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Home My WebLink About4-38-27 ---- --- <!tUg of ittbnstinn ar,metery lerIt nlGa8 NO. THIS INDENTURE MADE 'l1aIa ..3.rd...........,... day of ........... ,N~,vemb.e.r.............. ..... A. D.. 18,9.9.., between lhe CIty of Sebutlan, a municipal corporatlon exlatlng under the laws of the State of Florid.. aa Grantor and Clara N. Eytchison '. , ' , , " . , .., ,'..,...,,'.. ,....'". ",. ..,. '3'38' 'Concha: ' Dri''lre'.....'' .." ". .. " , . , . , " .... .. ., .. , ., . ,. .....",....,........ Sebastian, Fl 32958 ............................................. ............................................ ............................................ of the County of ...Jm~~I;l.~..R:j..y~;t:.................... an'J Slate of .........f.J..Qt::i.d~.................................. u Grantee, WITNESSETH. That the Grantor for and In consideration of the sum of $ 1.,. 9.Q9.: R9.. ... . . . .. . .., to it In hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument llfBnt, barpiD, sell, release, convey and confirm unto the Grantee .l].~;-. ... helrs,lepl representatives and assigns the foUowlns property sltuate4.1n Sebastian, Indian River County, Florida, to-wll: 26&?' 38 4 ' All of Lotb) . . . . d'S ,Block,.....,., ,UNIT ...,......... ,of Sebastian municipal cemetery as per Plat Number I thereof recorded In Plat Book 2, at page 65 of the public records in theofflce of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now IYins and being In lndIan R.iver County, Florida. To Have and to Hold the iame forever; provided that said property shaD be used solely and exclusively for the Interment of the human dead and shall 'a used, kept and maintained at aU times In accordance with the rules and regulations, ordinances and resolutiolll of the CIty of Sebutlan. Florida, hereto- to"" ltoW and htrelfter adO~ lit proYi4ed tor the aowrnmant IIld operation of said cemeterY. The conclitlon.. resttiotlons and requlremenU contained In thillnatrument diaD be covenants runntna with the IInd. In the event of the failure oftha owner of lilY property situated withln said OlImetary to ob- serve and comply with iuch rules, regulations, resolutions and ,ordJnances and the conditions of the deed of conveyance thereof than 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 IU City Clerk and its corporate seal to be hereto affixed, the day and year first above written. ed and Delivered ..":k,~~,."..,.,,.. "'~~""('P._......."...,.,..,",. crr,:,OFCAZ?z.;A ~~;h.." ";;;'7 'Cr' AtO~.. I h1 {);/dtH~........... te&rr1f~ City Clerk (GIitu ~eal) STATE OF FI.ORIDA COUNTY OF INDIAN RIVER I HEItEDY CERTIFY, That on thla ......... 3.r.d......... ,day of ..'......,......... ,N.o:vembe:c................., 1899., before me pe&'lOnllll:r appellred .9~~~~, .~~~l?~~a~,:r;",.,.",...".",..,.."""." and ~~ ~.~.t;'y.p., .~,~ ..9, ~~~~J.<?~~P... relpt.'<!tlvely Mayor and City Clerk of the City of SebAatlan, 8 munlclllal c:orporatlun under Ihe lawa of the State of Florida to me known 10 be lhe Individuals and officers deacrlbed In and who executt-d the forl'going cORveyance to ,.",..,.,...."..""." ..."......,..,..,. .G;I,~.~,Q.,.N.., ~Y.t.<;h;l.I3,O.t;l,..,...,..,....,.........,..."..,.,., ......"..,...,.,... .. , , . , .. . .. , . .. , .. .. . .. .. .. . . .. .. .. . .. .. . .. .. . .. .. .. . ... and severally ac:knowledgoo the execution thereof to be their free let and deed as Inch officers thereunto duly aulhoriaed; and that the OWcial seal of aaid corpon.tlon I, duly a thereto, and the aald conveyance is the ad ond deed of said corporation. WITNESS my signature and offldal aeal at Seb.stlan, In the Coun lasl aforl!llald. LlNDAM. tW.1EY MY COMMISSION. CO 74047 EXPIRES:.!tIIe 18,2002 1landsd1lVu NoIMyNlllc~ . ......................... ~ Name /l / II.'.' , . ~ r '> !~.. ht::..M !\ j !\f '" r.... ~ 1;- "', i "'f-; . ~'i ;':;~ () l~~j Umt Li Block ";C. (..1 ..;,) l..) Lot '1-1 ,~ I Date of Mark-out ... / :1..1 . > iitlJ //, I ..... j t../ , I Date of Burial J < 5"/ 30 I () I I Time 1/: 0 0 i' \ Authorize~ ( l \\ '....../ 5......... )" . vl( ! 1<... ,,{ ',j 1\",) 1nLL~otct . Name of Funeral Home J. . E 'Ire I! /S()~ Cf-IlR/l Itf, I "J)e Q& '. III q){ J. 6T ~ !3/--pe/( 315/ (J/lfirf - aj3~ / JdJ · YJ1 ~ '- - ..' --.. State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT L.~ :11 R; 38 /J 1 FLO A DEPARTMENT OF A. 1. Name of Deceased (TYPE) First Middle Last Month Day Year Clara Nora Date of Eytchison Death Name of (If neither, give street address) Hosp, or Inst. May 27 2001 2. Place of Death County Oran e 3, Name of Medical Certifier Fidel Rodriguez, Medical Examiner City, Town or Location Winter Park Winter Park Hos ital Address Phone Number 4. Name of Funeral Home/Dill6m Bi$".......1 Establishment Strunk Funeral Home 5, Check a. 0 Appropriate Box .0. Physician Address 200 N. Lakemont Avenue Winter Park, FL 407-599-6044 Fla. Lie, No.lReg, No, Phone No. (Area Code) 1623 N. Central Ave. Sebastian, FL 1228 561-589-1000 The medical certification has been completed and signed, A completed certificate of death accompanies this application. b, EilI sa was contacted on 5/29/01 He/she v.erified that this death was from natural causes, that there was no accident nor other extemal cause of death, and that Dr. Rodriquez will complete and sign the medical certification of cause of death within 72 hours. c,D was contacted on He/she verified that , Medical Examiner, will complete and sign the 6. Funeral Director/ DireGt DiGFt'f9r J eath within 72 hours. F.E. No.lReg. No. 1862 Date Signed 5 29 01 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose ofthis body. Permit No. 1228-01-0270 o A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within 72 hours. ONo extension oftime for filing the death certificate has been requested. RI.ilinu llr ~ Subregistrar Signature Date Issued: s1~,/OJ Date Certificate Due: t./~/O/ . C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA Approval Number: Date Medical Examiner, , gave authorization by telephone to Funeral DirectorlDirect 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. Method of Disposition: ~BURIAL DSTORAGE CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition r,/3 t) ;: ~ DCREMATION Signature of Sexton or Person-In-Charge DOTHER (Specify) } -~ f ~.t;, 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 County Health Department in the county where disposition occurred. DH 326, 8197 (Obsoletes all previoua edRiona) (Stock Number: 574Q.000.0326-2) Diatribution: WhRe: Cemetery or Crematory Yellow: FlA'IeI'8I Director or Direct Oispoaer Pink: Local Reglalrar 5.