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Home My WebLink About4-38-12 v , ..... Paid by CEMETERY Receipt No. ...7: .....Dated...4/.?AI.9.?-................. Lots 1. Block Maxlmum No. Burial SpaClll... .......... ... Uni t 4 12 NO. List Price s. 8eo~o()o....... Net Paid S . ~9.q: .q~....... Monument permitted. . . .. .. . .. .. .. . . . . . .. . . "1358 Joseph C. Monte interred 4/25/92 - Lot 12 (D.t. .bon ttd. line for City a-mt oaIy) CltUI1 IIf &tbastian Itfll "1358 atfmftfry NO. THIS INDENTURB MADB"... ....24th........... d.yof ....April................................. A. D.. 1...92., heh,'een lhe City of Sebastian, . lDunlelpal corpor.t..... exl.tln. under the I... of the State of Florid.. .. G....tor .nd Joan Monte ................ ..... ...... .................... '493"Qti~ltrY"L'aiit!.......................... ............. ..................... .............. ............................... . .~~.1?~~~~.~!1,...:f:r:..}f.~.~~........ ............................................ of the Ccnmty of .. .Indian..Riv.er..................... .n'l State of ...... ..flQ~i.d.a................ ................... as Gr.ntee, WITNBSSBTH, That the Grantor for .nd bI conaIderatlon of the sum of S ..... ~Q.Q ...QR .. ... .. . .. . to It In hand paid. the receipt whereof II herewith ae- IcnowJedsed. doea by thla Instrument pan" buptft. 11I0. relealll, convey and confirm unto the (;nntee . h~.J;... heln.lepl repreaentatlvea and ,."IS the followl... property situated In Sebastian. Indian RlYer County, Florid.. to-wlt: AU of Lat(.) .ll.~ {;Stock, . ..3.6.. . UNIT ......4...... ,ofSeb.stlan municipal cemetery as per Plat Number 1 thereof recorded In Plat Book 2. .t pap 65 of the pubUc records In the office of the Clerk of the Circuit Court of St. Lucie County of Florida; ..lei land now Iylnl and bel... In Indian Rmr County, FlorldL To H.ve .nd to HoleI the IIUlle fo_; pro1'IcIed that laid property shaD be used ..lely and exc:luslYely for the Interment of the human dead and lhall be uaed. kept anct maintained at .U times In acconfanc:e with the rule. and ftlIUJatioIll, ordlnancea and reIOlutIon. of the City of Sebastian, Florida. hereto- fore, now and hereafter adopted or pro9\ded for the so~ment and operation of laid cemetery. The condttlonl, restrlctlonl and requlrementl contained In thla lnItrument shaD be co_nts runnlns with the Janel. In the _ of the failure of the owner of any property situated within laid cemetery to ob- 11IM and comply with iuch ruIeI, ftlIUladonl, relOlatlons and ordinance. and the condition. of the dded of COlmlyance thereof then the title of such owner In and to laid property shaD terminate and the same shall_ to the City of Sebastian, Florida. IN WITNESS WHEREOF, The laid puty of the t1nt part hat cauaed thlJ Instrument to be executed In It....- IJId on Itl behalf by It. Mayor .nd attested by Ih CIty Clerk anctlt. COrpontl IIlaI to be hereto afflxed, the day and year first above wrIt~ "'TV OF C*.. FWft...A Atte't~ J ..In..D~d~~........ By..... . .~...... l--r.~ CI17 Clerk Illln,,<I, Sealed and Delh,erfll In the 7""" of. .;&;~....~......... M.tl~t~......~.......... (QIitv j\Jral) STATE OF FT..onlDA COl'N'fY OF INDIAN RIVER I HEREBY CERTIFY. Tllat on th.. '" ~~. ~.~..... .. .. .... .day 01 ... ~p.~.~.~..... .... ............................... II ..~.~ b.fnre me personally appe.rflI .. J.e9.t:l.l};f,~ ..l... .f.Q~~~).............................. and ~~.~h?-:y.t:1.. ~.... .9.'. ~~.g~!-:l!I.t:1... .",,,,,cU..I)' Mayor .n<l City ct.... of the City of Sebaotl.n, a munrell.al eorporatlon under the I... of the St.te of Florida to me known to be the ludl.idual. and ofn"",. d_rlbed In .nd ",ho exeeat,'" the forrgolnl eoayeyanee to Joan Monte . . . . . . . .. . .. . .. .. .. .. .. .. .. .. .. .. . .. .. .. .. .. .. . . .. .. .... .nd tenrally acknowledlt'd the ",,_tlon thereof to be their fre. ad .nd deed .. such offlc:e,. thereunto dely authorJaecl, and that the Omel.1 leal of IIld corporaUon I. duly .fnxed thereto, and the IIId cun.r)'ance II the net an.1 dred of IIId eorporaUon. LINDA M.1.OHSt. ...., NIIb8lIIIeI FtllIIdI .. eo.,~........1JpINI oIUN I'.'" COUM,CO"'-' the d.y and yea. WITNESS my ,ll1Iab".. and offldal _I .t &eb.atl.n, In the Coen laot alo...,..ld. Name ---- . .JOt> Ef' h /. L:. Hp()t{i Unit 'i Block ~9. "'-'u Lot i;).. Date of Mark~out ~I/ ;U!Q2- / I .y/~s/ cfz. ( I Time II .- 00 ./i.M. Date of Burial Name of Funeral Home ". j 1/1(' t..,,;/(j /. / / 'c'''\.;:?'-: .'4/:(,~'(,.":,,.~j"/J~>/>; . \""." ^,.....}/t/J ::,.~,.-~)'~~~,(:/ 'I,i~',';f,,-'~"'IX;.~:'~:~'/ Authorized by~"::::-", i .... ........:./1" ",' ,.i 5. List Price $. 800..-00....... NetPaidS .~9.q:.9~....... Paid by CEMETERY Receipt No.... 7.Q6......... Dated...4 I.ZIt I.~?................. Lots 11 & 12 Block 38 Maximum No. Burial Spaces. . . . . . . . . . . . . . . . Uni t 4 NO. Monument permitted. . . . . . . . . . . . . . . . . . . . . . . ;1358 Joseph C. Monte interred 4/25/92 - Lot 12 (Data ebove this line tor City Rec!ord ooly) - State of Florida, Departm.Health and Rehabilitative Services, Vital .stics APPUCATI OR BURIAL - TRANSIT PERMIT /-. III I:J- 13 3e tl1 A. 1. Name of Deceased (Type or Print) First Joseph Middle Charles Last Monte DATE OF DEATH Month Day Year 04/22/1992 Medical Examiner (If neither, give street address) 2. Place of Death County Indian River 3. Name of Medical Certifier Noor Merchant, M.D. Physician 4. Name of Funeral Home/ Address Direct Disposer 1623 North Central Avenu Strunk Funeral Homes P.A. Sebastian Fl 32958 ? 5. Check a 0 The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priste Box City, Town or Location Roseland Phone Number b Ck L i :{ was contacted on g 1/26/19 gvithin 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 Nnnr M,,"r~hAnt, 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 Sebastian Cemetery Final Disposition: 7. Funeral Director / "pi~tat 8iSl'OseF Indian River F.E. No.l~~. N().~ Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No. 1228-92-0213 Permission is hereby granted to dispose of this body. o A five clay extension of time for filing the death certificate (exclusive of weekends) has been requesteel and granted as undue hardship v.oolcl 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 steel. Registrar or Subregistrar Signature ~~: 7'-;(~~91- g:~Certificate 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: [J BURIAL o CREMATION Signature of Sexton ) or Person-in-Gharge ) o STORAGE o OTHER (Specify) '(7/' </,(' ~ ,,;n. .' Place of Disposition Sebast i an Cemetery Date of Dlsposition April 25,1992 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) :r