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Home My WebLink About4-40-28 Jk Lots 27 & 28 Block ') Paid by CEMETERY Receipt No.... 6.7.1........ Dated.... 5./ .31L 9.1........... .lJni t ..,_ List Price $ . .. ~.QP. ~ ~9. ... .. Maximum No. Burial Spaces...... ....... ... . Net Paid $ ... ~.QP. ~ ~9. '" .. Monument permitted... .... ..... ...... ...... . NO. '1327 (Data above thl. line for City Reeord only) Laura and Philip Ciano 1574 East Lake Lane Sebastian. Fl. 32958 atitv of &rbusthlU <1!rmrtrry I rrx. 1 ~~~~7 NO. THIS INDENTURE MADE TIaII .... ..:n ~ r, .. , .. .... day of .......... .May,... .. .... .................... A. D.. 18. .91., between the City of Sebutlan, a municipal corporation al.tln, under the ~aws of the State of Florida, a. Grantor and .."........................................... .J;..~~~~. ..~!!q ..~h~J..~p.. ~~.~.I).!=!................................................ 1574 East Lake Lane .. ... ......... ............................... . .S.eba.~.t;.:i.an,.. Flo.r.:i.da ..329. 5.8 ..,......................................... of the County of .. Indian..Riy.er...................... an:! State of ....... Flo.rida................................... u Grantee, WITNESSETH I That the Grantor for and in consideration of the sum of $ . .~~9... 9.Q...... ... .. . ... to it in hand paid, the receipt whereof Is herewith ae- knowledged, does by this instrument grant, bargaiit, sell, release, convey and confirm unto the Grantee . J:.l)~i;( heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s~ ? .&If}~ . 'Block, . . .49. .. ,UNIT .. It. . . . . . . . .. ,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 shall be used solely and exclusively for the interment of the human dead and sha11 be used, kept and maintained at all 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 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- se"e and comply with such rules, regulations, resolutions and ordinances and the conditions of the deled 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 Cust 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. CITY OF SEnABTIAN, FLORIDA Alt"t:~~Jn...f)/~.. -, /I'" City Clerk B1~.Y=..... " (aIitg jieaI) STATE OF FLORIDA -.--...--- - .- Name Unit Block Lot L /.:tu RfI (1;0/;0 ~ ,Ii 0 cP& Date of Mark-out 1/ h. -'//9:Z ' Date of Burial l\\:)}, ':,)~. '\1 d.. Nama~~,.'al 0 ma."...,~,.~,. C.,~~. k. -'~, Autho,;zk 4. . ;;0/ --~. , / . " -- ._......_....___.h_. '__..._ _ _ __,._.~., _ "'_ ..,.-'.,'~._ Time I(J. 0 () /1, /"Y""/ J. .-- '-'-'--- -. -._._-.~..-.__.._.._~ .. State of Florida, DepartmeaHealth and Rehabilitative Services, Vital SWicS APPLlCATI OR BURIAL - TRANSIT PERMIT I- ;;7, d 8" /3 /j t1 OJ A. 1. Name of Deceased (Type or Print) First Laura Middle Last Ciano DATE OF DEATH Month Day Year 11/23/1992 2. Place of Death County City, Town or Location 3. Name of (If neither, give street address) Hosp. or Inst. Medical Examiner 5. Check Appro- priate Box Physician Address 1623 N. central Ave. Sebastian, Florida 32958 11228 ? The medical certification has been completed and signed. A completed certificate of death accompanies this application. 1300 36th. Street 4. b q Ka.ren was contacted on 11/23/199'!ithin 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 G9rdd Pi9roA9j Jr 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. 6. Place ~f Sebastian Final DISposItIOn: 7. Funeral Director / Oil'Acl niolX'8er Removal from state Donation Date Signed -"'-... 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 filing ~ath certificate reques d. Registrar or ;<.lJ tf. /J // " a Date / I /];2 4''1 Date Certificate Subregistrar Signature ~ fC. , Issued: / / -~.J~ /.?o Due: Permit No. 1228-92-0536 C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA 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. D. CEMETERY OR CREMATORY Methods of Disposition: 1:8:1 BURIAL o CREMATION o STORAGE o OTHER (Specify) ~:-. Place of Disposition Date of Disposition ~ ,= ;";~~ Signature of Sexton ) or Person-in-Charge) -<..~/,o.;./ . tJ f....., "'- 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.