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Home My WebLink About4-40-05 -----,-.-----:'<"_~i~,<T-~ ... hi: by ~METERY Receipt No. . . . . . ?? ~ e. . Dated. . . ~l ~. ~ / ?~ . . . . . . . . . . . . . . . . list Price S.. ~9R: g9....... Maximum No. Burial Spaces................. Net Paid S .. aOQ,.Qo....... Monument permitted..... .................. Lots 5 & 6 ~k 40 tlfIIIIf t 4 NO. Charles E. Lockard interred 1/12/91 Lot 5 (Data abon thl8 line lor CUy Record only) \1305 Cecelia J. Lockard 322 N. Tamarind Circle Barefoot Bay, Fl. 32976 (!titg of &thastian QIrmrtrry m rrb "l305 NO. THIS INDENTURE HADE '111I8 ..JAth............ day 01 ....~.hm\l.aX'y............................. A. D.. 19..9.1, between tbe City 01 ~butlan, a municipal corporation exlstln, under the laws 01 the State 01 Florida, as Grantor and Cecelia J. Lockard ........... ... ..... ................... "'32'2" rL"iamar':lIid' .C.:lrc'ie.... .......... .... ......... ........................ ...................... ..... ................ ..Ba.r.efao.t. .Bay.~. .Fl... .329.76.... ...................... ...................... 01 the County 01 ..... ..~.:r;~y: ~.:r;4. . . .. . . . .. .. . .. .. .. .. . .... an') State 01 .....F 1 Q r.i.da.. . .. .. .. .. .. . .. .. .. .. .. .. .. .. .. .. . .. . u Grantee, WITNESSETH. That the Grantor for and in consideration of the sum of S . ~.Q9. ~ QQ.. ..... ... ...... to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargaID, sen, release, convey and confum unto the Grantee . .l:1~:r... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: AD of Lot(s} ~.. ~. . .6, Block, . .4 Q . .. , UNIT ...4......... , 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 shan be used solely and exclusively for lhe interment of the human dead and shall be used, kept and maintained at an 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 shan 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. CITY OF SEBASTIAN, FLORIDA Attests CJ(~f?J.:..()II~ . n . .. ./. . . .. City Clerk //~ c::::: . B1~~..........~... (Q!itu ~eal) SATE OF FLORIDA COUNTY OF INDIAN RIVER 1 HEREBY CERTIFY. That on thlll ... .14t.h............ .day 01 ..... . JaOllar.y. ...................... ..........., 19.9.1. before me personally appeared ..... ~ ~ .. ~ ... ..~ ~ ~ r.~.:r: ~ .. . .. .. .. .. .. .. .. ~ .. . .. .. . .. ... and ..~.~ ~ ~ ~.Y~ .. 9. ~ H~ J-J .<?}:; ~ 1;1. .. .. . respectively Mayor and City Clerk 01 the City 01 Sebastian, a municipal corporation under the laws of the State 01 Florida to me known to be the Individuals and officers described In and who executed the foregoing cORveyanee to .............. .......... ....................~~.~.~~~~..~.....:J;..c?~~E;l.:r;~........ ................... ..... ............... ............ · . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the execution thereol to be their free aet and deed as such officers tllereunto duly authorized; and that the Official seal 01 said corpondlon Is duly affixec! thereto. and the said conveyance is the lIet and deed of said corporation. -: . WITNESS my signature and officlal leal at Sebastian, In tbe County of Indian River and State 01 Florida, the day and year last aforcaald. Nota ubllc. State of Florida at Lar~. . My CODIIIIlulon expire.. Notary 'U~!Ir. Stat of Flo~lda My Commission Expiru April 30. 1994 Ionded Thru 1 roy Foin . In.uronce Ine:. "', '/,,(.J I ,-r::;:,.C._.., .' i.'. 0"'" '::' ILt!! f). Name: {~~11 '7 P .. ~ S ~ k Unit I ,. 1 'Y" BlocK' -'10 Lot ~....,.... " ;1111<;;/ I j I ';L J 9 I . Name of Funeral Hom$ '5 1"12' U rl ;::. ;1 // '. . rI./l . , ' A/"'C:~ ./' .A Authorized by .t~." '. '[>C" ~-' -.'7 (;;';". . "7 Date of Mark-out Time 11 :00 /l,f/t. Date of Burial _._ .,____...--...uu'_,,_. ..... .... .,.__., _______..__ ? LOTS 5, 6 BLOCK 40 UNIT 4 DEED 111305 CECELIA J. LOCKARD 322 N. TAMARIND CIRCLE BAREFOOT BAY, FL. 32976 CHARLES E. LOCKARD INTERRED 1/12/91 LOT 5 , " - J, J~ Paid by CEMETERY Receipt No. .... .??J:..... . Dated. . .~/)..~/.~.~................ List Price $ .. ~9~: g9....... Maximum No. Burial Spaces................ . Net Paid $ .. ~QQ,.QO....... Monument permitted....................... tharles E. Lockard interred 1/12/91 Lot 5 (Data above tbia line tor City Reeord only) Lots 5 & 6 Block 40 Unit 4 NO. \1305 Cecelia J. Lockard 322 N. Tamarind Circle Barefoot Bay, Fl. 32976 -, . . .' POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 . TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 January 18, 1991 Mrs. Cece1ia J. Lockard 322 N. Tamarind Circle Barefoot Bay, Fl. 32976 Dear Mrs. Lockard: Enclosed is Cemetery Deed No. 1305 for Cemetery Lots 5 and 6, 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. We are enclosing two copies of Receipt No. 651 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, ~~n, ()J/jtU6-,,-.., Kathryn M. O'Halloran City Clerk KMO: j s enclosure I I '.., -. . . ~0/ THB SBBASTIAN CBMBTBRY City of Sebastian Sebastian, Florida RECBIPT IS HBREBY ACKNONLBDGBD OF THB SUM OF: ~ fiT: &~P.// DDllars ($ ,f'dd. tf'rJ ) FROIf, (';o~~(?i, 4h~ . ..3~d 0/ ~~ ~ ~ 4. ,.c...!. au2/. on this //ft;;L day of iAf~.A~h , 199/ for the purchase of the following described Cemetery Lo~'~he terms and conditions as stated herein: Description of Property: Cemetery Lot(s)" 5" "'';0 Block" ~ tJ Unit" 7' Purchase Price, ~.I,,6 rji;~"L DDllars($ ?t!tJ.ti'tJ ) 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. . ~-~ d~/-:t ~ty of Sebastian . Witness .. , " III __ A . i ~ J;lg i:lm ./ . en '.l~,>,:~l ~;~. .. -I ~f :D ...C = ~~ F cnZ,.. m~C ~~Z - 0 m i > m:D ~~~ j:!J::Dr- > Ir-X >0 ~I: em m ~ ~ - do .. .... ... o -\1 \ " ........... .. ~ C&) ~ ~,-~' ~.. 8 f iJ ~~ U1 ~ ~ State of Flodda,"rtment of Health and Rehabilitative SerV.1 Statistics A~ICATION FOR BURIAL - TRANSIT PERMIT 2' $';7.t' /0 ftJ /j i A. 1. Name of Deceased (Type or Print) First Charles Middle Edward . Last Lockard DATE OF. DEATH Month Day 01110/91 Year 2. Place of Death County Indian River 3. Name of Medical Certifier George A. Mitchell, 4. Name of Funeral Home/ Direct Disposer Strullk Ftlllf!f'al 5. Check Appro- priate Box City, Town or Location Name of (If neither, give street address) Hosp. or Inst. Hu.ana Hos i tal-Sebastian Address Phone Number Roseland Medical Examiner 13855 U.S., 1 X Ph~~~n Sebastian Floirida 32958 407 589-8992 Address Aa.~. No.1 Reg. No. Phone Number (Area Code) 1623 North Central Avenue Ho.eSi" P.A. Sebastian FI 32958 1228 407 562-2325 a 0 The medical certification has been completed and signed. A completed certif~ate of death accompanies this application. D.O. PA b [] f.rtH a was contacted on 01/10/91 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 Georlte A. MitchelL D.O.. PA 1.\ will complete and sign the medical certif~ation of cause of death. c 0 was contacted on . He/she verified that ,Medical Examiner, will complete and sign the medical certification. 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 filin he d ath certific te re ested. Registrar or Subregistrar Signature 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. 6. Place of Sebastian Final Disposition: 7. Funeral Director/ Direet gie~99er 'B. C. Indian River F.E. No.ll1eg. NI): Removal from state Donation Date Signed BURIAL - TRANSIT PERMIT Permit No. 1228 !J1-Ul)15 Date / Q / Date Certificate Issued: . - 10 - r / Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA D. CEMETERY OR CREMATORY Methods of Disposition: ~ BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) o STORAGE o OTHER (Specify) r...p '}. ~~ L >. ()-1 Place of Disposition Date of Disposition SEBASTIAN CEMETERY 1,)1:./91 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 da~ to the local HRS County Publ~ 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) s