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Home My WebLink About4-40-07 ~ ",'ii,""V-.J:,"""~_,w..~",,..../...~,-;-:'.."i,,:,.,- ;--1:, ""N,~ "!; ,. ,..~; ,'_'\l!l:",~J;;l .-m',;.>:,' ,.,.~----::~~-~_..... : faict~;CEMETERY Receipt No..... .~?~....Dated..);(.~ ?.(~~....... .......... .k 7 4g 8 -I Unit 4 List Price $ . 6.QQ. QO. . . . . . . . Maximum No. Burial Spaces. . . . . . . . . . . .. . . . . Net Paid $ . ~.QR : QQ. . . . . . . . Monument permitted. . . . . . . . . . . . . . . . . . . . . . . Carolyn Dale Norman Dale interred 1/14/91 Lot 7 5620 Obey Place (Data aboye thll Une for City Reeord only) Ri V erG rove I I NO. 1306 Seb.,Fla.32956 C!titv of l'thastian (tttmtttry Ittll '1306 NO. THIS INDENTURE MADB 'I1dI 15th .......... ........ .... day of ... .".~n~~.J;y'............................. A. D.. 1;..~.t. between the City of Sebastian, a munlelpal eorporatlon exlstln<< under the laws of the State of Florida, .s Grantor and ..................................... ~~+.Q).Yn.. .:O~;J,~............................................................................. 5620 Obey Place River Grove II ........ ... ..... ..... ................~~P.~.s.t;;i,~.lJ."..f.l.~..~.Z.95.6....... ........... ......... ............. ...................... of the County of ....... .a.r.~y.a.t'.d........ ................. an'J State of .... ..F.1DJ:ida................... .................. u Grantee, WITNBSSETH. That the Grantor for and in consideration of the sum of $ .. ~.QR : QQ. . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargam, sen, release, convey and confirm unto the Grantee . h~.r; . .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . 7. . ~. ~Block, . ,. Q . . .. ,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 shaD be used solely and exclusively for th, interment of the human dead and shaD be used, kept and maintained at aD 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 shaD 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 rust 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 rust above written. CITY OF SEBASTIAN, FLORIDA .rn.....O,d~ City Clerk B, ..to?..~........... (QIitv jieaJ) ST 'fE OF FLORIDA COUNTY OF INDIAN RIVER I HRUEDY CERTIFY, That on thll ........1.5 .th....... ..day of ......... .Janua.qr.............................J 1..91. before me personally appeared........ ~.... .~.~.. G9.lJY~~.~......... ... ..... ... . .... . .. and . .Kathr.yn..O. ~ Hall.oJ:an..... respectively Mayor and City Clerk of the City of Sebastian, a munlc111al corporation under the I.ws of the State of Fiorlda to me known to be the Individuals and officers described In and who executed the foregoln<< eoaveyanee to I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<;: ~ ~ 9. + y.!1 . . I;>.~;l, ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the exeeution thereof to be their free .d .nd deed a9 sllch officers thereunto duly authorlled; and that the Offlelal seal of .ald eorporation Is duly....'.flxedtbereto, and the said eonveyanee Is the act and deed of said corporation. '. , WITNESS my sisoature .nd ottldal Ileal at Sebastian, in the County of Indian RI~er and State. of Plorlda, the day and year last aloreaaJd. . , N~p.Wk;"'2 .;'~~"""""""'" My c:ommluion expires. N...-y Puhlic, Stllte of "Hida My Commissi1m bpires Ar-ril 30, 199. landed Thru Troy Fain - Insuranc.lnc. !'JIame N oR ("no. '"' G.DI7 L r;. TI"" Unit 1../ Block. I_Jo Lot 1 Date of Burial. \/1~ /9 I ... I 11 /'1/ fl I ,- Name of Funeral Home ..511{ U Ii'/( A"thO"Zed~;j.I~~, ". Date of Mark-out Time ...-:;....---- I...J 00 LJ. m / J. -.--. -. -. ._~_.. . ~ Ii DAL:g;i\ CAROLYN 5620 OBEY PLACE RIVER GROVE II SEBASTIAN, FL. 32956 DEED 111306 J '\ LOTS 7 & 8 BLOCK 40 UNIT 4 NORMAN DALE INTERRED 1/14/91 LOT 7 I i.., '- Lots 7 & 8 Paid by CEMETERY Receipt No......~ ?~...... . Dated .. :J:!.~ ?(~.t................ Block 40 Unit 4 list Price $ . 8.Q D. t Q O. . . . . . . . Maximum No. Burial Spaces. . . . . . . . . . . . . . . . . Net Paid $ . ~.QR: QQ........ Monument permitted....................... Carolyn Dale Norman Dale interred 1/14/91 Lot 7 5620 Obey Place (Data above dill line lor Ci17 Record oo1y) Ri ver Grove II NO. 1306 Seb. ,Fla.32~ . l' . . POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 January 18, 1991 Mrs. Carolyn Dale 5620 Obey Place River Grove II Sebastian, Florida 32956 Dear Mrs. Dale: Enclosed is Cemetery Deed No. 1306 for Cemetery Lots 7 and 8, 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. 652 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 tru1y yours, ~Ih [)t!/ tw:v,,--<-> Kathryn M. O'Hal10ran City C1erk KMO: j s enclosure ''lot \ . . ~Sd- ~ THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: ~ &-.-. /~ Dollars ($ 8"00. g-o ) FROM, ~ ~~<<< f)".b, 000 % b~ ~~..:zr .. d~~ . .F~. 30l'?S~ , on this /S-Z:t day of 6 ' 1911 for the purchase of the following described Cemetery Lo6f's) upo he terms and condi tions as stated herein: Description of Property: Cemetery Lot(s)# 7"'-.? Block# ~t) Unit#.y Purchase Price: ~ ~;..L Dollars($ rtf'd. t:/'z:7 ) 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: x 00+ ~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. ~s~ ~ - ~' ..}tr/YLl~. AA"d~ tness ..... ., 4 . . ~ i ~\~~ hJ 0 ~ ~~ Jil[ ~\ ' 11:r, "i ~ ;D~I" o ~ I.. I. ~ ~ ~ I: U1 \ ~ U1 ~ o " "it\. ~ g ~ i ~~ o o O"J O"J ~ \ - o -~ .. ." 'ii - -----, ~ ...C ;ii fR~..... ~~i i J;l !D . ~ ~ ;n~r- IiI em m ... N ~ ~~ Ul o IIIJ State of Flodda, .rtment of Health end Rehabilitative ServtLl StatIStics APPUCATlON FOR BURIAL - TRANSIT PERMIT J.. 7 '^- r 18 /j () t/1 A. 1. Name of Deceased (Type or Print) First Norman Middle Last Dal e .- DATE ,.QF. . DEATH Month Day Oltll/91- Year E. 2. Place of Death County Brevard 3. Name of Medical Certifier 1750 Cedar Street '. 'I Dennis J. Wickham, M.D, H.E. Physician Rockled e Florida 32955- (407)633.1981 4. Name of Funeral Home/ Address Fla. LIc. No.1 Reg. No. Phone Number (Area Code) Direct Disposer 1623 North Central Avenue Strunk Funeral Homes P.A. Sebastian FI 32958 1228 407 562-2325' 5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box City, Town or Location Medical Examiner Name of (If neither, give street address) Hosp. or Inst. 5620 Obey Place' Address Phone Number Micco 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 and sign the medical certification of cause of death. Anita DennIS J. WIckham, M.D, M.~. was contacted on 01112/91. Me/she verified that , Medical Examiner, will complete and sign the c []. medical certification. 6. Place of Sebastian Cemetery Final Disposition: 7. Funeral Director / Direct Disposer .... Indian River 'f, FE No.lReg; No. "'1672 Removal from state Donation Date Signed 01/12/91 B. BURIAL - TRANSIT PERMIT 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 fiU death certificate req ted. Registrar or Subregistrar Signature Permit No. 1228-91-0019 ~::d: /-/ ~ 9 / Date Certificate Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL -AT-SEA Signature , Medical Examiner Date or Medical Examiner, I 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 Signature of Sexton ) or Person-in-Charge) o STORAGE o OTHER (Specify) Ki' 9- ;~~~. Place of Dispositio""" Date of Disposition J:E~S{I'A.J &-. /... /V. 1" Methods of Disposition: RJ BURIAL o CREMATION 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) J.