; /.?t ::s/O~
.
DCREMATION
Signature of Sexton
or Person-in-Charge
DOTHER (Specify)
} /yj 9'f'~')1'
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.
DH 326, 8/97 (Obsolete. en previous edftions)
(Stock Number: 5740-000-0326-2)
DisIrlbution: IMlfte: Cemetely or Crematory
Yellow: FU'18l'III Director or Direct DilpDHr
Pink: Local Regi8lm