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Home My WebLink About4-41-21 " J paid':' CEMETERY Receipt No.. .......... .Dated... ~{J~)9.9............. List Price $....9 ?9.'. 9.Q..... Maximum No. Burial Spaces................. Lots 21,22 Block 41 Unit 4 NO. Net Paid $ ....f? ).Q... 9.Q..... Monument permitted. . . . . . . . . . . . . . . . . . . . . . . l?q2 Mrs. Gloria Lusardi 5902 S. River Run Dr. S~!>astian, Florida 32958 Frank Lusardi interred 8/16/90 Lot 21 (Data above thl. line for eUy Record only) atity nf &rbasthtu <ttrmrtrry 111 rrb l2~2 NO. THIS INDENTURE MADE 'I1aII 16th .. '0... ...... dRY of .... .1\~g~.I?~.............................. A. D.. 19.. .~q. between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and . . . . . .. . . . . . ... .. .. . .............. .t1+.~.... . Gl.ox i.~. .Lu~ax.di. ..... ... . . . . . . .. .. 5902 S. River Run Dr. ....................... ............. ..S.~.1;>.CJ~t.i.an.,.. .f.1m:'.i.da. .3.2.958......... of the County of ... .:J;p:~.i.cm ..~.:ix~r.................... anI State of ..... XJqri.4~.................................... u Grantee, WITNESSETH. That the Grantor for and in consideration of the sum of $ .9.5 Q , .Qo. . .. . . . .. . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargaiit, sell, release, 'convey and confirm unto the Grantee . .R~r... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) Al& ?2, Block, . . ~.~ . ., ,UNIT .... It . . . . . .. ,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 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 fust 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: clr~~l~k':-<}.lI :. . v.'d aJ21!(I:!l{~.... .. () CIty Clerk .T&;r~~..... Ma,/" Signl'd, Scaled und Delivered In the Presence of: y(j ~~ . / ( ~- /' ,. , ~'- / "7'.::;~. ';?? d ~~;J ~~c:... ...~ .......... lr ~.. . I <i;;;-4UrU.tU-u~:. .1.... J>~~.L/........ (C1Iit~ Jital) STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEUEDY CERTIFY, That on tbl. .....l6t.b............day 01 .......August.................................. 1990.. bl'fure me personally app~ared .. ..W.... .l?... .Y.9rY~.~.~................................ and .K?t;p;r.:yt:l.. 9.'.~.~.~;I;9.~.~!!-...... respt'ctively 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 und officers described in and who executed the foregoing CORveyance to Mrs. Gloria Lusardi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., and severally acknowledgt'd the execution thereof to be theIr free act and deed as snch officers thereunto duly authorized; and that the Offlclai seul of said corporation Is duly affixed thereto, and the said conveyunce is the IIct and deed of said corporation. WITNESS my sIgnature and offIcial leal at Sebastian. in the County of Indian RIver ond State 01 Florida, the day and ,ear last aforesaid. &:~... ~~?t~~-:. ..~d~~9=............... ... Not ubllc, State of FlorIda at LarN My ommlsslon expIre., at _ r.' I:. q-.'" ,,' rl-tlTlrl!l I~O~I1, l tel...,... ...v ~ My (c;m:i::g~-::1 [7T!~C: ^r::1 ~~, 11?~ e;)nd~d Thil.l Tr~,/ r oin . Insur::.;r,co Inc,. ~.J ..... .~ '~ '" '''"', Nar"e l::i:/r/iyK I ;.1 ; (), ( t.) t , Ii' (~ __ ., . Block '~/' , / I . Unit Lot F, j ! Date of Burial /. I . / Ie,""': '"...~ "',' . ft. ",' , t_", t(; l....', 1 "'-~~ · / /'9 r,. t,/ I (::.i {,j. Time In () <'.; /../. ft...} Date of Mark-out Name of Funeral Home ~ < I .'; ....;, l /,,_. \.,/' r~" i.J I.. I l ,. / .; . 1.1<.<' ., A th . d by \ ""'( A '1". .-:'1 ,~"/ ./~ U' onze ....;.'."" .' ;,.... , L . I /---......,"'/ J BLOCK 41 UNIT 4 LOTS 21, 22 DEED 111292 J~ Gloria Lusardi 5902 S. River Run Dr. Sebastian, Florida 32958 Frank Lusardi interred 8/16/90 Lot 21 l _ '- - Paid by CEMETERY Receipt No. .. ..9.~9....... . Dated. . .~!.\~i~9................ list Price $....~ ?Q...9.Q..... Maximwn No. Burial Spaces ................. Net Paid $ ....f}? Q ... 9.Q . . . . . Monwnent permitted. . . . . . . . . . . . . . . . . . . . . . . Mrs. Gloria Lusardi Frank Lusardi interred 8/16/90 Lot 21 5902 S. River Run Dr. (Data above tblaline tor Cl7 Record 0011') Sebastian, Florida 32958 Lots 21,22 Block 41 Unit 4 NO. 1.?~2 --~~-------- ):::;<''^'~Q:~~' . , , . . . POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 FAX 407-589-5570 August 20, 1990 Mrs. Gloria Lusardi 5902 S. River Run Dr. Sebastian, Florida 32958 Dear Mrs. Lusardi: Enclosed is Cemetery Deed No. 1292 for Cemetery Lots 21 and 22, 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 when and if you have the deed recorded. We are enclosing two copies of Receipt No. 639 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, ~'rJJ Oil/~ Kathryn M. O'Halloran City Clerk KMO: j s enclosure t .,," . . &31 THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida FROM: RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: -4~.~ri7 r"" {l.!~ev 7 ~-L; S9tfc2 ~ /~~'J/~ ()~ _~~~/, ,r~ Dollars ($ ~ St!. ~^z:! ) 302 fP..s-g' on this /J, d day of d'~, 199CJfor the purchase of the following described Cemetery Lot(s) n the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)# :::< / "" ;;lc:L Block# ~/ Unit#..y Purchase price,.4.c ~L ~ Dollarsl$tS-tl.t!t7) Terms and' conditions of sale: 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: >< ~.: f:--A.^ / - 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. K4~~~ //;City of Sebastian (/ (/j'~ /....~..,;~"~......... - / . .' (./\~..-e / ---.lw1ness . .' f . . . -~,:~~~~ . . . r-- ~ ~ r~' 10, ~ l~ ~I i I ~ ~ (I) ... .I tx:J o 0'" U1 C\- O ... ~ % 0 ... t.D .... t.D w WO 0 :E~I 0 0< C\- :C... f t.D ..J~1t 0 c( . ~ a: ~ ~ . wj!:ti ~ '!: ! a: ~ Z u.ow Zen ~~ Z... ::::t II: t; V".1Ill,,",'J. a: ~ ''''':'''~'r,;~~:-::.4IT4?r,''''','''r ~. ~- ?~" /37'/ !I~ ~,' -~'la~' [13~1 State of Florida, _rtment of Health and Rehabilitative Servic_ital Statistics A CATION FOR BURIAL - TRANSIT PER. A. 1. Name of Deceased (Type or Print) First Middle Last DATE Month OF DEATH August Day 13, Year FRANK LUSARDI 1990 2. Place of Death County City, Town or Location Indian River Roseland Name of (If neither, give street address) Hasp. or Inst. Humana Hospital-Sebastian 3. Name of Medical Certifier Medical Examiner Address Phone Number Noor Merchant 4. Name of Funeral Home/ Oi~"t DiSPQ88f Strunk Funeral Home Physician138 7 5 USflI, Address 1623 North Central Avenue Sebastian, Florida 32958 Sebastian, Florida 32958 589-0879 Fla. Lic. No.1 Phone Number (Area Code) 1228 407-589-1000 5. Check Appro- priate Box a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b gg Dr. Merchant was contacted on 8/14/90 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 He 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 Final Disposition: 7. Funeral Director / ~i~Qt Diil'?9S&r €~-r ~ Removal from state Donation Date Signed Aug.14, 1990 B. BURIAL - TRANSIT PERMIT Permit No. 1228-90-434 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 filing the death certificate requested. Re€listFBr sr Subregistrar Signature 'f"r\ Date Issued: Aug .14 , 1990 Date Certificate Due: C. 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. CEMETERY OR CREMATORY Methods of Disposition: IX! BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) o STORAGE o OTHER (Specify) r..fJ 9 Place of Disposition Sebastian Cemetery Date of Disposition August 16, 1990 ,J:kC)1 - 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) - I ~_U