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HomeMy WebLinkAbout4-40-01 . '. ___ots 1 lit . 7 . 11/13/90 ~lock 40 ~ bYCE7~~Yo~ece1pt No................ . Dated. ............................. Uni t 4 List Price $ .. . . . . . . .. . . . . . . . . Maxhnum No. Burial Spaces. . .. . . . . ~. . . .. . .. ,. Net Paid $ fJ 5.0...00.. .. .. .. NO. \1301 Monumentpermitted.......................Joseph F. & 1<athleen L~ Gertze 4310 Blst Place/P.O.Box 697 Wabasso Florida 32970 (Data aboye thll Une lor al7 Record ollly) , cnitv of &rbusttun Brrb <1Irntrtrry NO. 1:l01 THIS INDENTURE MADB TIIJt 13th day 01 November 90 A. D.. 1........ ..................... . ............................................. between the CJty 01 Sebutlan, a munlelpal corporation exlltln. under the lawI 01 the State 01 Florid.. a. Grantor and Joseph F. and Kathleen L. Gertzen . .. , . , . , .. .... , ............. '4'310" 8'1'5 t' . PI'ace ~.. 'p'; (j:' ':Box' .697.........' . . '" ............ .. . ........................ . , , , . . . . . . . . . . . . .. .. .. .. .. .. . W ~.);).~ ~ ~9.J.. F: J..<?J;' ;i.9:~.. .~ Z 9. 7.Q. .. . .. .. . . . . .. . . . . . . .. ...."...................................... 01 the County 01 ..lnd.i.~J:)...Ri.v~~...................... an') State 01 ... ..:F.lQJ::i.d.EJ....................................... u Grantee, WITNBSSETH, ) ~ .. . That the Grantor for and in consideration of the sum of $ ......: .Q9. . . . . . . . . . . . . . . . to it in band paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, blllJabt. lieU, releelle, Convey and confirm unto the Grantee .~ \1.~ J... ~. heirs, lep1 reprelleDtatives and assigns the followina property lituat Sebastian,lnciian River County, Florida, to-wit: All of Lot(s) 1.. . .2, lode,.. ~.Q . .. ,UNIT ... '* . . . . . . . .. ,of Sebastian munidpal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 6 e pubUc records in theoftlce of the Clerk of the Circuit Court of St. Lude County or Florida: iaid land now lying and being in indian River Count ,Florida. 9>()-.~ 11J,"JloO To Have and to Hold the same forever: provided that said property shan be used IOlelyand 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 relOlutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the IOYernment and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shan be covenants running with the -.00. In the event of the failure of the owner or any property situated within said cemetery to ob- lIetVe and comply with iuch rules, regulations, relOlutione and ,ordinances and the conclitiom of the deled of conveyance thereof then the title of such owner in and to said property shall terminate and the .me shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the Ont part has caulled this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate 8eal to be hereto affixed, the day and year first above written. CITY OF SEBASTIAN, FLORIDA Attest~.t -~. .~. /JJ",{),'li~...... "7'~ City aerk 8, ~y..~..,""..:..... , (GJitv $tal) ST E OF Fl.ORIDA COUNTY OF INDIAN RIVBR I HEREBY CERTIFY, That on tbil ..13th.............. ,day of ..... Nov.ember................................. 1.9.0., belore me personally appeared .. W ..; ..~.~.. ~<?"Y.~+.~... .... .. ..... . .. . .... .. . .. .. ..... and .~~.th~.~.~n.. 0. ~ nAJJ.Qt.~~ .... respectively Mayor and City Clerk of the City 01 Sebaltlan, H munlellJlI c:orporatlon under the law. 01 the State of Plorlda to hie known to be the Indlviduall and ollleerl deICrlbed in and who executed the lor('lOln, eOllveyanee to ........................ ........,.9.~~P.I:t..~... ..I\lmt .~.~.~h~.~~n..~.L.~~.~.t~~~................ ............ ..... ............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. and seyerally ac:kDowledred the exec!utiontbm9l.tO be their free aet and deed 81 such olfleers thereunto duly authorised, and that the Olllelal leal of..id corporation I. duly .,ft{ed .lb1~..and the laid conyeyanee ,{ .,..'" f\r ". Is the act and deed 01 laid c:orporatJon. / ".~, ~ i' '7 ". '. . . ,/;'-,:--;;r~.""" ,j /'.; . WITNESS my IIBllature and oIllclal leal at 8ebaltian, in the County of Indian RI!ft'~1lilt ~tate of Jpld~ the day and Jear 18st aforenJcl. I ~f :;{~: i:" '-:-_~_ .. . ~- Not": P~bU~.8~ij.~..~il.i ..:, ................... My COIIUDlIaion explti!fp. Notary PubI!t, Sttite of Florida -.. lit COIIIIIlhskm tr-piros Ar-rll 30. 1994 .,. ....td.l""'-TlCly 'Clln. In.u,ancelnC. ~ ~ -, ~ ~ '" ~ t"u N- " l'~ :( ~.l~1 '-..!J LL ~ c:::s Q) E j:: ...~. ...", t' t" - , \ : Q; o:~~, tI1 - ~)/\ \) :J 'h 0 "'i-- r""-~ ~ ti ~f <~\ J -...,.,... ... ';: .r i -01 '. III :J ~ CD "1-4' Q)~ Q) '0 '0 Ol'~ ~ Q) 0 E ~ 0 Q) Q) E .-,= III c: 0 - Cii Cii - iii 0 III :J Z ::;) ...J C C Z <l: - Name' Unit Block Lot liAg.6 t ..(./ 'I _l~1 '-(' .t: l~ -<I iJ I Date of Burial / J..... " ~::. 7/)/ ?\/7/0 / ;! .' Date of Mark-out Name of Funeral Home )/"12 l/ l,l )::'5 Authorized by ......." (.:,/ ~1,1l ~~>~l' ,;l! l~ J , "'. .....;'):" '..-if" }'" "/'L.<)f\../:.;",~"~,: ' '"t>/[~ - "",;I' "f (// . ..- / .A.li /1/ Time ~~~ ~~ ~~ ~ ..., .-l o C'f'l .-l ~ A p;:j p;:j A . ...:I Z p;:j p;:j...... ...:10"1 l:I::\O E-4 < >< ~ 0 I:t:l A 0 Z ....... <00"1 . N . ~ C'f'l ~ ..<<I l:I:: Q) "c ~ CJ..-I p;:j<<ll-l rn...-to O~...-t IJ ~ +J ... tI.l .. Z ..:~ 0 f:I;':I. <Xl tI.l t'l3 tI.l E-I.O <<I ~ ...J ,0 ~C'f'l<<l d)4':3 /,'// )< ,-.'.-~~ I I :,1 ...., "',, -., . . I:.'/!"/ }J , I ~ '" ~ ~o 4' .-l 4' ~ '"'- tI.l CJ +J '--:z:. +J O'.-I~ O...-t j:l . ...:I~:::> ........ ~ --- \ ~ f-- ~ ~ -..:::::. t'- ~~ ~ I -- "\ \ \...L.. ~ \J , (1 n ~' "\ ~ ~- - ,/ I' I /' ;.' ' .. \. /'''. ,(", ~h/:.i /:/;, /:.,.' "l C1' it I s:; Q) N ~ ~,..... Q)O'\ t!h.O ..... o >< 1 . <:,) ....:l 0 0 ~,..... roS::OO'\ ~ Q) ON .' Q) 0 C"") .....tP-. ..c:........<<1 ~Q)'t:I <<1 (J'r-i ~<<1~ .....to C<SP-......t /Z.i o ~ ~rIl .. ,....lO ..;:t ..c:COrll ,....l ..;:t Po rIl ~ Q) 0 ctl rIl(J~ rIl,....l,.Q ~ O'r-i o C"") <<1 O.....t s:: ,";>..;:t:3 ....:l~p -- t '2 ! t- O 0: .. .. 8 .e 0'\: 8. ......... 8 C""): g'J . ~ i ::l ,....l: .~ .lS ......... ii ,....l: l:Q ,....l: ~ 8- ~ 5 .8 i ~ . t; .s e .3 ~ =' . ~ = Cl :j ..... ,.....: ..;:t. \0' 0 :z: ,s. 8 u 0: Q t:r: >- 0: 0 t:r: o. " i 0: q Lf'\ . Lf'\ \0: \Ct tl M M 8 .., >. ';:: '01 ,D ll.t ll.t .., ~ ~ ;f ;.:J . . ~1f7 THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: ~~~ ~llars FROM: ~.s E/'# r: ,.,,.u~ A":'J?-T#LEeAY ~ . ($ ~ StJ. tJ"t:) ) &E,er2€# -f..J/t!} J>/ oS, /lAl9fle /t/A~/1.s ~cJ , fi t1 ,,(3tJ~ b? 7 ad '77C> PL, on this /3'tt day of '11~ 19 f&for the purchase of the following described Cemetery Lot(s~pon the terms and conditions as stated herein: Description of Property: Terms and'conditions of sale: Unit# ~ Cemetery Lot(s)# Purchase Price: Dollars ($ ~S-t:J.tJ'd ) 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: Yr!'vf11r -r *+~ 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. ~,,~ .~~ ~ity of Sebastian Witness p' .,.~-'~' ,": .l_ ~'-~. . . ,. . .. ~\~,~, ;.,) ..:. ;~.. .. . . City of Sebastian POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 November 14, 1990 Mr. & Mrs. Joseph F. Gertzen P.O. Box 697 Wabasso, Florida 32970 Dear Mr. & Mrs. Gertzen: Enclosed is Cemetery Deed No. 1301 for Lots 1 and 2, Block 40, 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. ver-12'/~ r;,urlJl!/~ Kat~~ o 'Halloran City Clerk KMO: j s enclosure r- [lP.~] State of Florida, DepaAnt of Health and Rehabilitative Services, Vetatistics APPLlClF'iON FOR BURIAL - TRANSIT PERMIT t II ;2 13 ~O olf A. 1. Name of Deceased (Type or Print) First 2. Place of Death County I ndian River 3. Name of Medical Certifier Michael Tonner, 4. Name of Funeral Home/ Direct Disposer Strunk Funeral 5. Check a Appro- priate Box Joseph City, Town or Location DATE OF Gertzen DEATH July 12, 1997 Name of (If neither, give street address) Hosp. or Vero Beach Inst. Indian River Memorial Hospital W Medical Examiner Address Phone Number rxIPhysician 2300 5th Avenue, Vero Beach, FI 561-567-7111 Address Fla. Lie. No.1 Reg. No. Phone Number (Area Code) 1623 N. Central Avenue Home Sebastian, FI 1228 561-589-1000 o The medical certification has been completed and signed. A completed certificate of death accompanies this application. Middle Last Month Day Year F. M.D. b ~ Susie was contacted on 7/14/97 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. Tonner 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 6. Place of c;.Qh: . Final DisPtfsmtl~~tlan 7. Funeral Director / Direct Disposer I ndian River F.E. No.1 Reg. No. 1862 Removal from state Donation Date Signed 7-13-97 B. BURIAL - TRANSIT PERMIT Permit No. 1228-97-0306 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. il&gh 1 J.J liIi ~. k.t ~ ~ ~ Subregistrar Signature I. <2aJ. . ~ Date l 1 Issued: -, 1- 97 Date Certif~te /9 Due: 7 '" 7 c. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-:AT-SEA , Medical Examiner Date Signature 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: IE BURIAL o CREMATION o STORAGE o OTHER (Specify) Place of Disposition Date of Disposition ..L~.};-~ ~77;"1 1 r..J~ I <./, J ? ?? / 1 Signature of Sexton ) or Person-in-Charge) 7 LrooJ< -' - t'~ 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. () 1-. HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be uSlld) (Stock Number: 5740-000-0326-2)