HomeMy WebLinkAbout4-42-22
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... Paid by CEMETERY Receipt No....~............ Dated.. ~.~f.~/?q.... .............
List Price S . ~ .'. ?~ ? : ~ 9.. . . . Maximum No. Burial Spaces. . . .. . .. .. . .. . . . .
Lots 22,23,24,25,26
Block 42
Unit 4
NO.
(Data above tills line lor eu, Record only)
1264
Michael Kelleher
2025 Magnolia Lane
Vero Beach, F1.32967
Net Paid S .l.,. 6.2 5.. QO. . . . .
Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
Cltttu nf l'rhastiau
<t!tmtttry
II tt~
NO.
1264
THIS INDENTURE MADE 'I1aII ....l4t:h........... day 01 .n~:r.~n.................................... A. D.. 19.9.9...
between the City 01 SebllStlan, a municipal corporation existing under the laws 01 the State of Florida, as Grantor and
Michael Kelleher
....................... ..... "202~i'Magno'iia"Laiie""""'" ........ ..................... .......... ........................
............... ...... ........~eJ:o..Beach.,. .F1.orida.. 329.63...... ........... ....................... ............... ......
01 the County 01 ..~.~.~~~~..~~y.~.1:...................... ani State 01 ....~~~~.~~~.......................................
u Grantee, WITNESSETH.
That the Grantor for and in consideration of the sum of S .;\,.9 ~? ... 9.Q . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargaJD, sell, release, convey and confltm unto the Grantee. . hi.f? .. heirs, legal representatives and assigns
the following pro~ si~ed~~bastian, Indian River County, Florida, to-wit:
All of Lot(s) . . ~.! . . ~ Block, . . ~. ~. .. ,UNIT .....~....... ,of Sebastian municipal cemetery as per Piat Number 1 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 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 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 fltst 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 fltst above written.
Attes~-!..'. ~ .m...{)~;j~~.........
tl~.~ City Clerk
CITY OF SEBASTIAN. FLORIDA
B'~~{(~"'"
Ma:ror
Signed, Sealed und Delivered
In the P~ee O!l, )
AJ~uy(i..l(h~........
~~...
STATE OF FLORIDA
eOL'NTY OF INDIAN' RIVER
14th
I HEUEDY CERTIFY. That on this.............. ......... .Ilay of
(QIitu "eal)
March
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0'
90
I'. ....
befure lIle personally appeared .. .~.~~h?J;.4.. ~ ~.. y ~ t..~p~ql..... . . . . .. . .. .. . . . . . .. .. and KClt:n+,yn.. O. ~ nf\J)..Q~ ~~.. ......
resprctively Mayor and City Clerk 01 the City of Sebastllln, a municipal corporation under the laws of the State of Florida to me known
to be the Indh'illuuls and olfleers described In and who exeeutl-d the for('golng eORVI'Yllnee to
Michael Kelleher
., ............................................... ..... ..................................... ... ..... ..... ...............................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally aeknowledgrd the ellecutlon thereof to be their free aet
and deed
as snch offleers thereunto duly authorized; and that the Official seal of said corporation Is duly affixed thereto. and the said conveyance
Is the Ret and deed of said eorporaUon.
WITNESS my 81gBature and olnelal leal at Sebastian, In the County 01 Indian River and State 01 Florida, the day and :rea:-
lasl aforesaid.
~.'. .. .. ..s..~........
Notary Public State 01 Florida at LarsI'.
My commission expires. Motary Public, State of Floridtr
My Commission bpires Der. 10, 1992
~ Ibru r,,,\, fain. In...,ance I....
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Paid by CEMETERY Receipt No... .~~.~......... Dated.. ~.O..~/?q.................
List Price $ '+.t. ?~? : ~9. . . . . Maximum No. Burial Spaces. . . . . . . . . .. .. . . . .
Net Paid $ .1.,.625.. QO..... Monument permitted............. ..........
Lots 22,23,24,25,26
Block 42 NO.
Unit 4
(Data above thla One lor City Record only)
1264~
Michael Kelleher
2025 Magnolia Lane
Vero Beach, Fl.32967
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City of Sebastian
POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330
FAX 407-589-5570
March 15, 1990
Mr. Michael Kelleher
2025 Magnolia Lane
Vero Beach, Florida 32961
Dear Mr. Kelleher:
Enclosed is Cemetery Deed No. 1264 for Cemetery Lots No. 22, 23,
24, 25, 26, Block 42, 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. 611 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,
Elizabeth Reid
Administrative Secretary
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flHB SBBASflIAN CBIiB'rBRY
Clty of Sebastlan
Sebastlan, Florlda
RBCBIP'l' IS HERESY ACICNOfiLBDGBD OF flHB SUN OF:
FRON:
</~~ / cflLd"~'t'A"; ~~
~~-"~ y:/~~-/),
fZ~ ;:!r;}~)~~
Dollars ($ ~ ~ PIS, t:J () )
on thls' /~d day of ~, :19'~ for the purchase of the fOllowlng
descrlbed Cemetery Lot(s) pan the terms and condltlons as stated hereln:
Descrlptlon of Pzoperty:
, .
Cemetery Lot (s) , ~~. d.~~f';f;/.Block' ~d Unltll 7"
Purchase Pr1ce,~.(d;-<, &.J~~~llarS(' UJIS db)
Terms and' condlt1ons of sale:
Thls contract shall be blndlng upon both partles, the seller and the purchaser, when
approved by the owner of thepzoperty above descrlbed.
I
I, or we, agree to purchase the above descdbed property on the terms and condltlons
stated In the foregolng lnstrument:
x~~
The Clty of Sebastlan agrees to sell the above mentloned pzoperty to the above named'
purchaser(s) on the terms and conditlons stated In the above lnstrument.
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.e~ .~~
~lty of Sebastlan ,
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rHB SBBurIAN CBHBTERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOIiLBDGED OF 'l'HE SUN OF:
FRON:
~~'~'#?'4~~
~p~~--,~ y;/~~./) .
j~~;:Z;r;t"~~~
Dollars (I. ~ ~ PIS, () 0 )
on this. / ~d day of 'J~,. J9'~ for the purchase of thefollordng
described Cemetery Lot(s} pontile terms and cond1dons as stated here1n:
Description of Property:
. .
Cemetery Lot(s} , ~~. :l.{ ~f ~f.2LBlock' 7",2 Unit'.y
Purchas. Pr1C.:..r.e!~.I' cRI~.ah~~usrs ($ ;; ~.;15: dO )
'l'erms and'conditions of sale:
'l'his 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:
'l'he City of Sebastian agrees to sell the above mentioned property to the above named
purchaser(s) on the terms and concUtions stated in the above instrument.
4-
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r.:;:tity of Sebastian
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State of FlorIda. 0.8,- of Health and R~abllItaUve Servlces.1 Statistics
APPUCATlON FOR BURIAL -- TRANSIT PERMIT
2. Place of Death
County
Indian River
3. Name of Medical
Certifier
Noor Merchant, M.D.
4. Name of Funeral Home/
Direct Disposer 1623 North Central Avenue
Strunk Funeral Do.es, P.A. Sebastian '1 32958 1228
5. Check a 0 The medical certification has been completed and signed. A cor11)Ieted certlflC8te of death accompanies
Appro- this application.
priate
Box
A.
1. Name of
Deceased
(Type or Print)
First
Dorene
Middle
last
Kelleher
Month Day
11/01/90
Year
F.
DATE
OF
DEATH
City, Town or location
Name of (If neither, give street address)
Hasp. or
Inst. Indian River Meaoria
Address
Vera Beach
Medical Examiner
Physician
Address
b ()\
I.)'fliP'" was contacted on 11'02'80 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 Moor llaroha.nt:, M. D. 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.
6. Place of Sebastian Ce.etery
Final Disposition:
7. Funeral Director/
gj'G,,1 DRifJUser
Permission is hereby granted to dispose of this body.
o A five day extension of time for .filing the death cert,iflcate (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 filing death certificate d.
Registrar or
Subregistrar Signature
B.
c.
Removal
from state Donation
Date Signed
Indian River
F.E. No.lAeg. fJv.
BURIAL - TRANSIT PERMIT
Permit No. 1228-90-0632
~~: 11/0.2/90
Date Certificate
Due:
AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA
Signature , Medical Examiner Date
or
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.
Methods of Disposition:
RJ BURIAL
o CREMATION
Signature of Sexton )
or Person-in-Gharge )
CEMETERY OR CREMATORY r /J/
Place 01 ~~J'7-" L,~u..-P~
o STORAGE Date of Disposit~' ~~ J: /''1.16
o OTHER (Specify) , /l
/jJ ~' /f~9"
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 HAS 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: 574o-000~.2)