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Home My WebLink About4-39-20 r^""-' , <.~ by .:...ETERY........ N~.... .'?n ... D......... ?!.~~/?~............... List Price $... ~.QQ t QQ...... Maximum No. Burial Spaces................. Net Paid $ ... ~.QQ ~ R9...... Monument permitted....................... Mrs. Jean Fisher Mollie H. MeGuireinterred 5/28/91 Lot 20 757 Periwinkle Dr. (Data aboye this line lor Clt)' Record ODI)') Sebastian, Fl. 32958 ~ 20 Wek 39 Unit 4 NO. 1324 L Qtity of &rbustiun (!trmrtrry I rrb !1324 NO. THIS INDENTURE MADE TIaJa 28th .................. . day 01 ....... ~~Y................................ A. D., II..?~.. between the City 01 Sebastian, a municipal corporation existing under the laws 01 the State 01 Florida, as Grantor and Mrs. Jean Fisher . . ' . . . . . . . . . .. . . . . . . . .. . .. .. . .. .. .. .. . .. .. . . , . . . is '1" p e'r i w :i'ri k 1: e" 'J) r .: . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . . .. .. .. . .. . .. .. .. . .. . . ' . . , . ........ ............................... ...., .S.ebas.t.i..an,.. F.l. I.. .~~ 9.5.6. .. .....,...................................... 01 the County 01 ......;J;~<;lJ.~n..~.~y~.~.................. anJ State 01 ......f~.9.~~~~..................................... .. Grantee, WITNESSETH I That the Grantor for and In consideration of the sum of $ .4 QO... O.Q................ to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this Instrument grant, bargam, sell, release, convey and confum unto the Grantee .. . p.~ ~. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . h O. .. , Block, . . .3.9 .. , UNIT ..?t......... , 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 shall be covenants running with the iand. 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 tem, mate 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 fust above written. Attest(~~.,A.:.[).IIILt4~ , . . . '(I" .. City Clerk CITY OF SEBASTIAN, FLORIDA J B1 .....ItI'2:.... ~sealed and Delivered /q!tt~Y5if)~"";"'" \l7rd:.., ~., -"" STATE OF FLORIDA COl'NTY OF INDIAN RIVER I IIEUEBY CERTIFY, That on thlB ....... ..28 th ...... ..day (QIitu "~aJ) 01 ...... ,Ma y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 11..9.\ b~fllre me personally appeared ~ .... .:J!:.... .9.9~Y~F~... .. ,... .. . .., .. . .. , .. , . ... " . .. . ,. and .. ~~ ~.l,1.~y.!l:. .<?.')~?.~.~~~~.~..... respl.ctively Mayor and City Clerk 01 the City 01 Sebastian, a municipal corporation under the laws of the State 01 Florida to me known to be the Individuals and officers described In ond who executed the lor(.golng cORveyance to . . .., .... ..... ...............................' . . Mr.s.... J e.an.. Eish~r............... . ....... .................................... .' . . . , . . .. . , . . . . . . . . . . . .. . . . . . . .. . .. . ....... . .... ... ... . .. and severally acknowledged the execution thereol to be their Iree act and deed as slIch olflcers thereunto duly authorized; and that the Official scal of said corporation Is duly affixed thereto, and the said conveyance Is the Rct ond deed of said corporaUon. WITNESS any signature and olllclal teal at SebasUan, In the County of Indian River and State of Florida. the day and 1ea: last aforesaid. ..l/..~~7.~......~d/~;?............ Notary~J~, State 01 Plorlda at Larp!. -y' My commissIon explresl "'C.CfV ~..' ". C;'r"~ I"e o:!:--,,'.lo Ii .. 1......~~ih, _6...1.....<1 ~6".1 U My Cllmmh:k<1 r:::;-':'~'~';:J :W, 1i14 Bond.,~ T1"u lri.lj' f3in. :'nUl;.:n~e Inc. Nlime ;\I) 0 II... I f.. H. ~'r'<- .). IV. '-..::{ U. I t:. If., ". Block 1 39 Unit Lot A ","\0. Date of Burial -;~)-;yhl tr/~6/qj , . Time I 0 ~ 67). - .]4... 1"1'): Date of Mark-out Name of Funeral Home 5n 1.-( H K# . 0/(// AUlhO"'edby~ \}.~ '~_~~i~R~ MRS. JEAN , 757 PERIWINKLE DR. SEBASTIAN, FLORIDA 32958 ./', DEED 111324 Lot 20 Block 39 Unit 4 (jJJ( Mollie Mcquire interred 5/28/91 Lot 20 ~ -"\.' -~ I...... _ . . 670 5/28/91 Paid by CEMETERY ReceIpt No. . . . . . . . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . List Price $... ~.Q9., QQ...... Maximum No. Burial Spaces................. Net Paid $ ... ~.Q~: QQ...... Lot 20 Block 39 Unit 4 NO. Monument permitted....................... Mrs. Jean Fisher Mollie H. McGuire interred 5/28/91 Lot 20 757 Periwinkle Dr. (Data above tbla line tor City Reeord 0011') Sebastian, Fl. 32958 1324 , . . ( . POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 May 31, 1991 Mrs. Jean Fisher 757 periwinkle Dr. Sebastian, Florida 32958 Dear Mrs. Fisher: Enclosed is Cemetery Deed No. 1324 for Cemetery Lot 20, Block 39, Unit 4. 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. 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. We are enclosing two copies of Receipt No. 670 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, q~Jrn V~i~"'J Kat~r~-M. O'Halloran City Clerk KMO: j s enclosure . . ~ 7CJ THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida FROM: RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: ~~.J C}{~--P~./ Dollars ($ -Ythf./lhJ . '7f~ . ~ ~:O~A') 7$~ ~~/~ V.4 "-~~.wd%;;~.J ,,/: L L.,./ .301 y.s- t? ) on this c/~d day of "'7/Jaq , 19 ?/for the purchase of the following described Cemetery Lot(s) u~the terms and conditions as stated herein: Description of Property: Purchase Price:~~ Block# \3 '7 Unit# .y ~ Dollars($ -rtf;}. H ) Cemetery Lot (s) # d r:J Terms and' conditions of sale: ~'7 P7J~ IV ~I!~ l/ 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: x1Jt#,9'~ 1~ 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. ~ ,r:yL/~ Vi ty of Sebastian ~4{~L~~~~ itness . . . ~..- io<l ll'IIUldL r..J::.. _..... -"'........_ !Il_:'W i o~ ~~ ma J1 ~~ 3 ,"'," ~ m - P i ~ \U g ~ i~li It ~ ~ Ii r ~I~ F .~ z -+ >.... .. Oil? i ~'" 8$ 1J"2~ 1J"2l"" ...... Otv ;:'0 ... en iI ...C rf~ mz.,. lD ~ C ~;tZ >~m z ~:III . if. ;n~r- 1~6 zK ffim -' t ... ... co .. ~ + 8 8 ~ ,... 0 .- ~ --...J ::D (X) tn ~ State of Florida, Depaet of Health and Rehabilitative Services, VI.atlstlcs APPLICATION FOR BURIAL - TRANSIT PERMIT 1-3 / -~ A. 1. Name of Deceased (Type or Print) First Mollie Middle Hays last McGuire DATE OF DEATH Month Day OS/24/91 Year 2. Place of Death County Indian River 3. Name of Medical Certifier City, Town or Location Medical Examiner Name of (If neither, give street address) Hosp.or Inst. Indian River MellOrial Hos ital Address Phone Number Vero Beach Paul J. Bor .eier M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Ho.es 5. Check a 0 Appro- priate Box X Physician Address 1800 43rd Avenue Vero Beach Florida 32960 407 569-5773 Fla. Uc. No.lReg. No. Phone Number (Area Code) 1623 North Central Avenue P.A. Sebastian Fl 32958 1228 407 562-2325 The medical certification has been completed and signed. A completed certificate of death accompanies this application. btJ Laura was contacted on OS/24/gt 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 PA.ul .J. Rnrg.A i Ar, M. n. 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 Seb.flStian Ce.etery Final DispOSItion: 7. Funeral Director/ Q.jr",,..t Diwpoaer Indian River F.E. No.lReg. ~J8I Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No. 1228-9t-026t 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 the death certificate requested. R~gi.!tIAI or a... L..~:~ (1 6 . _ " , Subregistrar Signature -cr ~ Date ~ Jq Issl!ed: 5 ~ 'f I g:~~ 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: ~ BURIAL o CREMATION o STORAGE o OTHER (Specify) ./ / trY' ,. ;r~0 . Place of Disposition Date of Disposition S.t=i1 · dL.J!/1 ~~~J. ~hB/ql ' , 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 Se 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)