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Home My WebLink About4-39-34 .t' -1' . Paid blcEMETERY Receipt No... .~9}... ...ated....~!.~? !.~ ~............... i~.~9 & Li P' S 1 , 200 . 00 M im N . U . t 4 st nce .... . . . . . . . . . . . . . . ax um o. Burial Spaces. . . . . . . . . . . . . . . . n J. 1,200.00 34 NO. Net Paid S 1346 Monument permitted. . . . . . . . . . . . . . . . . . . . . . . Albert D. Strausbaugh interred 1/17/92 - Lot 34 (Data above this line lor City Record ooly) Cltity of &thusttuu (ttrmrtrry i rrb '11346 NO. THIS INDENTURE MADE TIdI ..17.th............. day of ooJ anuary.. .... ..................... .. ... A. D., 19. 9. ~., between the City of Sebllstlan, a municipal corporation existing under the laws of the State of Florida, as Grantor and Elizabeth Streusbaugh . . . , . . . . . . . .. . . ..... ........................... . . '765'6" Mont'a uk "Avenue" . . .. .. . . . . . . . .. .... . . .. ... ........................ Micco, FL 32976 .,.. .......................................... .... ........................................ ....0. ...................................... of the County 01 .. ;J;:n9..i~n..~.i~~~...................... an:1 State 01 .. ..f.+~~~.9-.~....................................... as Grantee, WITNESSETH. That the Grantor for and hi consideration of the sum of S ~; L~9.q :.9~. ..... . ... ... to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargaJD, sell, release, convey and conIum unto the Grantee .. . . . . . .. heirs, legal repreJeJltatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: .A All of Lot(s) .~.~ ~ ~ ~ Block, . . .~ 9. .. , UNIT .. ~. . . . . . . . .. ,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. ~.I' I To Have and to Hold the . e forever; provided that Said property shall be used solely and exclusively for the interment ofthe human dead and shall be used, kept and maintained at times in accordance witlthe 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- 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. CITY OF SEBASTIAN, FLORIDA AI".~J 1lJ,{)d~.... tll.~ City Clerk /,1< ~ B'~'''''~'''''''' Signed, Sealed IlIUI Delivered In the Presence of: ~ . . ~~~.....~........... S~A":::l~I~' YJF. >............. .... COUNTY OF INDIAN RIVER 1 HEltEBY CERT! FY, 'l'hat on thla .. .2.0.t h .. .. .. .. . .. .. . dll}' of . J.an:ua r.y.. .. .. . .. .. .. . .. .. .. .. . .. .. . .. . .. .. ..., 19. 94 before me personally appeared ..~. ~ ~:. ..q~~y.~.:r; ~ .. .. .. ......... .. .. .. . .. .... .... .... andK~ ~.~.;y.~ ..~. ~.. ~ ~ .I;I.~~ ~.<?; ~~... 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 executl-d the forl'golng cORveyance to Elizabeth Strausbaugh (GIit\! ~t~J) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the execution thereof to be their free act and deed as snch officers thereunto duly authorized; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance is the lid und deed of said corporation. / _" -'__~.r WITNESS my signature and olfjclal seal at Sebastian, In the last lIloresa1d. at Lirp. otary Public, State of Florida My Conunisslon Expires June 18. 1994 ~nd.d Thrv Troy Fain. In.urance Ine. N~rne ,q l...1.5 i...e r S ~I7U S iSlfu L-..r tI~ Unit -</ Block 0)9 q1 Lot v Date of Mark-out J ll'/ 9:l. Date of Burial 1//7/~;;1... r I Time II'!:);;,) /\.1',\. K. a.1-,. .. State of Florida, Departm~ Health .and Rehabilitative Services, Vital .tiCS APPLlCATI!r FOR BURIAL - mANSIT PERMIT A 33;~ ~ 39 t;~ A. 1. Name of Deceased (Type or Print) First Albert Middle David Last Strausbaugh DATE OF DEATH Month Day 01/15/92 Year Name of (If neither, give street address) Hosp. or Inst. I d' R . n lan v Address 2. Place of Death County Indian River 3. Name of Medical Certifier G A. h 13855 U.S., 1, eorge . Mltc ell, D.O., P.A Sebastian F . 4. Name of Funeral Home/ Fla. Lie. No.1 Reg. No. Phone Number (Area Code) Direct Disposer 1623 North Central Avenu Strunk Funeral Homes, P.A. Sebastian FI 32958 5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box City, Town or Location b OX NnrRI'! was contacted on 91/16/92within 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 Gl'!orgl'! A. Mit~h~ 11, D, 0, J P A 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 Final Disposition: 7. Funeral Director / .Direst (;)iSP9se(. Indian River FE No.lF1eri. t~CT.'" Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No. 122R-9?-OO?fi 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 fir the death certificate re uested. Registrar or Subregistrar Signature Date Issued: /-/~- '1~ Date Certifipate ..., I 0" Due: 1- ~ -7e?- C. AUTHORIZATION 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: kJ BURIAL o CREMATION o STORAGE o OTHER (Specify) Place of Disposition se tuac.: to;:ll; n ('"AmA'" ArY Date of Disposition January 17, 199~ Signature of Sexton ) or Person-In-Charge ) l~,. ~~9' 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) a.r,