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Home My WebLink About4-42-08 /Paid by CEMETERY Receipt ~o.. .5............. .Dated. .~.~t.~9/~?.............:. Lots 7 & 8 List Price $ .~9.Q...QQ........ Maximum No. Burial Spaces.. ............. ~lk. 42, Un. 4 Net Paid $ .~9.q :.9~........ NO. 1)IiQ "'~<') Monumentpermitted....................... Raymond J. Sloman Marguerite E. Sloman 914 Red Bud Road (Data above thlaUne lor Clt, Record only) Barefoot Bay, FL 32976 atitu af &rbastian <ttrmrtrry mrrb 1248 NO. THIS INDENTURE MADE 'I1ala ...f.Q.t;h............ day 01 Nav.ember............................... A. D.. 188.9.... betwern the City of Sebllltlan, a municipal corporation existing under the laws of the State 01 Florida, as Grantor and ........................................... ..~.~Y1ll9.I:1.4..J:!.. .~;L9.f!1.~P.. .l;l.I:1.4. .Ml;l.~g~~+.tt;~. .~.~. .~:J..<?ro.~n......... ...... 914 Red Bud Road . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'B'ar e f o'o't . 'B'a y'; . 'FL' . 32'976 . . . . " ............................................ 01 the County 01 ... :f3x.~Y:~+.4.. .. .. .. . .. . .. .. .. .. . .. .. . .... an:l State 01 .. .~J q +.i.4~. .. .. .. .. .. .. . .. .. . .. .. . .. .. .. .. .. .. . . .. u Grantee, WITNESSETH I That the Grantor for and in consideration of the sum of $8.~~: .Q9. . .. . . ... . . . . . . .. . to it in band paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargatD, seU, release, convey and confirm unto the Grantee t.4~. ~ J:.. heirs, legal representatives and assigns the foUowing property sit~ed in Sebastian, Indian River County, Florida, to-wit: Ii!"; AU of Lot(s) ?. ~.1;~., Blocle, . A? . .. ,UNIT .4........... ,of Sebastian municipal cemetery as per Plat Number I thereof recorded In Plat Book 2, at page 65 if the pubHc records in the office of the Clerk of the Circuit Court of S1. 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 shaU be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at aU 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 iuch 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 first above written. CITY OF SEDABTIAN, FLORIDA <- ~ -~- .Y)/ "'-t,//,1. .I ~ Attest I t:f:ki~"y. J.//.. .L:". .f.'.l~~.... <./ City Clerk B, .~/{~......... Ma,or Signed, Sealed and Delivered In th~re&ence ofl ~' . 'I )1/ - . . . . .14; II.. . It!.b.............. .geh)1(\J.~.......... . I STATE OF FLORIDA , (GIitll ~taJ) r-~ ," 'A_(-\::!!:?~~'~:-Af~~JE.Bt~"-::r.-;~j;,,,; " .~ ....." ^\. "- (" '., :... () 'X V .CD E j:: :< ....;1:..... '\' :; 0 ~' ii .. .. ;: &II -<. ~ ::J m lD ~ '0 '0 -5" :- g CD CD &II -'I: ''S iii - z j iii &II ..J 0 C 00 .~ 1("1 ..-I =:::: \0 . ....... r:q ~ ("I .r:q C"1 IJE-4 H'd~ t::l~as~ Zr:q 0 o :;:J ~ .. ::E: ~ >. ~~'d as <<::SlXl ~::E:lXl ~ .. "'d 0 ~ZaJO i1;j~iti OO..;t .... ~~r-4 as l:f.ll:f.l~lXl ~ ~ \ "- . ~ ~ ~ r:q r:q ~ ~ - _"I 00 ~ ("I ..;t ..;r..-.. E-4 .C1.l I-l::.:::~ Z~O :;:JlXl~ - " ;y- ~, ~.~.~--:..~~"'" " -' 1 Paid by CEMETERY Receipt No. .. ~.9f>......... . Dated. .~ ~.!.~9.( ~?................ Lots 7 & 8 NO. . 800 00 .' Blk.42,Un.4 Ust Pnee S . . .. . .... .. . .. .. . . . Maximum No. Burial Spaces. . . .. . .. . .. .. . .. . 1 'I 4 0 Not P,;d S !!9.<! ...9R........ ........................................... Raymond J. Sloman" 6 Marguerite E. Sloman 914 Red Bud Road (Data above tbll Une tor CltJ' Beeorcl only) Barefoot Bay, FL 32976 .. State of Florida, oAent of Health and Rehabilitative serVices,. Statistics APPUCATION FOR BURIAL - TRANSIT PERMIT A. 1. Name of Deceased (Type or Print) First MARGUERITE Middle E. Last SLOMAN 13~;J- Vi DATE Month Day Year OF 6/4/90 DEATH 2. Place of Death County B~VMm ~LOOU~E 3. Name of Medical Medical Examiner Certifier 13865 U. S. # 1 M. NASIR RIZWI, M.D. Physician SEBASTIAN, FLORIDA 32958 407-589-6844 4. Name of Funeral Home/ Address Fla.lic. No.lReg. No. Phone Number (Area Code) Direct Disposer 1623 N. CENTRAL AVE. STRUNK FUNERAL HOKES/SEBASTIAN SEBASTIAN, FLORIDA 32958 #1228 407-589-1000 5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box City, Town or Location Name of (If neither, give street address) Hosp.or Inst. HOLMES ~GIONAL MEDICAL CENTER Address Phone Number EDIE was contacted on 6/4/90 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. RIZWI will complete and sign the medical certification of cause of death. bfi c 0 medical certification. was contacted on . He/she verified that ,Medical Examiner, will complete and sign the 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. It 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 ~xtension of time for filing death ce~ificatzre ue~te . RegIstrar or Date / / Subregistrar Signature ' Issued: 6 4 90 6. Place of SEBASTIAN Final Disposition: C~TERY 7. Funeral Director / Dir",,..t niQpnc:u:>r SEBASTIAN FLORIDA y:INDIAN RIVER COUNTY F.E. No.lReg. No. 111672 B. BURIAL - TRANSIT PERMIT C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT"':'SEA Signature or Medical Examiner, , Medical Examiner Date Removal from state Donation Date Signed 6/4/90 Permit No. 1228-90-307 Date Certificate Due: , 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. CEMETERY OR CREMATORY Methods of Disposition: lJ. BURIAL o CREMATION Signature of Sexton ) or Person-In-Charge ) o STORAGE o OTHER (Specify) r >,(..1"?> 7 . Place of Disposition Date of Disposition ~. ,~ SEBASTIAN C~TERY 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 HRS County Public Health Unit in the County where disposition occurred. HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-21 s.