HomeMy WebLinkAbout4-41-35Certificate No. 2378
CITY OF S �B STTI N
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Margaret E. Rera
382 Periwinkle Drive
Sebastian, FL 32958
In and for consideration of the sum of $600.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 41, Lots 35, 36, & 37
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
This Certificate supersedes Deed #1298 cited in Indian River County Clerk of
Court Records, Book 0924, Page 0605.
CONVEYED THIS 20th day of May, 2013.
OF hEBASTIAN, FLORIDA
' CAI Minner
City Manager
ATTEST:
Sally k, ,Maio, MMC
City Clerk
RECORD VERIFIED
0 T i t ij of # P fi a s t i M ri JEFFREY K. 13ARTON
6.0 CLERK CIRCUIT COURT
0
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y p INininNI DIWCD n� — t 2 9 8
THIS INDENTURE MADE This ......9.t1 ........... day of ..... October ........................... A. D., 19.90.,
between the City of Sebastian, a municipal corporation existing under the laws of the State. of Florida, as Grantor and
Mr. Jack Rera
.......................... z"MTUR9 _�0 ........... .
................................. ...............................
1017, "Seamist. Lane
Sebastian, Florida 32958
............. ............................... .............. ...............................
of the County of . Indian ..Riv.er ....................... and State of .... F1. orida.......................................
as Grantee, WITNESSETH:
That the Grantor for and in consideration of the sum of $ 800: OO • • • . • 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 . , .Y11 S.. heirs, legal representatives and assigns
the following prope3ysitu tied in Sebastian, Indian River County, Florida, to -wit:
All of Lot(s) 17., 3 8 , Block, .4.1. , , , , UNIT ..4. • , , , , , , • , , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded i
Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying ing
in Indian River County, Florida.
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DOCUIeWARY STAMPS �. O _.
p' `
JEFFREY K. BARTON, CLERK 01�
INDIAN RIVER COUNTY `»
cn
To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human de d and shall Cif
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 first above written.
CITY OF SEBASTIAN, FLORIDA
Attest. ........... By ..
City Clerk Mayo
Signed, Sealed and Delivered
ir(tbe Presence of: J
... .).. ......... ................. ((Qttg Ytt1) � .
Q
. .....
_ . 6e.3
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
9th 890
I HEREBY CERTIFY, That on this ........................day of .......... October ........... .............................., I ....,
before me personally appeared .....W.r..E.,C,onyer,s..,, .. and ..Kathryn,.O'Halloran.,
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 individuals and officers described in and who executed the foregoing conveyance to
............. ............................... Mr. ....J a c,k.. R e r. a....................................................................
......................... ............................... and severally acknowledged the execution thereof to he their free act and deed
as such officers thereunto duly authorized; and that the Official seal of said corporation is 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 of Indian River. -and State .ot.); lorida, the day and yea;
last aforesaid.
No Public, State of Florida at, Large.y'
My commission expires:
Pio r.ted'ihru Troy fcin - ta;urorve� ;ne.
Name__ /� �i' k
.t�Llnia
Lot 3
Date of Mark -out r {' & A�.
r i
Date of Burial ' ! � A Time !" C r_`
Name of Funeral Home_`
Auihorized by �i ='•.ter r_
`xERA,,JACK - DEED #1298
1017 SEAMIST LANE
SEBASTIAN, FLORIDA 32958
LOTS 35,36,37,38
BLOCK 41
UNIT 4
L,
Paid by CEMETERY Receipt No..... 6 4 5 ....... Dated ....1.0/9./9.0 ...............
List Price $ . 00 0 r Q Q........ Maximum No. Burial Spaces .................
Net Paid $ . $ l0 : 0 0 ....... Monument permitted .......................
(Data above this line for City Record only)
J
Lots 35,36,37,38
Block 41
Unit 4 No.
.1298
Mr. Jack Rera
1017 Seamist Lane
Sebastian, F1. 32958
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THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
Pilo* V
/D
►. �_
on this 91 day of � tom, 19 fefor the purchase of the following
described Cemetery Lots) upon the terms and conditions as stated herein:
` Description of Property:
Cemetery Lot (s) 3S 3��T Block# /{/ Unit# y
Purchase Price: &O�� &� � Dollars
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:
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.
fSLni r.P�
City of Sebastian
fitness
City of Sebastian
POST OFFICE BOX 780127 o SEBASTIAN, FLORIDA 32976
TELEPHONE (407) 689 -6330 o FAX (407) 669.6670
October 9, 1990
Mr. Jack Rera
1017 Seamist Lane
Sebastian, Florida 32958
Dear Mr. Rera:
Enclosed is Cemetery Deed No. 1298 for Cemetery Lots 35, 36, 37
and 38, 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. 645 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,
Q�OU�
Kathryn M. O'Halloran
City Clerk
KMO :js
enclosure
State of Florida, Ortment of Health and Rehabilitative Servoital Statistics y�
APPLICATION FOR BURIAL — TRANSIT PERMIT L/
A. (Type or Print)
1. Name of First Middle Last DATE Month Day Year
Deceased CHARLOTTE RERA DEATH 10/5/90
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
INDIAN RIVER VERO BEACH Inst. PALM GARDEN NURSING HOME
3. Name of Medical Medical Examiner Address Phone Number
Certifier
14UHAMMAD FAROOQ, M.D. Physician 777 -37TH. ST. VERO BEACH, FL 32960 407 - 567 -2277
4. Name of Funeral Home / Address Fla. Lic. No. /Reg. No. Phone Number (Area Code)
Direct Disposer 1623 N. CENTRAL AVE.
STRUNK FUNERAL HOMES SEBASTIAN, FLORIDA 32958 #1228 407 - 589 -1000
5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies
Appro- this application.
priate
Box b ®C NURSE was contacted on 10/6/90 within 72
hours after death. He /she verified that this death was from natural cages, that there was no accident
nor other external cause of death, and that DR. FAROOQ will complete
and sign the medical certification of cause of death.
c ❑
was contacted on . He /she verified that
Medical Examiner, will complete and sign the
medical certification.
Dip
6. Place of OF1305ASTIAN Instate cemeter / SEBASTIAN, FLORIDA Removal
Final Disposition: CEMETERY crematory - /county: INDIAN RIVER COUNTY from state Donation
7. Funeral Director/ Sgnat F.E. No. /Reg -No, Date Signed
-DDw_ #1672 10/6/90
B. BURIAL — TRANSIT PERMIT Permit 28_90 -500
Permission is hereby granted to dispose of this body.
❑ 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.
❑ No extension of time for fill the death certificate requested.
Registrar or lj% Date 10/6/90 Date Certificate
Subregistrar Signature �_ Issued: Due:
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
M
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.
Methods of Disposition:
1913URIAL
❑ CREMATION
Signature of Sexton )
or Person-in-Charge)
❑ STORAGE
❑ OTHER (Specify)
CEMETERY OR CREMATORY
Place of Disposition SEBASTIAN CEMETERY
Date of Disposition OCTOBER 9, 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)
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