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HomeMy WebLinkAbout4-40-36 :~ ~ '. 658. 2/6/91 . .Paid by ~E~ETERY Receipt No. ...... .... . . Dated..... .. ..................... List Price S . . ~.QR : .Q9. . . . . . . Maximum No. Burial Spaces. . . . . . . . . . . . . . . . : Net Paid S .. ~.QR :.Q9....... Monument permitted..... .................. Helen Fevang 573 Benedictine Terr. Sebastian, Florida 32958 Is 35, 36 ck 40 1t 4 NO. 1312 Edward Fevang interred Lot 36 2/6/91 (Data above lbla line lor CU,. Reeord 0011) C!titD nf l'rbastiau <1!rmrtrry Itrb NO. "'1312 THIS INDENTURE MADE 'I1aII ... ~ ~.J.:l.. . .. " .. .. '" day 01 .... .Ii'~ P~.'l:1.~~y.. ...................... '" A. D.. 19...~~, between the City 01 Sebastian, a municipal corporation exlstln. under the laws 01 the State 01 Florida, aa Grantor and ...,........... ... ...... .... ........~~~.~..~~~.~~..~~.'f~~&.. .... ..... ............,........... ......... ........................ 573 Benedictine Terrace ........ ......... .... ...............,Seb.a.sti.an., ..F.l.ori.da. .329.5.8........... ....................... .......... ... ........ 01 the County of ..lml;i.~.I).. R;i.v.~r....................... an-J State 01 ....... ..I:'.1.9f.i4A.................................. u Grantee, WITNESSETH. That the Grantor for and in consideration of the sum of S .~. 9 ~ : .Q 9. . .. . . .. . . . .. .. . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargaiit, sell, release, convey and confirm unto the Grantee.. h~~ .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of LO. t(~'l ~. 6, Block, . . ;.Q . .. ,UNIT. .. . . It. . . . . .. ,of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at e 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 R er 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 aU 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 "he 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 fust 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 SEBASTIAN, FLORIDA AttesllC~-: A. .' .J1J~.Otl.~. 7..~ City Clerk M" ~..- BT ..................~r ~................ (QIitv jieaJ) STATE OF FLORIDA COtTNTY OF INDIAN RIVER I HEUEBY CERTIFY, That on thll ....... 6 th......... ..day 01 ......... f.~.1;>.r;~~Xy............................., 19.. 9,}. W. E. Conyers Kathryn O'Halloran belore me personally appeared ............................,............,...............,. and ....................................... respt'ctively Mayor and City Clerk 01 the City 01 Sebastian, a municipal corporation under the laws 01 the State 01 Florida to me known to be the Individuals und officers described in and who executed the lorC'going cORveyanee to ......................................... ..MJ:;{3.~.. H~~.~.~. .f.~.Y.~ng............................................................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the execution thereol to be their Iree act and deed as such officers thereunto duly authorized; and that the Ofliclal &eal of said corporation Is duly affixed thereto, and the said conveyance is the act and deed 01 said corporation. WITNESS my alpature and olf1clal leal at Sebastian, In the County 01 Indian Rlyer and State 01 Florida. the day and Tear last aloresa1d. Nr!,Y.. ",.u.., ;,~i. .f .Pio~.............. My ommlsslon expire.. raoft7~l' r~':"~:~.. ~l::;:l d nd~n .. ( .. ~. ~., "'n 1~"4 .Oiy ol!"'.r:r":'-~-:~: i..:-:;:;':'-:J ~ ::',. ~l '. v, ' t B"'nd~,tfhru 'ire, F.;;n. k,~!::':;,:'-"~ tnt. ,- Name k (1,.AJ(;; (l. I) Fi~VonJ Uni~ ~ Block '-10 Lot 30 Date of Mark-out :;J .,. s~.." 7/ ..'......r Date of Burial J - tf) ~ 9/ Time /,'OOOrn, , J!/, ..x " Name of Funeral Home """. /f"Cn -I /.A~) ---r. / ...;:.~V:J'/-:/ Authorizek-r-:?:,,(?::;\?t)~??k>" , I J. . ---", ---..--,.-.-.-.- ~ F:EtiN~" HELEN 573 BENEDICTINE TERRACE SEBASTIAN, FLORIDA 32958 "'" DEED 111312 J LOTS 35, 36 BLOCK 40 UNIT 4 9JJl EDWARD FEVANG INTERRED 2/6/91 LOT 36 M-t 35 ~ ~ j;;{) ~ 31;;I.i/q~ ~ - '-- Paid by CEMETERY Receipt No...... J~?~..... . Dated.. ..~/.9/.~.~................. list Price $.. ~.QR :.Q9.. ..... Net Paid $ .. ~.Q~ : .Q~ . . .. . . Edward Fevang interred Maximum No. Burial Spaces. . . . . . . . . . . . . . . . . Lots 35, 36 Block 40 Unit 4 NO. -.---.--.,.. '-~'-',-- Monument permitted. . . . . . . . . . . . . . . . . . . . . . . Lot 36 2/6/91 Helen Fevang (Data above this line lor City Reeord only) 573 Benedic tine Terr. Sebastian, Florida 32958 1312 _n _.,. ,~ . . POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 February 7, 1991 Mrs. Helen Fevang 573 Benedictine Terrace Sebastian, Florida 32958 Dear Mrs. Fevang: Enclosed is Cemetery Deed No. 1312 for Cemetery Lots 35 and 36, 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 ~y 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. 658 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. Ve;;;};7}i/~ Kathryn M. O'Halloran City Clerk KMO: j s enclosure . ~ &'S-f THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: r-~ &__~p/~ Dollars ($ ~~. ~ &'~~) r~~;;: S-73 /J,-47P~~::6Ar';J ~ ~A~..jt}, r~.J 302956" ) FROM: on this t t.i day of F~~, 19?/ for the purchase of the following described Cemetery Lot(s) upo e terms and conditions as stated herein: Description of Property: Cemetery Lot (s) # ..3 s #I-- ..3 b Block# ~ ~ Uni t# .y Purchase Price: ~~ ~ Dollars($ ~tftJ. ~ ) 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: ~J~-= <'"\ 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. ~ ' ........ · ...tness'. / L..-h ~ c:JCity of Sebastian .~-- ~ ..... __..."~ 1111. . tli\l JII .ll. J. .. -., lIl"""""A ~ O~ ~~~ 0.... ~ I> ~ ~~ ~ lilf ~ m i~l[ ~ ~ ~f ~'\ \ :D .' ,.)\, J,~'d': : ...C ~~ ~~ ~ b . cnz.,. m g c - jI> <\ ~ ~:r!Z .. - 0 m 0 i >m:D ~ ~~. -.J ~ ;!! :Xl r- 0 I~:I: 0 ~o ~ mil: ~ ~m ... m 0 ... - ~ .. ~ ~ t: . .. . .. . . 8 r- ~ :u o ~~ U1 ex> m '" '::-',) >~ 1 ':; . . . City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589-5330 0 FAX (561) 589-5570 MEMO To: From: Subject: Date: 1anet IsmaB, Finance Directo~ ~ Kay O'Halloran, City Clerk ~ Check Request March 24, 1998 Please issue a check as follows: AMOUNT: $200.00 (FormaIlin.ckreq) PAYABLE TO: HelenJ. Fevang RR 3, Box 2005 Richfield Springs, NY 13439 PURPOSE: Repurchase of Cemetery Lots 35, Block 40, Unit 4 by City. SUBMIT TO: Linda Galley ACCOUNT NO.: 001-30-590-995 $100.00 601-27-539-995 $100.00 .. "l l' 1 o :?~ - d/ ~<.i. ~~7 ~.h ~cJ/~r;;(4; STATE OF NEW YORK COUNTY OF OTSEGO SWORN TO ME THIS 22ND DAY OF JANUARY 1998. No!gf~~ {} ItnL4 ~,...~ 'III1f1<<f pU&t.lC.STA"ot'-~ ~tM~~c.t:.,./ :.-..;...._doIoo. ........ ,...............v.. "'Jl""'U :Kl I l"Y tI!1t ~...~";'':"-1;.t1'il;o1!''i :"~i':""'~i' !,", ",-,;r., , ~. ~.-- ST.NK FUNERAL HOMES, P.. 916 17TH STREET 1623 NORTH CENTRAL AVENUE VERO BEACH, FLORIDA 32960 SEBASTIAN, FLORIDA 32958 (407) 562-2325 " (407) 589-1000 STATEMENT OF CASH ADVANCE ITEMS 1 DECEASED /~>D cdA--t2~) DATE ;; . ~/ 1 ( ;::-/ ~'4~ <S Cash Advances are for items that you may ask us to purchase for you. The charges for these items are made by third parties and are not part of our charges for services or merchandise. I CASH ADVANCE ITEMS MUST BE PAID IN FUll PRIOR TO SERVICES BEING RENDERED. WE ARE NOT PERMltT~Q'T0 ADVANCE 'I . f FUNDS FOR THESE ITEMS, EXCEPT IN THE CASE OF INSURANCE ASSIGNMENTS. . , \ ,.. I ,t f /,. \, I; '..) \:- cJ oy .,} . I$~~-- ), \$ J.j- '-'~ ;; 06 ~.~ $ $ $ $ $ $ $ $ $ $ $ ut.) ESTIMATED CASH ADVANCES "",.,., ,.,.",., . ,TOTAL $P'; Date Paid. ./. .if' ':PI ('7 ~ A."..J...IJ - Amount Paid $ f w- .~ {~~4< / ~~~,. ~~</tl-li j1r;;/~~fif.i~i:.2 ~ Funeral Director Person(s) Responsible for Arrangements CASH ADVANCES: _.._~_ ~ ___ Grave Opening/CloSing.~i<~('/:;;~<<, (";/,/,~, ~.,~~( ,. .~~.,J,' E~ L., Vault Installation/Matkingi~dSQdd.U:1g I'~ ' Cemetery Property ,L//"/ ,. ..",. ,..-6. ( Air Transportation of Remains (Estimated) " , ., ,."..".""'.',,.., "" , , . . . , ") , . Gratuity to Clergy .' /i.. /: t-J... r!-U/ L-(/:-~c.?':"'~/!r.~ ' I '/~'. \....., Hairdresser, Organist. Soloist .. . .' .,..'"... :I . "----::7/ -Y;/f. I -- )/ .-.t:'/.J Flowers.-.....,j".. ,/!? ..,... ". *C t'f' d C . ,/)' -/ I t.) /.1 er I Ie oples 0 . ."... . ,', ;/J' , '~,. '-;''1 I ?J' } - . ~ . . . . . . . ~ . . . . . ,.,.~"),/2' ;;t!:'I~.-{ ... J", I: ~':L,. . DISCLOSURE STATEMENT 7j- uy ~~ /c)O - i-bJ b? Our contract obligates you individually for payment of the services and merchandise provided in the Agreement. Your liability under the contract is not affected by the subsequent probate of the estate. However, you should be aware that in the event there is a probate proceeding, the Personal RepresentoUve is directed to pay reasonable funeral, interment, and grave-marker expenses, whether paid by a guardian of the decedent, the Personal Representative, or any other person, so long as the aforementioned expenses do not exceed in the aggregate ~om of THREE THOUSAND DOllARS ($3,000.00). Florida Statue Section 733.707 (1 )(b). As a result, you have the authority 10 immediately pay this bill to us and file your claim for reimbursement if there are any probate proceedings being done. *Certified Copies of Death Certificates may be retained by the Funeral Home for the purpose of filing your claim with Trust Departments, Veterans Administration. Pre-Need Contracts and Insurance Companies. The undersigned hereby acknowledges receipt of this statement. ,\ /, . (f i /1 WE ACCEPT MASTERCARD AND VISA ,,/ / (. (',' ~!I _, I-- I I / . STRUNK PRE-NEED CENTER 884 - 17th STREET VERO BEACH, FL 12960 . FUNERAL INSTRUCTIONS FOR Helen J. Fevang Selected Funeral Servicps: Graveside Funeral Service, Strunk Funeral Home, Sebastian, Fl. Clergy Preference: Christ The King Lutheran Casket Selected/Preferred: 4-RJ Citation Vault or Urn Selected/Preferred: Wilbert Continental Clothing Preference: Disposition preference: Burial Cemetery name/location: Sebastian Cemetery, Sebastian, Florida Receiving Funeral Home(if applicable): FlJlleri'll expense hn>akdown( figures expressed are approximat.e and subject. to.- change llnless protected by prepaid funeral agreement or our insurance policy: $$5,159.00, PROFESSIONAL SERVICP''s, FACILITIES & EQUIPt-mNT ,AUTOMOTIVE EQUIPMENT r.ASKF.T PURr.HASE, BURIAL VAULT, MEMORIAL BOOK, FOLDF.RS & ACKNOWLF.DGEMF.NT CARDS IIAIRDRESSER,CERTIFTED COPTES OF DEATH CERTIFICATF,S Special Instructions: Sebfl$ti,an Cemetery - two plots pnrchAsed when Mr. Fevang died. The above information is for guidance at the time of my death. It is intended to assist those handling my personal affairs. I have expressed my preference on certain subjects which, unless changed by unexpected circumstances, I herehy desire and request. My signat.ure certifies that t.he information herein is correct.. Witness: (Counselor) Signature: Date of Arrangements: Printed Nflme: - State of Florida, .rtment of Health and Rehabilitative Servicatal Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT L. 3~ t3 .tl dJ t/~ A. 1. Name of Deceased (Type or Print) First Edward Middle Last Fevang DATE OF DEATH Month Day 02/04/91 Year G 2. Place of Death County Indian River 3. Name of Medical Certifier City, Town or location M.D. .-J Medical Examiner m Physician Address Name of (If neither, give street address) Hosp. or Inst. 573 Benedictine Terrace Address Phone Number Sebatian Muhammad Farooq, 4. Name of Funeral Home/ Direct Disposer Strunk Funeral 5. Check Appro- priate Box 777-37th St.~ Suite A-104 Vero Beach, ~lorida 32960 (407)567-2277 Aa.lic. No.1 Reg. No. Phone Number (Area Code) 1623 North Central Avenue Homes, P.A. Sebastian, FI 32958 1228 (407)562-2325 a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b [I was contacted on O?/04/Ql 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 Muhammad Farooa. M. D. 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 of Sebastian Cemetery Final Disposition: 7. Funeral Director/ li}iF'Qet QiB~g8gr Indian River F.E. No.lReg. No. Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No. 1228-91-0062 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 , death certificate reque. :dt Registrar or .. Date ') / J C / Date Certificate Subregistrar Signature . Issued: ~-~ -7/ Due: C. AUTHORIZ~TlON for CREMATION, DISSECTION or BURIAL -AT-SEA \, Signature or Medical Examiner, , 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: o BURIAL o CREMATION o STORAGE o OTHER (Specify) ,/"r~ ~~0. Place of Disposition Date of Disposition Signature of Sexton ) or Person-in-Charge ) 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) ,~ttv"Jr NI.rnhAr. ~7An...nnn..n~~R_"\ J.