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Home My WebLink About4-40-12 /' - .JaW-"1 CEMETERY Receipt No. . .Q ~.~. . . . . . List Price $. A9Q ~.QR....... Net Paid $ . AQ.Q I.QQ....... . .Dated.... ~.{AtI.9.t.............. T")ts 11 & 12 ock 40 Unit 4 NO. William D. Glessinger, Lot 12 Maxbnum No. Burial Spaces. . . . . . . . . . . . . . . . . 1 3 - 7 Matilda Gressinge~ l} Monument permitted....................... 660 Balboa St. Sr. interred 1/19/91 Sebastian, Fl. 32958 (Data aboye thll Une for Clt, Record only) atitv of &fbustian <l!rm'rtrry mrrIt 1307 NO. THIS INDENTURE MADE TIaII ........~.\~~....... day of .......J~n1:l.~;l;y............................ A. 0.. 19..~.~.. bet,,'un the City ot Sebutlan, a municipal corporation exlltlng undcr the lawI ot the State ot Florid.. al Grantor and .... . .. . ................................ .~.~.t;;i,l(l.~.. ~t:'.~.~~;i,1;l.g~J::."................................................... .'........ ' 660 Balboa Street ...................... ...................S.ebas.t.ian,.. Flo.rida. .3.29.5.8....... .....,...................................... of the County ot ....... .r.I:1.d;i.~J;1.. R;i. V.~.:r;................ an'] State of .... ..:FJPJ:::j..Q..~..................................... u Grantee, WITNESSETH I That the Grantor Cor and in consideration oC the sum oC $ .49.Q... 9 ~ . . . . . . . . . . . . . . . . to it in hand paid, the receipt whereoC is herewith ac- knowledged, does by this instrument grant, bargalD, seD. release, convey and confirm unto the Grantee ... ~.~ ~.. heirs, legal representatives and assigns the Collowing property situated in Sebastian, Indian River County, Florida, to-wit: 11"1''2 40 4 All oC Lot(s) . . . J . :. ,Blodc,........ ,UNIT ............. ,oC Sebastian municipal cemetery as per Plat Number 1 thereoC recorded in Plat Book 2, at page 6S oC the public records in the office oC the Clerk oC the Circuit Court oC St. Lucie County oC Florida; said land now lying and being in indian River County, Florida. To Have and to Hold the same Corever; provided that said property shaU be used solely and exclusively Cor th~ interment oCthe human dead and shaU be used, kept and maintained at aU times in accordance with the rules and regulations, ordinances and resolutions ~C the City oC Sebastian, Florida, hereto- Core, now and hereafter adopted or provided Cor the government and operation oC said cemetery. The conditions. restrictions and requirements contained in this instrument shall be covenants running with the land. In the event oC the Cailure oC the owner oC any property situated within said cemetery to ob- serve and comply with iuch rules, regulations. resolutions and ,ordinances and the conditions oC the de!ed oC conveyance thereoC then the title oC such owner in and to said property shaU terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party oC the first part has caused this instrument to be executed in its name and on its behalCby its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. Al':'-:-'~ )AJ,Dd~,...... ~~ (j City Clerk CIT:,~~~..........~... STATE OF FLOnIDA...5f~:::::.:::.:.:. COUNTY OF INDIAN RIVBR ' (GIifu Jieal) Name w; Ih'arYl '....~... D. G- R E: ,:5($ IrV ("1 e f;' "i(( , Unit, , J \,.,.-1 Block qo Lot 11... Date of Mark-out j/J9Jqf / , f l/Jq/9i I I Time 300 P ,m. I Date of Burial Name of Funeral Home """4.N, "K,' ,"",', 'Y\l'~ l~~./ .,,( ; ," Authorized by!\//7.;/c _""'/ it. <~ (<:',:,;~~,.. .,.:,j:'$ /'.'\.1/// J. Lots 11 & 12 1/21/91 Block 40 .............................. Unit 4 NO. Maximum No. Burial Spaces. . . . . . . . . . . . . . . . . M t . Matilda GressingeJ.307 onumen pernutted....................... 660 Balboa St. Sr. interred 1/19/91 Sebastian, Fl. 32958 (Data above tills line tor C1l7 Record only) Paid by CEMETERY Receipt No...Q ~J.......... Dated List Price $. A9.Q ".QR....... ,Net Paid $ . AO.Q ...QR....... William D. Gressinger, Lot 12 State of Florida, _rtment of Health and Rehabilitative Servl.ltal Statistics APJIrICATlON FOR BURIAL - TRANSIT PERMIT /.. llrA/;; ,(J /f tJ !Ii A. 1. Name of Deceased (Type or Print) First WILLIAM Middle Last DATE OF DEATH Month Day Year DONALD GRESS INGER, SR. 1/17/91 City, Town or location Name of (If neither, give street address) Hosp. or Inst. 2. Place of Death County INDIAN RIVER 3. Name of Medical Certifier FREDERICK P. HOBIN, 4. Name of Funeral Home/ Direct Disposer STRUNK FUNERAL HOME, 5. Check a 0 Appro- priate Box ROSELAND ~. Medical Examiner HUMANA HOSPITAL-SEBASTIAN Address Phone Number 407-464-7378 FT. PIERCE, FLORIDA 34891 Fla. lie. No.lReg. No. Phone Number (Area Code) M.D., M.E. -, Physician 2500 - 25TH. ST. Address 1623 N. CENTRAL AVE. SEBASTIAN SEBASTIAN, FLORIDA 32958 1228 407-589-1000 The medical certification has been completed and signed. A completed certificate of death accompanies this application. 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. HELEN c QJ was contacted on 1/18/91 . He/she verified that ,Medical Examiner, will complete and sign the DR. FRF.DF.RTCK HOBTN medical certification. 6. Place of SEBASTIAN Final Disposition: CEMETERY 7. Funeral Director/ Direct Disposer SEBASTIAN, FLORIDA INDIAN RIVER F.E. No.1 Reg. No. b7' Removal from state Donation Date Signed 1/19/91 B. Permit No. 1228-91-0032 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 flied with the local Registrar of the County in which death occurred. o No extension of time for fir the death certificate requested. Registrar or Subregistrar Signature C. Signature or Medical Examiner, BURIAL - TRANSIT PERMIT 1/18/91 Date Certificate Due: Date Issued: AUTHORIZATION for CREMATION, DISSECTION or BURIAL -AT-SEA , Medical Examiner Date , 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: Q:BURIAl o CREMATION Signature of Sexton ) or Person-In-Charge ) o STORAGE o OTHER (_)~ ,(y 1- /~? Place of Disposition Date of Disposition SEBASTIAN CEMETERY JANUARY 19, 1991 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. '-