HomeMy WebLinkAbout4-40-14
J,A-
, . 655 I
Paid by CEMETERY ReceIpt No. . . . . . . . . . ;
List Price $ . ~.~~ : ~~. . . . . . . .
400.00
Net Paid $ ..................
v......s 13
...Dated...J/??!?t.... ...... .... B ck 40
. Unit 4
Maximum No. Burial SPaces. . . . . . . . . . . . . . . . .
14
NO.
Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
, 13t)9
Sophie I. Milano interred 1/25/91 Lot 13
(Data above this line lor City Reeord only)
Et tore lUlano
1581 Emerson Lane
Sebastian, Fl. 32958
OIttll nf l'rhasttan
OJrmrtrry
i rr~
"1.~1-'9
NO.
THIS INDENTURE MADE 'I1aIa
25th
day of ...~~~':l.~~y.............................. A. D., 19.~~...
between the City of Sebastian, a munlclpal corporation existing under the laws of the State of Florid.. as Grantor and
Ettore Milano
............... ......... .... .........i.s.81..En{ers.o.;.. 'L~';"e" .... .......... ............................... .... .................
Sebastian Fl. 32958
. . .. . ........................................ .......,.................................... ............................................
of the County 01 .... ..Indian.. Ri v.er.................. an'J State 01 ..... Flar.ida.. ...................................
as Grantee, WITNESSETH I
400.00
That the Grantor for and in consideration of the sum of $ .;........................ to it in hand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargaID, sell, release, convey and confum unto the Grantee .. .l?- ~ ~.. heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
13 14 40 4 .
All of Lot(s) . . .'. . .. ,Block, . . . . . . .. ,UNIT ............. ,of Sebastian mumcipal cemetery as per Plat Number 1 thereof recorded in Plat
Book 2, at page 6S of the public records in theofftce 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 in accordance with the ruies 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 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 Cierk and Its corporate seal to be hereto affixed, the day and year first above written.
AIl'''~~.' ;.......) .'.m...{)~tI~
"., ~..'. {l"~ City Clerk
CITY OF SEBASTIAN, FLORIDA
B, .~.~."'" ~
M'~
.'<.~~...................
STATE OF .OllIDA
COlrNTY OF INDIAN RIVF.R.
(<<Iit" JiJ!aJ)
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NameE iro f\ E
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Unit ~
Block
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Lot
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Date Of Mark-out
. ,3 .:-'1 "":,9:h---.,."
Date of Burial .3 - II 9 =<..
Time
ID
v~;) 14.1111-
Name of Funeral Home
(7
Authorized by _.k~tf~';rl-l\."{
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flll~1
State of Florida, Department of Health and Rehabilitative Services, Vital Statistics
APPLICATleOR BURIAL - TRANSIT PERMIT .
/-. /3~ 7J?
/3 ~IJ
01
2. Place of Death
County
Indian River
3. Name of Medical
Certifier
Mohammad Idrees
4. Name of Funeral Home/
Direct Disposer
Strunk Funeral Homes
5. Check a 0
Appro-
priate
Box
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 e death certificate requeste
Registrar or 4>
Subregistrar Signature
A.
1. Name of
Deceased
(Type or Print)
First
Ettore
6. Place of Sebastian
Final Disposition:
7. Funeral Director /
-/;)iFe8t e;OJ^I~~r
B.
C.
Signature
or
Medical Examiner,
Middle
Last
Milano
Month Day Year
03/07/92
DATE
OF
DEATH
City, Town or Location
Name of (If neither, give street address)
Hasp. or
Inst. H .
umana Hos
Address
Phone Number
Roseland
Medical Examiner
1454 S.W. Bel Aire Lane
Ph~ician Palm Ba Florid
Address As. Uc. No.lReg. No. Phone Number (Area Code)
1623 North Central Avenue
P.A. Sebastian Fl 32958
The medical certification has been completed and signed. A completed certificate of death accompanies
this application.
b [j
~l1l"Q~ was contacted on 03/10/92 within 72
hours after death. He/she verified that this death was from natural causes, that there was no accident
nor other exte'!lal cause of death, and that Mnhamman T nrpP~ 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
medical certification.
Indian River
F.E. No.lPeg "Ie:-
Removal
from state Donation
Date Signed
BURIAL - TRANSIT PERMIT
Permit No. 1228-92-0117
~~: 3_/0- 9'2.- ~~ Certificate
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.
Methods of Disposition:
m BURIAL
o CREMATION
Signature of Sexton )
or Person-in-Gharge )
CEMETERY OR CREMATORY
o STORAGE
o OTHER (Specify)
Rra '7- Lk?"
Place of Disposition 5eb a s t i an C emet e r v
Date of DispOSition 3 / 1 1 / 9 2
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)
I (Stock Number: 5740-000-0326-2)
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