HomeMy WebLinkAbout4-38-29
,
b
hid byCEMETEJtJ RecM!t No... .1....... Dated... .~.~~,(fJ.?................ tot. 2A
400.00 Block.
Ust Pdce $.................. Maxlmum No. BurfalSpacea................. Uni t 4
400.00
Net Psld S .................. Monument permitted. . . . .. . . .. . .. . . ; ... .. . .
NO.
1.3'75
(Deta lit-. tbli line 1O't Clt, Beeord onJ,)
. .
Cltttu df' &fbusthttt
at,tttrt.ry Iflb
~.
1375
THIS INDENTURE MADB 'l1da ...................... d.., of ..........................,.................. A. D. .t......,
bet...een II.. City of S.butla... a mUIeipa! ecirporatlon eslatln. ude. tbe laws 01 tb. State of Florid.. .. Grantor and
Charles & Helen Clark
. ... .... ..................................... .6"74. 'r;a.1tij' 'Ut'! VI!.................... ........... ..................................
P.O Box 780091
...................... .... ................... !;'ebas"t'tiiii~" :tlod.aa "~'21178'.:.()tj9T.."""'.''''''''''''''''''''''''''.
of the Coanty of . .In.d.:t.an. .a.b:e.r...................... Ii':'" Stat. of ..... Flo.r.ida................... ..................
U Gr.ntee. WITNB881tTH.
That the Ormtor for and In conskleratlon of the 11Im of S '" ~ 9.Q .' .QQ . . . . . . . . . . . . . to it In band palel, tile receipt wbereof la herewith ao-
knowledpd, does by this Instrument arant, 1mplft, seD, release, convey ancl confirm unto the Grantee t; \1.~ ~.:r; .. 1teIn,.1 representstiYea and esslpls
the foDowJns property situated In Sebullan, Indian RJoer Couty, FIorldI, to-wlt:
An of Lot(s) .?~... ,BIo"", J.f} . . .. ,UNIT ..... ~. . . . . .. ,of Sebastlan municipal cemetery .s per Plat Number t theieof recorded In Plat
Book 2, at pap 65 of the pubUc records in \beomce of the Cleric of the C1rcuft Court of St. Lude County of PIorida; .Ielland now tylns and beilll
In Indian Rioer County, FloddL
To Hsve snd to Holel tbe ssme fore_; pro9lcled that aid property thad be uaed IOIeIy and elteluslvely for the Interment oftbe human dead and shall
be used, kept and maintslned at sJJ times in .ccordance with the rulea and rep1atlon.. orcllnances .nd resolution. of the City of Sebssllan, Floricla, hereto.
fore, now .nd hereafter adopted or protfded for the IO-.,ment and operation of aid cemetery. The condition.. restrlctlona and requirements contained
In thla lnatrument shaD be cmenanta runnInt with the land. In the eoent of the fsJJure of the owner of any property situated within aid cemetery to oil-
_ and comply with iuch rules, .....letlon.. relOlutIons snd .ordinancea and the condltlona of the deed of conoeysnce thereof then the tItle of lOch owner
In and to said property shan termln.te snd the .me sha1l revert to the City of Sebssllen, PIorlcla.
IN WITNESS WHEREOF, The aid party of tile lIrat part bes caused thlalnatrument to be executed In Its name and on itabebelfby Its Msyor.nd
.ttested by Its CIty CIerIt md Ita corporate seal to be hereto afIIxed, the day and year IIrst .bo~ written.
Al~ . )n.:..{)~.
tiirtl~ City Clerk
!II...'"", Sealed .00 n.lfyer.d
In the P.....""" of,
.~~..e.~...................
C.I~"..""......"
COl'NTY OF INDIAN RIVER
2nd September 92
I HEREBY CERTIFY, That 011 thl. ....................... .de, of ..................................................., It....,
brfore me penonally appeared... ~~nt:1.~~ ..~. ~.. r~.~.~g....... . . . .. .... . .. ........ .nd ~~J~J:y.n. ".-!'..<? ~ ~~~J<?J:~~..
relpt..,U..ly Meyo, ...d City Clerk 01 the City 01 8ebaatlen, a munldllll ~rpo'atlon und.r the law. of the State 01 Florida to me known
to be the Indl.ldu.ls and offl.... cleserlbed In .nd ",110 exeeuted the forrlOl.,1 eollveyan.. to
Charles & Helen Clark
(Oltit 'eal)
. . . . . . .. . . .. ... . ... . . ........ ..... .......... ....... ..... end ....relly ""kn....ledrcJ tbe exeeutlon thereof to be their f.... .et .nd deed
sa aurb ..ffleers thereonto duly eutborlsed I and tb.t the Offlelal ...1 of uld eorporatlon Ie duly lifflxecl thereto, and the aald eon.eye_
II the .et end dred of IllId eerporattoR.
WITNB88 IlIJ .I....hlre .nd offlelat Ra1 .t 8ebaatlan, In the Coon
lest aloM8kl. .. .. .... .. a .. ..
UNDlM. UlMM,'
..,..............
~ CIllIlIIIIIlIn......... ",....
CCMot.OC....
Name
"/Ie J. 6 Jj
"/'
3B
?""t
/../~ ,,;;l //
f . / v- f:-... 1'-_
. Unit
Block
1" 9
Lot d<
D~te of Mark-out
JO- :rf3.~.. .9 '1
Date of BuriaL
qa
10 .. 50 -I 1
Time
/11 : 00 ;:I. /'fJ.
11.I. .'" me-m~1 Hom('j .t) 7f:? t.r fU. K. ~s
'ya ~----.L/ .,.. .
,.. "'-/'7 /,,;:.//
'''!~ " .~ '\, ~.:',--;' ..,;. -... A; ..--': ./ ~/~ 'I
Auth1:>rized by_ ;-"'" "-X.,,, -' ..c.K.-.' . SJ....<,
_...__.r \ __ "
..:\
-----.......-----......- . --..-.....--..-.-.--..---- .~_...._. ----..---.'--.-..---.--...--.-..
.. .~.- ...----- ..---.___________m__________._________..___ ___~
___ ~arl~ 4J1elen ])eed.
h 71 We }:;r-j ve-
-p D. boX '71JD()Q J /luJ
Sefu6~;a.n rL 3(}978 ~
/
Lo+ &~ 1JDcl3~J U();~4
~~-Uc2Jl- /tJ-3tJ-ry
.......,
J375
I
\
~
..... -
. . 726 9/2/92 Lot 29
Paid bYCEMETEld~:OSNO.. .............. . Dated. ............................. Block 38
un Price $ .. ...... ,.. .. ... .. Maximum No. Burial Spaces. ............ .... Uni t 4
400.00
Net Paid $ .................. Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
NO.
1 . .":i5
~j." ..
(nata above this line tor City Record only)
...
~
.
.
'7d0
TIlE SEBASrIAN CEMETERY
Citf} or Sebastian
Sebastian, Florida
FROM:
Dollars ($ ~..t:t-
)
t//
'~~/' V~d~ 0:2?7?- t)()f /
&~ ~. .
on t::bis dag ,. l~q ~or t:.be purchase or the rollowing
described Cemeterg Lat(s) pan the terms and conditions as seated herein:
Description or Propertf}:
Cemeterg tet:(s}' ctJ~ ~ . Blockll ,31l" UDit:I <I .
Purcbase pri~~~ DollarS($~, t;JJ-j
Terms and' conditions or sale:
{i)uJk #' IP1S
This contract: shall be bi.Dding llpon both parties, the seller and t:he purchaser, P1Then
approved bf} the owner or the propertg above described.
I, or M!t, agree to purchase tbe above described propertg on the f:e.rms and condi tions
stated in the foregoing inst:.rument::
~ C~- ~
~J:. n~
The Ci tg of Sebastian agrees to sell tbe above mentioned property to t:l1e above named
purcbaser(s) .on the terms and conditions stated in the above inst:rament.
~ fiA.Lu ~ .;' /J A-L. 11/'
Wi t:12ess -,
r---
.. . ~ ..
.
,-1" 0
'" "
~,
,
IJ' 'J - ~
~. {'
.u '1 " 1 '
.
"J: fJH,-:'_;:"'~
City of Sebastian
POST OFFICE BOX 780127 IJ SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330 IJ FAX (407) 589-5570
September 3, 1992
tr--
Charles & Helen Clark
P.O. Box 780091
Sebastian, Florida 32978-0091
Dear Mr. & Mrs. Clark:
Enclosed are Cemetery Deed No's. 1375 and 1376 for Lots 29 & 30,
Block 38, 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.
Very truly y.ours,
~l<,f,.- /J1. O'I/~~
Kathr1h M. Q'Hal10ran .
City Clerk
KMO:lml
enclosures
1--
FLORIDA DEPARTMENT OF
_ S~.~'9rida, Dep.~rtment ,of Healt~! Vi~~ ~.iCS
APPLICATION FOR BURIAL - TRANSIT PERMIT-
c1 ~~~,_, ~. ::-:.: >'. : '_;~..- . ,...\.,.. ~ .
1--,;29
/838
t/~
A.
1. Name of
Deceased
HEALT
(TYPE)
First
Middle
-, ---.-last
.;'::'" Cla'rk
Date
of
Death
(If neither, give street address)
Month. ,Day _..Year
Helen
Jurgensen.
10/27/99
2. Place of Death
County
I ndian River
3. Name of Medical
Certifier Noor N. Merchant, M. D.
Medical Examiner Physician
4. Name of Funeral Home/Direct Disposal Address
Establishment .. 1623 N. Central Ave.
Strunk Funeral Home > Sebastian, FL 32958 1228 (561)589-1000
5. Check a. 0 The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate - _ "app~\catio~: - . . -
Box
Address
7744 Bay Street Center '2
Sebastian, FL 32958
Name of
Hosp. or
Inst. Sebastian River Medical Center.
Phone t-!umber
-;.~'i.::-:
City , Town or Location
Roseland
(561)589-0879
Fla. Lic. No.lReg. No. Phone No. (Area Code)
b. ~ Wendy was contacted on 10/28/99
He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death,
and that Dr. Merchant . 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/
Direct Disposer
'1
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose ofthis body. Permit No. 1228-99-0497
D 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. "
[YI No extension of time for filing the death certificate has been re'quested.
RGaistrar or ..
Subregistrar Signature
Date
Issued: _L 0 - d-.'e- q<1
Date Certificate
Due:
C.
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT -SEA
~i <:
Approval Number:
Date
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..
[KlBURIAL
DCREMATION
SignatL:re of Sexton
or Person-in-Charge
DSTORAGE
CEMETERY OR CREMATORY .
Place of Disposition 0 d J_ .... t:., ."u
Date of Disposition ec.-.\ D\.~
(~AYI<-t;:7'
~O I ,Q9<1
D.
Method of Disposition:
DOTHER (Specify)
}
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. 6/97 (Obsoletes all previous edijions)
(Stock Number 5740-oolJ.{)326-2)
Distribution: \/\/hije: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar
:Y.
Name e/1,4,e5 C4 - 2I L 4C' V�• 1A5 6R1A.ll,Ali) 2 y�-
Unit if
Block 3 g
Lot A •
Date of Mark-out 21/6 liE
•
7
3fl
Date of Burial �//� /!� • Times
Name of Funeral Home S b2 ear!
IC-
�i W
Authorized by /
CITY OF SEBASTIAN
FINANCE DEPARTMENT RECEIPT 9 9 8 3
Name Strunk/C1 ark Cash
Date 2/18/16
It)Check# 7377
Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit-
001501 362100 Taxable Rent-
001501 362150 Non-Taxable Rent-
450010 369900 Airport Badge
001501 329500 Alarm Permits
001001 218010 CobraServe
001501 354100 Code Enforcement Fines
001501 347557 Community Center Revenue
001501 341920 Copies
001501 369900 Miscellaneous Revenue
001501 359000 Other Fines/Forfeitures
001501 351140 Parking Citation
001501 342100 Police Security Services
001501 343805 o/c 150. 00
`� Total Paid 150. 00
ni'als
White-Dept.of Origin • Yellow-Finance • Pink-Applicant
1