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Home My WebLink About4-42-12 -... . 6t 12/19/89 Paid by CEMETERY ReceIpt No................. Dated........................... ..... Lots 11 & 12 B1k.42,Un.4 NO. List Price S .. ... . .20Q........ 400. Net Paid S .................. John J. McGrath interred Lot 12 - 12/20/89 Maximum No. Burial Spaces....... .2........ Monument permitted. . . . . . . . . . . . . . . . . . . . . . . 1256 (Data aboye this line for CIty Record oDly) Eleanor McGrath 385 Bay Harbor Ter. Sebastian, Fl. 32958 atitv of &rbnstinu Cltrmrtrry I r rb NO. 1256 THIS INDENTURE MADE 'I1LIa .19 th............. day of ........... .D.eceIJlb~;(................... A. D., 19.. .~9.t between the City of Sebllltlan, a municipal corporation existing under the laws of the State of Florida, 08 Grantor and ..................................... .El.~~nQr.. M~Gr.~.th...................................................................... 385 Bay Harbor Terrace ........ ....... ..... ..................Se.'basti.an.,...F.1oz:ida.....3.2.958....... ....................... ... ....... ..... .., ... of the County of .......... In.~H..l;ln.. .R:j...y~~............. an:1 State of ..... ..:f.+~~?-.~.~.................................... u Grantee, WITNESSETH I That the Grantor for and in cansiderstion of the sum of S . 4QO ",.Q 0 . . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grsnt, bargam, seU, release, convey and conrum unto the Grantee.. hf!!.~.. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: AU of Lot(s) .l:L.. ~l;iIOck, . . {J.~. .. , UNIT ... {J. . . . . . . .. , of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 6S 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 shan be used solely and exclusively for the interment of the human dead and shan 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 Such rules, regulations, resolutions 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 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. Attest:cJ?6..74--1.. ~m: .D,tl.tUI!-.~........... ~.~ T/~' City Clerk CITY OF SEBASTIAN, FLORIDA B,~f.~......u....... Mayor Sl~nl'd' ellled ond Delivered . In th esence of: .. .. 'f~~(;'C.. )..7IJA..<.. ~(,e~,:-:: STATE OF F .ORIDA (QIitv 1ieaI) Lots 11 & 12 B1k.42,Un.4 602 12/19/89 Paid by CEMETERY Receipt No. . . .~,,~.... . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . List Price s...... .200........ Maximum No. BurlalSpac:es....... .2........ 400. Net paid S .................. NO. 1256 Monument permitted. . . . . . . . . . . . . . . . . . . . . . . Eleanor McGrath '385 Bay Harbor 'Ier. (D'" ................ a", ..........) SebastiaD. Fl. 32958 John J. McGrath interred Lot 12 - 12/20/89 ~ o ::r' ::s ~ t"'ItxlC::: Ot"'lZ rt ~. l:Il . .I::- 1-'.1::- I-'N Q') s: n G1 11 I>> rt ::r' ..... ::s rt CD 11 11 CD P. t"i o rt I-' N ~~ I-' N - N o - co \0 =_..... -.- .-.--.-..-..-...-.-- .'" .-/ I \ )> c: - ':s o .... N' CD a. ~ Z III 3 CD a .." c :::l CD .... !. ::t o 3 'CD t:::l tr:l U,H.JoJ tz:l tz:l ..... CD co I-' t; .3' ~ 0' V1 CD Z CD I>> I>> 0 l:Il td::S . rtl>> 0 .....'<1 11 ..... I>> N () ::s ::c:s: V1 .. I>> n 0'\ 11G1 t%:l0'11 v' 1-'0 I>> 0 . 11 rt ::r' .!' t-3 ~ WCD NI1 \0 . V1 co o 0 ~ !. CD CD a ~ "'CD , .3: ~,." .~ !. If o c - r- So !l .i c: :::l ;;: %~,,," -0:. AI ~. I ! .~ ..... )-> \A ~ .~ ;:\ ,~ '.~ .~ ---: ~1 Name of (If neither, give street address) Hosp. or INDIAN RIVER ROSELAND Inst. HUMANA HOSPITAL-SEBASTIAN 3. Name of Medical ~hysician Address Phone Number Certifier NASIR RIZWI, M.D. 0 Medical Examiner 13865 usH 1 SEBASTIAN, FLA 32958 4. Funeral Home/ Name Address Phone Number (Area Code) ~~ STRUNK FUNERAL HOME 1623 N. CENTRAL AVE. SEBASTIAN, FL 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. priate Box 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 fir the death cer 'fica equested. Registrar or Subregistrar Signature -- IJI,PARTMENT UF HF..AI.TH ANO RF.II,-\hUJT"nVE St'R\"k:I'.S A. 1. Name of Deceased (Type or Print) First JOHN 2. Place of Death County 6. Funeral Director/ 9ir=1 Di1>"v~er ~ B. C. Signature or Medical Examiner, 1L';f"r?:".-\':;''''T.ii::;.---\,,~~!:;;--:,.~U';;7~;~"?~71'':'7Z<.__" t. /1 cr- . STATE OF FLORIDA /.2 PARTMENT OF HEALTH & REHABllIT. SERVICES /O)j rJ- VITAL STATISTICS t; i APPLICATION FOR BURIAL-TRANSIT PERMIT "~"":'r"~.~::':;::;'~:~:';!'::;';ioi.~:r~_,.,,,. Middle JOSEPH Last McGRATH DATE Month Day Year OF DEATH DECEMBER 1 7, 1989 City, Town or Location bJC!l EDIE was contacted on 12117/89 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.RIZWI will complete and sign the medical certification of cause of death. c 0 was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. Fla. Lie. No./Reg. No. 111672 Date Signed 12/17/89 BURIAL-TRANSIT PERMIT Permit No. 1228-89-557 12/17/89 Date Certificate Due: Date Issued: ~' AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT -SEA , Medical Examiner Date , gave authorization by telephone to Funeral Director/Direct DisDoser. 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: g BURIAL 0 STORAGE o CREMATION 0 OTHER (Specify) Place of Disposition SEBASTIAN CEMETERY Date of Disposition DECEMBER 20. 1989 Signature of Sexton ) or Person-in-Charge ) r, a. j~ G. 7\ 'I," (L i I I / . 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. HRS Form 326, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2) 1