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Home My WebLink About4-41-01 ..... ~~...11!RY R_ No... .,~....... not...... ~.(H.~?9...........~ List Price $.. .~.q9. ~ R9...... Maximum No. Burial Spaces ................. Net Paid $ .. .~.Q9.~ ~Q...... Monument permitted....................... Thomas H. Baker interred 5/16/90 Lot 1 Lots 1,2 Blk. 41 Unit 4 NO. 1275 (Data above this line for Clt, Reeord 001,) Mrs. Helen Baker 850 Lance St. Sebastian, Florida 32958 attty uf l'rbasttan aIrmrtrry mrrb 1275 NO. THIS INDENTURE MADE nta ..... J.4.t;.h.. . .. . . .. day of ....... r1~Y. ................................ A. D.. 1...~q., between the City of Sebastian, a municipal corporation exlltlnlJ under the lawI of the State of Florid.. al Grantor and ~1rs. Helen Baker ........................ .... ....... "SS'O"Lanc'e" St:............. ..... .................... ............. ........................ .................. ...................Seb.astian.t. .F.1.o:cida..329.5a.......... ...................................... ...... Indian River . Florida of the County of ............................................. ani State of ....................................................... u Grantee, WITNESSETH I That the Grantor for and in consideration of the sum of $ ~ 9.Q ... <;> ~ . . . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargam, sell, release; convey and confum unto the Grantee . h~.:r: . .. heirs, legal representatives and assigns the following propet!y situated in Sebastian, Indian River County, Florida, to-wit: An of Lot(s)l. ~.? .. , Block, . ~. ~ . . .. , UNIT ..~.......... , of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 65 of the public records in the offtce 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 shall be used, kept and maintained at an 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 shan 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~t. . ~ iDJ....f).~dtU4~. ~. City Clerk Signed, Sellled and Delivered In the Presence Ofl :Iz::~"""""H" 4q......~.W............................ (((tit\! JieaJ) STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEUEDY CERTIFY, That on this ...... ..1.4.tb........ .day of ........ May......................................, 11.9.Q W. E. Conyers Kathryn 0'Ha11oran before me personally appeared ........................................................... and ........................................ respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the Indlviduuls and officers described In and who exeeutc.-d the forl'golng eoaveyance to .. . . .... . ..... .......................... .~~.~ .... .~~.l,~~. .~~t<;~.J;'........................ . .......... .... ........................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the execution thereof to be thelr free ad IInd deed 8$ slIch officers thereunto duly authorized; and tbat tbe Official leal of said corporation Is duly affixed thereto, and tbe said conveyance Is the act and deed of said corporation. WITNESS my Ilpature and official R8I at Scbaatlan, In tbe County of Indian River and State of Florida, the day and ,ear IlIst aforesaid. N~t~';; "';bj,~ b.~;?!L~:...................... My COIDIDI~'~~Xr"\~r~ll::c:.~ < ;1 .'. r~~~. ~~.;..'::~:~iH'(t:; J~) :r:' (":'.~' r., ~ />, Ilonded Ihm ltn" ;::ain. _ I..._u.'~ _~ : aid byd!METERY Roceipt No..... .~~!...... . Dated .... ?();~/?9............... .ist Price $ .. .~.q9. ~ R9...... Maximum No. Burial Spaces................. lot Paid $ .. .~.Q9.~~9...... Monument permitted....................... Thomas H. Baker interred 5/16/90 Lot 1 (Data above till. Une tor Clt)' Record only) Lots 1,2 Blk. 41 Unit 4 NO. .. ~ ~ .~ " C:::t:=t"I Zt"lO I-IO~ ~ C'Hn ~ .I::'- .... c .1::'-" .... N enoota::l t:J:jU1l)loo tdO.?=I :> -tz:t ent"llltl ~:>.. . 1-1 Z y,:S'\;l :> ("') :3: Z t:J:j lX:f en en. 1'Zj~ t"I. = o t:<:l lX:f t"'I 1-1 t:<:l t:l Z :> w N \0 V1 00 t;j t:<:l t:<:l .t:;l ::::::: .... N -...J V1 " ~ " "" ~ 1275 Mrs. Helen Baker 850 Lance St. Sebastian, Florida 32958 ~~- )00 Z c:: III :T 3 o <D ia- a p', ~ .". \'\ t7' c:: .\-< i .. \ !. ~:I: ~~ ~~.,. ~ <D \~ >t ~. i' i' i ;: g.." S- ID c:: .. ! r ID -0 .- -()' - n ~ I I l, \ 3: III ... ~ o c - ':0' -f 3" <D - () o ~ ~ ~ c: :!. _. ,Z III 3 <D .~ 7/1o'ktJJ d~~If/l- /Jo&:,- r990 f~J~ 916 - 17th STREET . BEACH, FlORIDA 32960 1623 N. CENTRAL AVENUE SEBASTIAN, FlORIDA 32958 LIft I~N$i1~j :~,.,.'f:':;'~:;::i;~i"0:(~:'"1'~~~'l\;i':'?~:'[:?''' . . . . POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 May 17, 1990 Mrs. Helen Baker 850 Lance street Sebastian, Florida 32958 Dear Mrs. Baker: Enclosed is Cemetery Deed No. 1275 for Cemetery Lots No. 1 and 2, Block 41, Unit 4. If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, 2145 14th Avenue, Vero Beach, Florida. Also enclosed is a form - Return for Transfers of Interest in Florida Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court. We are enclosing two copies of Receipt No. 621 and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided for your convenience. veC;Z;3;rDJI/~ Kathryn M. O'Halloran City Clerk KMO:js enclosure 'c;7,;""'~:'''~',~'::t,:F'f(;fi3i~'tM~~ii~~-'!f<.\:';:';''<::I':::ry -, "';):>~";:-'':'.~',f<~'';'"~%~V~_;'7Jj'';.:';:::(:,'': ;.; ."e,' ',':'<1111 . . ~~,. ". '1'HE SEBAS'1'IAN CEME'1'ERY City of Sebastian Sebast:l.an, Florida RECEIP'1' IS HEREBY ACKNONLEDGED OF '1'HE SUN OF: r-~ f!/~p/_ Dollars ($ ~t1tJ. hJ ) FNJH: ~4' .~_ !/!Id~; ?StJ ~ 4-. cy{~~Z-;;.;, ~ , r-~) . t307 ?S J' on tms /~t;t day of · ~ · 'HJi99t1 for the purchase of the following described Cemetery Lot(s). ... ... . the terms and conditions as stated herein: , ' Description of Property: Cemetery Lot(s)/I/ .;.. 7- Block/l ~ / Purchase price:'y:-H.aJ ~~~_ Terms and'conditions of sale: Unit/l ~ Dollars ($ 7"& d hJ ) 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: xJ~~~ 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. ~~4U_ .Q.{~~ . City 01' Sebastian ~~ . , J d~ " '.. itness- ':l"..,;..,*,-:',T_~' ~(t'" "''':'',i!f,;f'''.;'':W-:' '-:;~~":".,;_,'F'_.,,' "!,",,;;~- ;.,'r't.:l ....--."',:,,-_;'-'<--:'~'11\,,,..,,~ -~~,''',,------ <-:;;><"F"'-,-,-'_ ~-- 0-.. ,,"-"r:'''~,,__~ ;,'I!''-_''~'''''''''.___'''''''',~_. ""'''---'''''''''''''",,-'''''.,--~ I I.~) State of Florida, Denent of Health and Rehabilitative serVice. I Statistics APPLICATION FOR BURIAL - mANSIT PERMIT '1- f/- 0/ A. 1. Name of Deceased (Type or Print) First THOMAS Middle HENRY last BAKER DATE OF DEATH Month Day Year MAY 12, 1990 2. Place of Death County INDIAN RIVER 3. Name of Medical Certifier City, Town or Location Medical Examiner Name of (If neither, give street address) Hosp. or Inst. HUMAN HOSPITAL-SEBASTIAN Address Phone Number ROSELAND MUHAMMAD SIDDIQUI, M.D. 4. Name of Funeral Home/ Direct Disposer Physician 937 Address 1623 N. CENTRAL AVE. SEBASTIAN, FLORIDA 32958 1228 407-589-1000 The medical certification has been completed and signed. A completed certificate of death accompanies this application. BAREFOOT BAY, FL 32976 407-664-4349 Fla. Lie. No.lReg. No. Phone Number (Area Code) STRUNK FUNERAL HOME 5. Check a 0 Appro- priate Box b:q] LOIS wascontactedon 5/13/90 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. SIDDIQUI will complete and sign the medical certification of cause of death. c 0 H_~:l 6. Place or-. SEBASTIAN Final Disposition: CEMETERY 7. Funeral Director/ DiFect Dispo<:>t::, medical certification. In state cemetery/ INDI RIVER COUNTY matory - name/coun gn e F.E. No.1 Reg. No. -C..<-c...~1672 was contacted on . He/she verified that , Medical Examiner, will complete and sign the Removal from state Donation Date Signed 5/13/90 B. BURIAL - TRANSIT PERMIT 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 fili e death certificate req~es d. Registrar or ..A /J .. "" ~ Date 5/13/90 Subregistrar Signature -lL.--{. .,/ . Issued: Permit No. 1228-90-263 Date Certificate Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature or Medical Examiner, , Medical Examiner Date , 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: ~BURIAL 0 STORAGE o CREMATION 0 OTHER (SpecifY)~ SIgnature of Sexton ) ~ 'I L l)"t or Person-in-Charge ) ;(). . , Place of Disposition SEBASTIAN CEMETERY Date of Disposition MAY 15, 1990 This permit must be endorsed by the Sexton '" person-in-chalge ('" by the Funeral Dtrectoo-/OIrect [);spos", when there Is no Sexto~ and returned within 10 days to the local HRS County Public Health Unit In the County where disposition occurred. HAS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-21