HomeMy WebLinkAbout4-41-12moots 11,12
~' Paid by CEMETERY Receipt No... (j.~, ,, .........Dated ... ~ ~ $ ~.~ Q ................. B 1 O Ck 41 NO.
List Price S , , 6 5 0.: ~ ~....... Maximum No. Burial Spaces ............. . . Uri 1 t 4 12 8 2
Net Paid $ , , 6 5 0 : 0 0....... Monument permitted ...................... .
Denise ~elkey
124 South Magnolia
(Data above this line for Clty Record only) F e 11 s me r e, F l. 3 2 9 4 8
fiti#g of ~~brtt~#ittn
('~ y~ ~} s~ ~ 12 8 2
~GY ~ dig ~ i ~ ~ ~ fia ~ ~ ~ NO.
THIS INDENTURE MADE Thin .....8.th............ day of ........June .............................. A. D., 1890..
bet~ceen tl-e Clty of Sebastian, a municipal eorporatlon existing under the laws of the State of Florida, ae Grantor and
Denise FelkeY... ........................................................
...............................................124 ~ South ~ ~Magnol~ia
..............................................F,ellsmere ~.. Florida_.32948 ............................................
.. ........... .. ... ........
of the County o! .....~.i?.dl~~,. R~,V~.~ ................... an•l State of .....~.~~~?-.4ia......................................
to Grantee, WITNESSETH-
6.5 0:00.
That the Grantor for and in consideration of the sum of S .. ............... to it in hand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargain, sell, release, convey and.confirm unto the Grantee , ,her . , heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
All of Lot(s) ~-.~.r. ~.Z, Biodc, ..~+~„ ... ,UNIT . 4 .......... , of Sebastian municipal cemetery as per Plat Number l thereof recorded in Plat
Book 2, at page 65 of the public records in the ofSce 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 cers-etery to ob-
serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the dried 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: l .. 1 ... . ~.:. ~ ~ I. / L~F~-'•ti-r. .
Ctty Clerk
Signed, Sealed and Delivered
1 the Presence ots
L d~~ / ............................
1=••-`-
CITY OF SEI3ABTIA-N, FLORIDA
Mayor
~~[~ oral)
STATE OF FLORIDA
__
Name ~° `~
d
Unit ~~
Block ~~
f<
Lot ~ '•~ ' '
Date of Mark-out -°°~ f ~' ~ ~~~ ` \
,;„ ~ ~ yy ~' , ~-'~ ~,~!r' S ~ .ems.. ,~ ,~
Date of Burial --~ ~ ~ ~ Time
Name of Funeral Home. ~'~ ~~ ~~ ~A~ ~,rf~'
Authorized by`
FLORIDA DEPARTMENT OF
HEALT
A• (TYPE)
~i ~ ~a
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
1. Name of First Middle
Deceased
LYNETTE ANN
2. Place of Death City, Town or Location
County
Miami-Dade Miami
3. Name of Medical
Certifier Dade Medical examiner
(~X Medical Examiner nPh~
4. Name of Funeral Home Dire isposal
Establishment Van 6rs~e~l
Last Date Month Day Year
WALSH of
Death March 18, 2007
Name of (If neither, give street address)
Hosp. or
Inst. Kendall Regional Medical Center
Phone Number
Number One on Bob Hope Road
lician Miami FL 33136 (305) 545-2400
Adts~ S. W. 40 Street Fla. Lic. No./Reg. No. Phone No. (Area Code)
Salga o- ~r Road Chapel yMiami FL 33165 665 (305) 553-0064
5. Check a. ® The medical certfication has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b• ~ was contacted on
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that will complete and sign the medical
certfication of cause of death within 72 hours.
c• ~ was contacted on He/she verified that
Medical Examiner, will complete and sign the
medical certification of cause of death within 72 hours.
6. Funeral Director/ F.E. No./Reg. No. Date Signed
Direct Disposer- ,~,~}{} "~ (~, j ~ n ~ / ~ n / n ~
B.
RIAL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 665-45
A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted sing the physician has
been contacted by the funeral director and will not be able to complete the medical certfication of cause-of-death section of the death cert~cate within
72 hours.
~No extension of time for filing the death certificate has been requested.
Registrar or ~~~~" ~ Date Date Certificate
SubregistrarSignature ~~~ ~,~/,' Issued: 03~20~07 Due:
c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
7{pproval 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. Awaiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY Sebastian Cemetery
Method of Disposition: Place of Disposition
BURIAL
~GREMATION
Signature of Sexton
or Person-in-Charge
STORAGE
OTHER (Specify)
___1~L~/ ''I___ ~
Date of Disposition 3-24-07
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.
DH326. 8197 (Obsoletes all previous edRbns) Distribution: ~Itow: Funer la Dfredor ortDired Disposer
(Stock Number- 5740-000.0326-2) Pink: Local Registrar
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E SUNTRUST BANK 9624
COX-GIFFORD-SEAWINDS FUNERAL HOME vERO aEncH, FL s2sso
1950 20TH STREET 63-215/631
VERO BEACH, FL 32960
4!4/2007
d PAY TOTNE I ~ **S4.OO
` oROER o= City of Sebastian
Flfri--Four and 00/100************************************~******************~*********ooLLARS 8 ,~
City of Sebastian ~
1225 Main St. ,F~` li l~ ~~ 1
Sebastian, FL 32958
~~'009624~~' ~:063L02L52~:L0000~7377762~~'
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-~ '~'~ ' '~ CITY OF SEBASTIAN
1225 MAIN STREET
~' ~~ ~ SEBASTIAN, FL 32958
- OJ-043
`~~ Wr~C%~OVIA CHECK NO. 0 6 4 3 9 5 670:
64395
GENERAL ACCOUNT
HOME OF PELICAN ISLAND
PAY
TO THE
ORDER
VENDOR CH CK D TE CHEC AMOUNT
23300 03~30~2001,125.0
******1,125 DOLLARS AND NO CENTS
~~~!-~~IEGt7TlASZ~
John G . Wal SYT ' tJ IFlNOT PAID WITHIN 90 PAYS ' "
9740 SW 54`th Street
Miami FL 33165- nr
~a,~,;,....•---------
nm
7W0 SIGNATURES REQUIRED
II'064395i1' ~:06 70064 3 2~:20000273L6296i1' S1i
-64395- _ _ . _ -- --
CITY OF SEBASTIAN SEBASTIAN, FL s2ssa 0 3 3 0 0 7 0 6 4 3 9 5
--- _..-- - - -- -- - ~U~
1NVOICE DATE ~
03/20/D7 INVOICE NU1:4EiER ~~
REFUND : INVOICE DESGHIN i Iurv ~
refund Cem lot-Lynette W ~ ~ roc ~ ir,vvi~,~ Hwwu~+ ~ ~ ~
gl') 1,125.00 ~ _
57165
J~~
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233005 John G. Walsh
- ^
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~ ~ ~~
1,125.00 64395
LACP4GL
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CITY OF SEBASTIAN
CHECK REQUEST
Accounting Use Only
Input Date 3/20/2007 Fiscal Period
Document # Entered By
Document Amount # of Lines
otal HC Hash
Due Date To Be Completed By Department
3/24/2007 Single Check Y / N Y
Vendor Number
LN
TC
Reference Organization
Code Object
Code Project
Code
Amount
010099 534959 $1,125.00
Description Number of Lines Amount $1 12 5.00
Decided not to urchase cemete lot. Will use cemete lot previousl
urchased for interment of L nette Walsh
ISSUE CHECK TO
NAME John G. Walsh
ADDRESS 9740 SW 54th Street
CITY Miami State Fl ZIP CODE 33165
DRAW CHECK F OM SEE BELOW
APPROVED B ~ DATE 3/20/2007
BUDGET APP
D
4
/` IL ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach
a copy of documentation along with the original)
OTHER INSTRUCTIONS
Please make copy of check for Clerk records -Thanks
r
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JOHN G WALSH ~'~`~~ ~ ~ ~ ' ' 0'1197
LYNETTE A WALSH ~ i ~~; ~ ~
9740 SW 54Th ST j 80-568/1012
MIAMI, FL 33?S5 1- C3 `{" 3 ~ ~ .` 1 ti' ."~%`~-l=' y~
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JOHN G WALSH `~~~~ ~ ~ ~
01197
LYNETTE A WALSH i ~; ~, ~ ~'
9740 SW 54TH ST .~ ~ _ ~~ _ . 80-5681 i 012
MIAMI, FL 33?SS ~ .. - ~ ~
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Page 1 of 1
Ann Rousseau
From: Denise Nichelson [dnichelson@cdcnews.com]
Sent: Tuesday, March 20, 2007 8:43 AM
To: Ann Rousseau
Subject: Transfer of Plot
~~ ~i ~~~ ~ kph J~ [.
f p p~,~+[, S i
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My husband passed away in June 1990, I purchased two lots 11, 12, I believe the deed # is 1282. I have
the paperwork at home. My sister-in-law passed away last Sunday and her family would like to bury her
next to her brother, how do I transfer the extra lot to them? What is the cost of transfer?
Thanks,
Denise (Felkey)
Denise Nichelson
Architectural Reporter
888-232-0301 ext. 1515
dniche_I_son_@ cdcnews.com
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3/20/2007
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03/20/2007 11:29 FAX 7725829148 CDC EDITORIAL N0~.431
f~i3/2r~?C~IC~. 1?:23 F'UEL1X 5TOF~E L'237 ~ 188823202999
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NOME OF f'Et1GN 16LAND
Burial rights fn me Sebastian Iv'iuniclpal Cemetery lots/niches purctlased by mP
-2~hrl 5~~~ 1 4 F''1~ ~~ ~ X11 sn~c~
--r----
{Please print name. an agtlre5~s of purCnaser)
(LotJriiche, block, unit, dQSCnpticn)
are Intended for interment of the following individuals;
Please pant name(s); '
(21
(3)
f al -~
(5)
Intemte~nl IotslnChes are not to be traftsferred without written ap~~val of the City of
Sebastian. Intehrnent~ lots/nii:hea in. the Sebastian Municipal Celnrrtery are allowed to be
passed oh to heirs bui the CiEy requires a cert~ed copy of relev~lM probate or athe~
Caurt documents
I hAve read and understand IhE: terms of this agreement.
a~ ~,~~ ~ ~ 3lZQ~ 07
Signature Date n~',~ -7
6~becribed and -swum to oc-ontr me -~Is -doy o1 ~~.(;~5.~~,,,... ~~a / , py
Who ly per5onol-y knGVm to me, ur nra~ produced
' ~e'J'a;I~dn~n~lifi~Gallon.
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