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Home My WebLink About4-39-02 Lot 2 Paid I!YCEf:lE!ERY Receipt No.... P.QZ.... aated.... ~t.~f.1.9J.............. .~~~.39 Li~t Price $ .. . ?q~: ~9. .. ... Maxbnum No. Burial Spaces............. ... . NO. Net Paid $ 200.00 .................. Monument permitted. . . . . . . . . . . . . . . . . . . . . . . 1321 Hilda L. Pohmer interred 4/22/91 (Data above ibis line lor City Reeord only) William J. Pohmer ~~~a~~~~n~vFl. 32958 atitu of &fhastian <!trmrtrry IIrrb "1321 NO. THIS INDENTURE MADE 'l1lIa ...4 ~mi.. . .. .. .. .... day 01 ....... Apf.:J.,l,... . .. . '" . .............. .. ... A. D., 19..9.\.. between the City 01 Sebastian, a municipal corporation exlstln. undcr the laws of the State 01 Florid.. us Grantor and William J. Pohmer .......................... "88S"'CodY"Aveiiue' ... .......... .......... ..... ................ .............. .... ........... ...... . . . . . . .. . .. . . . . '" .. ........ .~~ P.til.f?4 ;Ltil.I)., . . F.1.Q,:;' ;i.~l;l.. ~? 9.5.6... ... . . . . ... . . . . .. ............................................ 01 the County of .....);n<;l.~~n..~.:i;y~.~.................. an:1 State 01 ....f.J-.9.1;';i,9.~....................................... u Grantee, WITNESSETH, That the Grantor for and in consideration of the sum of $ " f.QQ: R9. ... .. ... .. . .. . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargaiit, sell, release, convey and confum unto the Grantee . h:!-.~. .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . . .? .. ,Block,... ~ ~ .. ,UNIT ....4........ , 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 shall 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 shan 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 Sebastlan, Florida. IN WITNESS WHEREOF, The said party of the rust 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 fust above written. CITY OF SEBABTIAN, FLORIDA AIl<'C!ltdwJn.. f)'IItUhA--.. (J City Clerk B1 (Gritv ~eaJ) STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEltEBY CERTIFY, That on this ... ..22nd.. .... .. .. ..day 01 .... .Apr. il..... .. . ................... '" ..... .... 19.91. bt'fore me personally appeared... ~.'.. .~. ~.. G9.r:tY~rf? . ...... ..... . . . . . ... . ... . . . . . . .. and K? th~Y~.. Q.'.ft~.t\~r.~n....... respt'ctively Mayor and City Clerk 01 the City 01 Sebastiun, 8 munlclllal corporation under the laws of the State of Florida to me known to be the Individuuls and officers deserlbed In and who executed the fore.golng cORveyunce to William J. Pohmer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledged the execution thereof to be their Iree act and deed us such officers thereunto duly authorl.zed; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance is the IIct and dt'ed of said corporation. WITNESS my signature and official leal at Sebastian. In tbe County of Indian River und State 01 Florida, the day and 1ear last aforesald. Hi< ~.n.,s~.~.~<1T.................. My commlaalon expire.. r~=fC'r''1 r,."'- ('.~.- f fr ... . ..: .-....'1 C enull my (-::1':::::>:17:1 r::,..'.-~ rr;'il ~o }':'14 8....0.)::" Th."lJ f," j ';-':~'l'.'n':L'~:;n:'~~'~~(. .. Unit fI/ L l> }1. "/ 3<1 ,/.,.', 10 1-11111 I~ e . Name Block Lot ;... Date of Mark-out 1/9/91 , Name of Funeral HO,~e i~/// ,:-,/t. _ <(~/:~ .1', _ J .' >I }", .' c .~ i d".:,-e...,:....,& . Authorized ~_;7/:I</V< -' '. 'y / .,1 \./ ...;/u! '11 I I . 5/t? V-AJL Time //'O(J -4 14 Date of Burial u Lot 2 Paid by CEMETERY Receipt No. ... P.9Z....... . Dated. ... ~!.~7.1.9.l.............. .~*~~k4 39 List Price $... ?q~: ~9...... Maximum No. Burial Spaces................. Net Paid $ ... ?q~: ~9...... Monument permitted... ........ ........... . NO. 1321 Hilda L.Pohmer interred 4/22/91 (Data above Ibfa line lor City Record oo)y) William J. Pohmer 885 Cody Ave Sebast1sn, F1. 32958 . . POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 April 24, 1991 Mr. William J. Pohrner BB5 Cody Avenue Sebastian, Florida 3295B Dear Mr. Pohmer: Enclosed is Cemetery Deed No. 1321 for Cemetery Lot 2, Block 39, 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 by 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. 667 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. Very truly yours, ~'rh D#~ Kathryn M. O'Halloran City Clerk KMO: j s enclosure . . &~/ THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida FROM: RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: (;?~d~~~ V-~~ J, /:u,~ {/ ?YS ~ d~ ~~~J , r./~~ Dollars ($ oZ ct?? th:J ) 3cJ9sR on this ~~ day Of~ ' 19?/ for the purchase of the following described Cemetery Lot( upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)# oZ Block# .J r r&~J~. Unit# 'l Dollars($oZ~,/Z1 ) '-" Purchase Price :~/73 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: X4v~e,L 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. cr~f~~stl~4 ~.~ ~_'11!}1 . W. ness lIIti.. ... ,. t . .. . J.l~ u. 4W1 ~--...... J.A~'..j_...., ClJAMlDCNlI A z > i - .. - o -.J ~ ~ ~',;'<c4l ."'...--..... (I) ... :u ...C ~~ m~'TI lD:DC > -I Z ~:rm ); O:u z m. ~~r- r-:D > Ir-% >0 ~K ~m m ... d: .... ~ ~ t- ....... State of Florida, Depart. of Health and Rehabilitative Services, Vita.tistics APPLlCA~ FOR BURIAL - mANSIT PERMIT L ~ t?;3f /Ii A. 1. Name of Deceased (Type or Print) First Hilda Middle Last Pohmer DATE OF DEATH Month Day 04/18/91 Year L. 2. Place of Death C041')ty . IndIan RIver City. Town or Location Roseland Name of (If neither, give street address) Hosp. or Inst. Humana Hospital-Sebastian 3. Name of Medical W Medical Examiner Address Phone Number Certifier 13865 U.S.1 Nasir Rizwi, M.D. ~ Physician Sebastian, Florida 32958 (407)589-6844 4. Name of Funeral Home/ Address Fla. Lic. No.1 Reg. No. Phone Number (Area Code) Direct Disposer 1623 North Central Avenue Strunk Funeral Homes, P.A. Sebastian, FI 32958 1228 (407)562-2325 5. Check Appro- priate Box a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b b Lillian was contacted on 04/18/91 within 72 hours after death. He/she verified that thil:Nsllii'r "ffz~ 'ltt~ 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. 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/ -Direct BI::;poser / /county: Indian River F.E. No.me~. No. 1672 Removal from state Donation Date Signed 04/18/91 B. BURIAL - TRANSIT PERMIT 1228-91-0198 Permit No. 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 fili the death certificate re ested. e. Rbl::l;~iftr ar Subregistrar Signature Date / f ;.' f7 OJ Date Certificate Issued: T - 4 - 7 Due: 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: .R1 BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) o STORAGE o OTHER (Specify) fi' 9- ,~~ 0- Place of Disposition Sebastian Cemetery Date of Disposition April 22, 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)