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Home My WebLink About4-41-14 ~ by CEMETERY Receipt No. ~J!-L.... ..... .Dated.. .7/~.~...9.q... ... ..... ..'::~ Lots 13 & 14 Block 41 List Price $. .~RQ... 9.q....... Maximum No. Burial Spaces ................ .Uni t 4 Net Paid $ . .~~g:. 9.~....... Monument permitted...................... ~~66l~~ S ~a~~;n~ -Lot\~ 8 7 Sebastian, FL 32958 NO. America Zarcone interred 6/20/90 Lo t 14 (Data above tld. line for CIty Record ooly) mity Df ~rbn.stiau <!!rmrtrry irrb NO. '1287 THIS INDENTURE MADE 'l1llI 19th day of July 90 A. D., 19......, between lhe City of Sebastian, a municipal corporation existing under the laws of the State of Florida, os Grantor and Matilda Zarcone ..................... '8000'U':S :.. H~y' '1":":" 'Lc>'r.' .98..... .... ... ... ........................... ...... ......... ... ........... . . . . . . . . . .. . . . . . . . . . . . ~.~ ~? ~. ~ .~ ~ ~ ~ .. ~ ~ ).~ ~ ? ~.. .. . .. . .. . . . . .. .. .. .. .. .. . .. .. . ... ............................................ of the County of . Indi.an..Riy.e.r....................... an:1 State of .F.l.o.:t;';i,dGl.......................................... u Grantee. WITNESSETH I That the Grantor for and in consideration of the sum of $ . ?Q9.: ~Q. . . ... . .. . . . .. . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargam, sell, release, convey and conium unto the Grantee h~~.... heirs, legal representatives and assigns the following property sitt.ted in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) ~J ~ l.4, Block, . .4;1.. . .. ,UNIT ....~. ~ . . . . .. ,of Sebastian municipal cemetery as per Plat 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 tbis instrument shall be cove~nts 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. . '..c" IN WITNESS WHEREOF, The said party of the lust 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 rust above written. CITY OF SEBASTIAN, FLORIDA Altest~~m. '... t)ltIa~ a:.-r.~... ,- t1 City Clerk Signed, Sealed und Delivered In ~resence of: y ~ ?er~j~<d.) .!f(eu-~~... .~/J..!.1f~.................. STATE OF FLORIDA r.OflNTY OF INOIAN RIV1P.R (QIittl ~eaJ) ..... .< - '...'" .;;,~ ... ., II IJ; t, J(;: ;' ( ~! /:.) l:"''^ C, ,;::",'; /i'-, Name Unit 1 ~Jock /1 { f Lot If Date of Mark-out 7 /1 <1 J7t) , Date of Burial ?~;:)...I ;~o . . / .l Time ID () c7 jJ; " ilTf -:- Name of Funeral Home . ~..., r ~5. I J<; j~{ II 1\-' r~ , !~. Authorized by i.,i:<,-:- .:.f -5, .' "- -.--- .-~.. ..-~ .-.---.'. ~--- _.~._--_...,.__.._-' ..-.--- .. State of FI4partment of Health and Rehabilitative S.s, Vital Statistics APPLICATION FOR BURIAL - mANSIT PERMIT <3 1"/ tli A. 1. Name of Deceased (Type or Print) First Middle Last DATE OF DEATH Month Day Year AMERICO E. ZARCONE 7/17/90 2. Place of Death County INDIAN RIVER 3. Name of Medical Certifier FARHAT KHAWAJA, M.D. Physician 4. Name of Funeral Home/ Address Direct Disposer 1623 N. CENTRAL AVENUE STRUNK FUNERAL HOMES/SEBASTIAN SEBASTIAN, FLORIDA 111228 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 ROSELAND Medical Examiner 13865 U. S. II 1 SEBASTIAN, FLORIDA 32958 407-589-3000 Fla. Uc. No./Reg. No. Phone Number (Area Code) Name of (If neither, give street address) Hosp. or Inst. HUMANA HOSPITAL-SEBASTIAN Address Phone Number City, Town or Location btJ MARY was contacted on 7/18/90 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. KHAWAJA will complete and sign the medical certification of cause of death. c 0 B. medical certification. In state cemetery / crematory - name/county: Signature was contacted on . He/she verified that . Medical Examiner, will complete and sign the 6. Place of SEBA TIAN Final Disposition: TE 7. Funeral Director / Dire9t DililJt9lil9r SEBASTIAN, FLORIDA INDIAN RIVER COUNTY F.E. No./Reg. No. #2368 Removal from state Donation Date Signed 7 18 90 BURIAL - mANSIT 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 reque d. Registrar or Subregistrar Signature Permit No. 1228-90-388 Date Issued: 7/18/90 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: Ii BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) o STORAGE o OTHER (Specify) ~ f /~7 Place of Disposition SEBASTIAN CEMETERY Date of Disposition JULY 20, 1990 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: 5740-000-0326-2) 5,