The URL can be used to link to this page

Home My WebLink About4-41-24 , pa~ iyCEMETERY Receipt No... ?9A... ...Dated... A!.~!.?)................... ~ List Price S .. 7.QQ, QQ.... ... Maximum No. Burial Spaces..... ...... .. ... . Net Paid S ..?QQ ,QQ....... Monument permitted....................... ~~~~-~-7/ (Data above this line for CU, Record only) .t 24 ock 41 Unit 4 NO. "1318 Richard C. Shields 198 Royale Palm St. Sebastian, Fl. 32958 ~-~---- . ""'J atitv nf l'fbastiau o.trmrtrry mrrb '''1318 NO. THIS INDENTURE MADE TIaIa .....7.t:l.Q............ day of ....Apr:::j)................................. A. D., 19.~.t., between the City of Sebastian. a munlclpal corporation existing undcr the laws of the State of Florida, 08 Grantor and . . . " .. .... . ....... ........................ . . .. . ...... .:R.::i~h~.:r;Q... C.,.. .Sh:j...~JQ.~.. . . . . . .. ........ ..... . .. ..................... 198 Royale Palm St. . . . . . ... ....... .............................. ........... .S-ebas.tian t.. Fl ,.. -329-5.8. .. . . . . ..... . . ... . ........................ of the County of ..... ..I.n.di.an.. R;i, v.ex................. an'] State of .. . F1Q.t;';i,da.. ...................................... as Grantee, WITNESSETH I That the Grantor for and in consideration of the sum of S ...? QQ. ~ 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. . \1.~~. .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . . '1..4.. ,Mock,.. ~.l. .. ,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 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 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. AlISriY~flJ..,..O:r.I~.~"^-- (j City Clerk CITY OF SEBASTIAN, FLORIDA ~r5~ . .,t//'- H M~..c: H. H H. H.. (QIitu jienl) STATE OF FLORIDA COllNTY OF INDIAN RIVER I HEUEBY CERTIFY, That on this .. ..2nd............. ..day of ....... Ap.r.il...................................J 19.. 9l bl'fore me personally appeared ......~ ~.. ~ ... ..<;:~~y.~.1:' ~ .. .. . .... .. . .. . .. .. .. .. .. .. " and . ~~.~h~Y.I?-. . ~ .... 9.'. ~?J.~ !=!~.~.~. 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 Individuals und officers described in and who executed the forl'golng cOAveyance to .............. .... ...... .......... ..................... .:R.::i.Gh~.t'.d. .G,.. .8hi.e.lda...................... ..... ...... ........... ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corp()ration 18 duly affixed thereto, and the said conveyance Is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the County 01 Indian River Dnd State 01 Florida, the day and year last aforesaid. ~;;~................. My commission expire.. Notary l'fJt!:r~'3 d H::~1(b My Commissbn ~::rire~ t.pril 30, 19~4 Bonded Thru Troy Fain. """uran,.lnc. Name Ho. '2 f: L ii ~- T.:;, -2. j\ i'2 G{' '<... i Ul1it LI 1.../, :;2.l..j Block Lot Date of Mark-out 4 - i -<1 ! Date of Burial ,i i, _ 'g" .\. ,r,.._~_ ~ __ Time ! 0: <) 0 ,^. fJ.. 6-lf{ LiNt<. '6 Name of Funeral Home ,".~t /7 1/,( ~. I i ",~,. ...' ....., Authorized by Aki.~~ ",cd.. . ~ /'7 .. . \ (/ UNIT 4 BLOCK 41 LOT 24 DEED 111318 Richard C. Shields 198 Royale Palm St. Sebastian, Fl. 32958 ~ ~ ~ "/-</-9/ i '- - '- - j' . . 664 4/2/91 PaId by CEMETERY Receipt No................. Dated.............................. Ust Price $. .7.QQ t QO....... Maximum No. BurialSpaces................. Net Paid $ .. ?QQ t .QO. . . . . . . Monument permitted. . . . . . . . . . . . . . . . . . . . . . . ~ ~ ~;z;,~.-r-r-:T/ (Data above this One toJ' City ReeoJ'd only) Lot 24 Block 41 NO. Unit 4 \1318 Richard C. Shields 198 Royale Palm St. Sebastian, Fl. 32958 \ ' . . .. " City of Sebastian POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 April 8, 1991 Mr. Richard C. Shields 198 Royal Palm st. Sebastian, Florida 32958 Dear Mr. Shields: Enclosed is Cemetery Deed No. 1318 for Cemetery Lot 24, 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. 664 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, ~In V;/(~ Kathryn M. O'Halloran City Clerk KMO: j s enclosure .: . . THE SEBASTIlIN CEMETERY City of Sebastian Sebastian, Florida FROM: RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: C~tlA ~:-,--i,p~, ;(;,2,,--,~, (D. ~~L.L) /9.f 4d-- /lLnJ ~ . d ,L, A7;:~'''' -I . ~, ..3 02 9..5 -J"'"' , Dollars ($ ,;( ~ . d-zj ) on this ~V day of ~1 , 19~/ for the purc11ase of the following described Cemetery Lot(s) upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)' o<~ Block" y/ Purchase pricerL'M &~p~_ Uni t' r Terms and'conditions of sale: Dollars($oJ~.~ ) This contract shall be binding upon both parties, tlJe 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: x~~~ C~:&- 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. ~P<t~I/;( ~~ ( ltness _J2~~S(, W~~ ~., City of Sebastian " " . . .... .. .... . ---.,....,., o I~'r is':;. . ;~Ii "8: .. = ~ ... lIJ~ws o~ "'-< 0-.; ~o 0-.; ..,:r m z ~ i :D cn....n mi.z ~:D~ cnO:D -i~o j;- zFiin . . ;n~fn ,r-.z ~iii ~6 fn : ~ ~ ... \0 0 tv @~ 0 \\ ,.. ,.. () ~ > 0) '" ~ VI [l;l.~] State of Florida,.artment of Health and Rehabilitative servilVital Statistics A ICATION FOR BURIAL - TRANSIT PER T 'I- 'Ii 0# ;1 Y A. 1. Name of Deceased (Type or Print) First Hazel Middle Austin Last Benedict DATE OF DEATH Month Day 03/28/91 Year 2. Place of Death County Brevard City, Town or Location Micco ... o Medical Examiner Address 1750 Cedar Street hPhysician Rockledge, Florida 32955 (407)633-1981 Address Fla. Lie. No.1 Reg. No. Phone Number (Area Code) 1623 North Central Avenue Sebastian, Fl 32958 Name of (If neither, give street address) Hosp. or Inst.8520 U.S. , 1 Apt.E-5 3. Name of Medical Certifier Dennis J. Wickh~,M.D., M.E. Phone Number 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Ho.es, P.A. 5. Check Appro- priate Box 1228 (407)562-2325 a 0 b 0 was contacted on 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 will complete an~j't.re medical certification of cause of death. DeBBis J. Wiekha.,M.D., M.E. cb was contacted oR4/01/91 . He/she verified that ,Medical Examiner, will complete and sign the medical certification. PI fSebastian Ce.etery 6. ace 0 Final Disposition: 7. Funeral Director/ l3ifeot Oisposer Indian River Removal from state Donation FE ~%7~ Bt'o~Jlff B. BURIAL - TRANSIT PERMIT 1228-91-0164 Permit No. 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 f I the death certifi te uested. / Registrar or Subregistrar Signature ~~~~d: /f-/- 9/ Date Certificate Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature or Medical Examiner, , Medical Examiner Date , gave authorization by telephone fo 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: o BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) o STORAGE o OTHER (Specify) ?t'l ;{Acr" Place of Disposition Date of Disposition 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. Q HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-21