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Home My WebLink About4-39-17 \1Jata auoye allB sIne lur .....LI' ..-..-... v_,, Qtitll af &tbastiau (!temelery l1eeb NO. "\1341 THIS INDENTURE MADE 'l1aIa ..1.4th............. day of .No.v.erobex.............................. A. D., 19.9'+.., between the City of SebtlStlan, a municipal corporation existing undcr the laws of the State of Florida, as Grantor and Carole Phelps ........................................... '1053' 'Pa-lmet.to' .A-venue........................................................ Sebastian, Florida 32958 '0 ........................................... ......................... ................... . " ..... .................................... of the County of;I;:nQ.J~n..~.:i,.~~~........................ an'J State of :fJ<?~~~.~........................................... II Grantee, WITNESSETHt That the Grantor for and in consideration of the sum of $ ~,q~.: ~~... .. ... ... .. .... to it ~ hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargam, sell, release, convey and confum unto the Grantee .. ~~. . .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: . All of Lot(s) . ~.q ~.\ ~ Block, . ~ ~ . . .. , 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. To Have and to Hold the same forever; provided that said property shall be ,used solely and exclusively for the interment ofthe human dead and shall be used, kept and maJntained 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 instrwnent shall be covenants running with the land. In the event of the fallure of the owner of any property situated within said cemetery to ob- serve and comply with Such rules, regulations, resolutions and ,ordinances and the co~ons 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 Attest:~. .- .....m....Od~ ~(,.~ City Clerk //fr~. B, .kv.k........~...:..... Signed, S aled and Dcllvered '~~P -'.. tl..);J~...~.............. ....e~.............. (OIUu 'JiJeal) . STATE OF FLORIDA COUNTY OF INDIAN RIVER I HE1l.EDY CERTIFY, That on this .~.IJ.4................. .day of .J;>.~.G~m1;>.~~...................................., 19.9J. W.E. Conyers Kathryn M. O'Halloran before me personally appeared ........................................................... and ....................................... respectively Mayor anel City Clerk of the City of SebtlStian, Ii municipal corporation under the laws of the State of Florida to me known ,__ I.. oL_ . _"1..:.'1....... ....." ,.,,____ ,__..._'" -.~ 1- ...._..l ....._ __............" ..,.... ,...___...t__ ........-..........-...... ~- Name 'v') \ ('., f < <.f) 7:). i)Ji.f...),D :J } ..', f. Unit -</ ...., 9 Block J Lot 11 Date of Mark-out. I'll Date of Burial Time .?, " c 0 f). TeJ ' , Q.(L ;' Carole ""'" 10 Palmetto Avenue Sebastian, FL 32958 DEED II 1341 Lots 16 & 17 Block 39 Unit 4 Wilford D. Phelps interred 11/15/91 - Lot 17 , l, - I '- - Lots 16 & 17 . . 687 11/14/91 Block 39 Paid by CEMETERY ReceIpt No. . . . . . . . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unit 4::- un Price $ .. ~.Q~ ~ .Q9....... Maximum No. Burial Spaces................. Net Paid $ .. ~?~ :.~~...... Monument permitted. ...................... NO. 1341 (Data above this Une 10-, City Record only) [il.~] ~~ hI 7/6311/1 State of Florida, Departme.~~alt~jin~ Rehabl,litative ~erv,ices,Vital Wtics APPLlCATI OR BURIAL - TRANSIT PERMIT A. 1. Name of Deceased (Type or Print) First Wilford Middle Doyle DATE OF DEATH Month Day Year Last Phelps. 11/12/91 2. Place of Death' County City, Town or Location Name of (If neither, give street address) Hosp. or Inst. 3. 4. Name of Funeral Home/ Direct Disposer 5. Check Appro- priate Box Phone Number Address he medical certification has been completed and signed. A completed certificate of death accompanies this application. . b 0 was contacted on within 72 hours after death. He/she verified thatthis death was from natural.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 Dc He] eu was contacted on 11/14/91 He/she verified that Frederick Hobin. M.D.. M.E. ,Medical Examiner, will complete and sign the medical certification. 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 he death certificate re sted. Registrar or Subregistrar Signature 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. 6. Place of Sebastian Final Disposition: 7. Funeral Director/ 9ireet;.Q~ B. C. Indian River F.E. No./Reg. No. BURIAL -TRANSIT PERMIT 1228-91-0485 Permit No. ~~d:II-/B_9/ ~~ Certificate/I_If'., 9'1 AUTHORIZATION for CREMATION, DISSECTION or BURIAL -AT-SEA D. CEMETERY OR CREMATORY Methods of Disposition: [Xl BURIAL o CREMATION Signature of Sexton ) or Person-In-Charge ) o STORAGE o OTHER (Specify) /1"?' ;(~7' Place of Disposition Sebas~.~i.n:~~~~t;prY. Date of Disposition Noveinber 15, 1991 This permit must be endorsed by the Sexton or person-in-charge (br 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 t~e County where disposition occurred.~, Q 4' , HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-2)