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Home My WebLink About4-40-09275 Kusilek Street River Falls, WI 54022 March 8, 2011 Jeanette Williams Deputy City Clerk City of Sebastian c/o Sebastian City Hall 1225 Main Street Sebastian, F1 32958 Dear Ms. Williams: We, the heirs of Elizabeth Ferguson, wish to sell Sebastian municipal cemetery Lot 10 back to your city. Please see the enclosed copy of the certified deed. Our mother's cremains have been placed on top of our father's casket in Lot 9. We both live in Wisconsin and have no need for Lot 10. Please make the check payable to Onnolee E Hill and mail it to the above address. We will then send you the original deed. Sincerely yours, �- Onnolee E Hill Don, na Hill - ul Lq4,, I Ap Ij B ' *1 OF yVV5 '11:11moiC`- Y , A,q Sty . CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash Due Date To Be Completed By Department 3/18/2011 Single Check Y / N Vendor Number LN TC Reference Organization Code Object Code Project Code Amount 601011 534959 $190.00 Description Number of Lines Amount $190.00 The Lee Sisters wish to sell back one of their parent's cemetery lots. The parents paid $200.00 a piece for each lot. Refund will be $200 minus admin fee of (request attached) ISSUE CHECK TO NAME Onnolee F. Hill ADDRESS 275 Kusilek Street CITY River Falls STATE WI ZIP CODE 54022 DRAW CHECK FROM SEE BELOW , APPROVED BY DATE 3/11/2011 BUDGET APP 0 MAIL ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach a copy of documentation along with the original) OTHER INSTRUCTIONS Please give copy of check to Clerk's office L 9, 10 2/19 91 Bl�k 40 Paidfiy CEMETERY Receipt No... 661 ......... Dated ....... . � .................. Unit 4 NO. List Price $ .. 40 • 00...... Maximum No. Burial Spaces ................. 1315 t� Net Paid S .. 4 0 �: 0 0 5 .......... Monument permitted ....................... Elizabeth Ferguson Leo Ferguson interred 2/18/91 Lot 242 Del Monte Rd. (Data above this Ile for City Record only) Sebastian, Fl 32958 Tifv of orhafi ian AT y}� iii A p 1 `315 w it it t s r� i NO. THIS INDENTURE MADE TLis ....19th.........„ day of ..... f('-t?I~LXa y .......................... A. D., 19.9.1., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and . ............................... Elizabeth Ferguson 242 Del Monte Rd.... ....................... .....................Seas,tian F1Qrc1 b .. X29..$................. ............................... of the County of ....Indian River . an] State of .......Florida as Grantee, WITNESSETH► That the Grantor for and in consideration of the sum of $ . 4M.90 .......... , , 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 .. her .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) 9 10 , Block, .. 4 �.. , , UNIT , 4 .......... , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat 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 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 to accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for tfp 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. Attest -7 /...... 1. /.1..� City Clerk Signe ,Sealed and Delivered in Presence of GCfhr'......... ... ......... S ATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By..................... M r I HEREBY CERTIFY, That on this ....... 1.9.th .......... day of ......... F. ebruary ............................. 199.1., before me personally appeared „W. E. Conyers and Kathryn 0! 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 ................... ............................... Elizabeth... xgusoA ............................ ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorised; 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 of Florida, the day and year last aforesaid. ..r'. V . •.. . fir.... .. .......... . Not& ublic, State of Florida at Large. My commission expires► Metary Fall-r!, State r° Fl ^riao My Coirminbn Expires C,:r! 30, 1994 Bonded Thru Troy Fain . Insurance Inc. Name ^ /.Z NG �/t' /' G� gsi :SOW -_T-i'!'r!P g4*7,# /N Unit Block Lot 9 Date of Mark -out / �► d Date of Burial � / �� l Time �l /ici ,� G.�� !A( Name of Funeral Home Authorized by Apri126, 2010 Sebastian City Cemetery c/o Kip Kelso 1225 Main St. Sebastian, FL 32958 Re: Lot #9 Leo Tom Ferguson Dear Kip: Enclosed please find a check in the amount of $50 for prepayment of the excavation fee for the burial of my mother's (Elizabeth Ferguson) cremated remains. A receipt would be greatly appreciated. Sincerely, 9 Donna L. Hill 216 Liberty Rd. River Falls, WI 54022 715- 425 -6927 jim.donna.23@sbcglobal.net 0 o = -7!3 � C M CO CITY OF SEBASTIAN CITY CLERK'S OFFICE 4691 RECEIPT Name bon na 0 1 0 Date 5 0 No. 001001 208001 001501 322900 001501 341920 001501 341910 001501 341930 601010 343800 00`1501343805 ❑ Cash ��/^� 77� (Check few Amount Paid Sales Tax Garage Sales Copies/Bid Specs. LDCICode of Ordinances Election Qualifying Fees Cemetery Lots( re V3 u-'s 01) LotfNiche _L —, Block —►=, Unit 4 Cemetery Fees * Total Paid • 0 0 Initials White - Dept. of Origin • Yellow - Finance a Pink - Applicant Name 0 Unit Block �� t Lot Date of Mark -out Dafeof Burial A ` �` i l Time f Name of Funeral Home ,r Auth6 ied by F'ERGUSO ELIZABETH DEED #1315" 242 DEL MONTE RD. SEBASTIAN, FLORIDA 32958 LOTS 9, 10 BLOCK 40 UNIT 4 LEO FERGUSON INTERRED LOT 9 2/18/91 -I Lots 9, 10 Paid by CEMETERY Receipt No. ... 6 61_ ........ Dated ....?.� 1?/ 91. , Block Lots 4 0 400.00 No. List Price $ Unit 4 .................. Maximum No. Burial S Paces ................. Net Paid S .. 400.• OO 1315 . Monument Permitted .. Leo Ferguson interred 2/18/91 Lot Elizabeth Ferguson (Data above tb� ne for City Record only) 242 D e 1 Monte Rd. Sebastian F1. 32958 A City of Sebastian POST OFFICE BOX 780127 ❑ SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589 -5330 o FAX (407) 589 -5570 February 22, 1991 Mrs. Elizabeth Ferguson 242 Del Monte Rd. Sebastian, Florida 32958 Dear Mrs. Ferguson: Enclosed is Cemetery Deed No. 1315 for Cemetery Lots 9 and 10, 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. 661 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, Kathryn M. O'Halloran City Clerk KMO:js enclosure I. THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: �/'� -� �� -r-✓ Dollars ($ `�D`D• O`D 1 FROM:_ on this /9-t,C day of , 19 9 /for the purchase of the following described Cemetery Lot(s) upon a terms and conditions as stated herein: Description of Property: Cemetery Lot (s)# 9 "� /D Block# ! O Unit# '/ Purchase Price:_Fe� &,,z.1,_z Dollars($ ",O� ) 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. Witness ty of Sebastian • f •rrr A o OM ' v mo �m O r O O 00 0 I 0� r O so a- 0 to O r ru °i } 14T PIC 0 1- 1 i m v N i lm m Z '11 z�� P� D m m V rn 0 U1 State of Florlda,artment of Health and Rehabilitative Services, Vital Statistics A6 Ild APPLICATION FOR BURIAL — TRANSIT PERMIT • u / A. (Type or Print) / 1. Name of First Middle Last DATE Month Day Year Deceased Leo Tom Ferguson OF 02/14/91 DEATH 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian InI42 Del Monte Road 3. Name of Medical Medical Examiner Address Phone Number Certifier Physician 7744 Bay Street Noor Merchant Ph vs Sebastian Florida 32958 (407)589-0879 4. Name of Funeral Home / Address Fla. Lic. No. /Reg. No. Phone Number (Area Code) Direct Disposer 1623 North Central Avenue Strunk Funeral Homes P.A. ISebastian, F1 32958 1228 (407)562-2325 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box bg ❑ was contacted on 09114 /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 thalloor Merchant will complete and sign the medical certification of cause of death. c ❑ was contacted on . He /she verified that medical certification. Medical Examiner, will complete and sign the 6 Place( Cemetery In state cemetery/ Removal Final Disposition: XFbcrematory - na nty: Indian River Elfrorn state F1 Donation 7 Funeral Director/ ature F.E. No. /Reg. No. Date Signed Direct Disposer / _ B. BURIAL — TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit NJ228 -91 -0077 ❑ 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 certffica�req ed. Registrar or Date Date Certificate Subregistrar Signature Issued: Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA Signature , Medical Examiner Date or Medical Examiner, gave authorization by telephone to The Medical Examiner's approval must be obtained before disposal by any Disposer. above methods. A waiti death is required for all cremations. ng period of 48 hours after D. CEMETERY OR CREMATORY Methods of Disposition: ❑ BURIAL ❑ CREMATION Signature of Sexton ) or Person -in- Charge) _ ❑ STORAGE ❑ OTHER (Specify) 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. HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740 -000- 0326 -21 J. FROM :EAST COAST MONUMENT COMPANY FAX NO. :3212598690 Feb. 03 2011 10:29AM P1 l '1 ti ry1KN• Sebastian 1)i'1I4:1 II()X )11017) n it IIA!OJAN, 1I01{IIfA %&.v#pII If1.1'r'lIf)tll (4(17) rill 1 A +4r) I) frl!)r,r'i)p tJ()I'fi: '1'111: I': FUft I( !"ORMA'!'1(.)NAT, 1'Ultl'():;F::i fit:f;l�lillitlf: 1t�ItJUMF.IIZ'$ AT SrIIA;;T•1,AN Cr-.Mr- -rpRY: Pl,rAS IZF:'I'l1RIJ '1'c,Ti f;1'I'Y OF Sr:13A:;'I'11 AN D� Y N' ' X ` ;rT1Af;T 1 AN CITY IIAI.I, 1) 7!1 MAIN !i 1'111 l {'1' `myv-y rw7-, :17'1'111 / Ire i Qo 4MP NAME: _....w. 12 A� L�.a -.I So, D.O.B. _._.. ! 2aD O.D._ . 'ZQ 1 5 /VAvE" HER 'NAME: LEGAL AESCRZPTION: UNIT: - -- ---- _- - - - - -- - -- - — BLOCK, LOT: - - -- - -- -- — •- SQUARE' FEEr: APPROVED:_ CHECKED BY: DATE: SUBMITTED AY: EAST COAST MONUMENT COMPANY low�p� Tif�ic,C 'Y A o.