HomeMy WebLinkAbout4-38-31
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...
Paid by CEMETE~~~-;~ No.... n..... Dated......... ~.!.~ (.~~............ ~~~c~ 1..
Ust Price $.. .. . . . ..... ., .. ... Maximum No. Burial Spa_.. .. .. ....... ... .Uni t 4
NO.
Net Paid $ .... .600.. GO....
1.)66
Monument permitted. .. .. . .. .. . . .. .. .. . .. . .
(D.ta .boore this Jlne for City Record aaly)
Q!Uv of 1'rbustiutt
Ctttmtttr!J
mtt..
') 1;)66
NO.
THIS INDENTURE MADB TtlIs . ..3rd.... . .. ...... d., of ............. J.UJ:l.e...................... ... A. D., 1'.~ ~..,
belween the Clt, of Sebastl.n, . lIIunlelpaJ eorporatlon nlstln. under lhe law. of the State of Florid.. .s Orantor .nd
Olive A. Crompton
...:::::::: ::::: ::::::::::::::::::::: :~~~;.~:~~r~:~:~;;~~~~~~~~~::~:~?!6...::.:.::::::::::::::: :::::::::::::::::: :::
of the County of .. .lnd.i.Q.n..\Ux~r..................... .n.1 State of .......... f.~.<?1?~~~.................................
u Or.ntee, WITNB88BTH I
Tlat the Grantor for and in consideration of the sum of $ ...... ~.q9. : ~9. . . . . . . . . . . to it in hand paid, the tec:elpt whereof Is herewlth .0-
knowledpd, doea by thla instrument IUnt, b...sift, sen, release, convey and confirm unto the Orantee h e.!: . . .. heln, 1ep1 represent.tlves and as.s
the folio..... property situated in Sebastian, Indian River County, florida, to-wlt:
Anof Lot(s) . ...~~. ,Block,.. ~.~. ., ,UNIT ...~......... ,of Sebastian munlc:lpal cemetery as per Plat Number I thereof Iecorded in Plat
Book 2, at Jl8I8 65 of the pubnc records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; aid land now lyIns and bel"l
in Indian Rita County, Florida.
To Raore and to Hold the _e fomer; provided that said property thaIl bo used aolely and exc:luaPely for the interment of the human dead and allan
bo used, kept and maintsJned at aU dmea in acconlance with the rulea and replatJons, ord~ andreaolutlon. of the aty of Sebastian, Florida, heleto-
fore, now and hereafter adopted or prOYIded for the lOftIDIIIent and operation of said cemetery. The c:ondJtlona, reatrletIons snd Iequlrement. contslnecl
in thla InstfUlMllt thaIl be eo_nt. rannIna with the land. In the event of the r.l1are of the owner of any property situated within said cemetery to ob-
_ and comply with inch rulea, replatlona, _hrllolll and ordlnanoes and the eondltJons of the deed of conftYlUlce thereof tll!>n the title of such owner
in and 10 said property allan terminate and the ame ahaII revert to tll!> CIty of Sebastian, F1orlcla.
IN WITNESS WHEllEOF, TII!> said party of the first part Ias caused thla instrument to be executed in Its name and on Its behslf by It. Msyor snd
attested by Ih CIty Clerk and Its oorporate ... to be hereto affbed, the dsy and year first abo\'8 written.
CITY OF SEBASTIAN, FLORIDA
Att"~J.'A !1JJ,...o..r.I~~
---..""7........... CIlJ' Clerk
llllllt.'(\, Sealed .nd Delivered
;e;~~nnn..n....
v.~. .c2..I1f..~...................
(GUt; ,-ral)
STATE OF FUJRIDA
COl'NTY OF INDIAN RIVER
I HEREBY CERTIFY, That... thla ......... .3x!t. ... . ... .d.y of ........... .-7~m~. .. .... ........... .. . . . . . ... . . . .., I'.??
....fore me personally .ppe.red ..t.onnie..lt...P.ow.ell............................. and Kathry.n.H....O.~HalloJ:aJ:l..
re8""rtively Mayor .nd City C1m of the CIty "I Seballtlsn, a munlell..1 eorpordlon under the laws of the St.le of Florida to me known
to be the Individuals .nd officers d_rIbed In and who neeuled the for"plnl eoIIvey.nee to
.......... .... .......... ............... ........ .9.t~x~ ..~.....C;:.J;.<?!I!P.t.9~... ...................... ....... ....... ....... ...........
. . . . . . . . . . .. . .. .. .. .. .. .. .. .. .. . .. . . .. .. .. .. .. .. .. .. .. .. .nd ...verally ....nowled..... the entutlon thereof to be their free .el .nd d.ed
as SlIch offleers ther""nto duly aulhorlsC!d I au that the Offlci.1 ....1 of .ald eorporatlon Ia duly .fR.ed therein, .nd the ssld eonv.yanee
I. the aet .nd deed of BRitt eorpontlon.
WITNESS my s....atare 81Id "'net.1 _ .t Sebastl.... In the Corty of Indian Rive and
lilt "0-' oL '
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Date of Mark-out
Time
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DatI! of Burial
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Narlle of Funeral Home
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Authorized by
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A .;E~r;tj.i(i
'txve ~'+ ~I fl- 3G1!?1&,
(Lo.J- 31)
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Paid by CEMETERY Receipt No. ... 7JA....... .Dated......... ~.(.~t.~~............ Lot 31
List PriCe $.... .(>~9... 9.Q.... Maximum No. Burial Spaces................ .~~~~k 4 38
NO.
.1366
Net Paid $ .... .gOO'..O'O....
Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
(Data above thls line for City Record 0011)
.. .
.
.
7/1
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIP'1! IS ~RBB; f'C~DGED OF THE SUM OF,
&cI ~~d }IV . Dollars
FROM: l2iJ~~ 12, I!.-~
($b,jtJ. ~
)
on <hi.S,-~r:J- day o~ ,~99.;l.ror t:he purchase of the following
described Cemetery Lot( upon the terms and conditions as stated herein:
Description of Property:
Cemeterg UJt(sJ# ~/. ~OCk# ~~
Purchase pric ._~_tpdY
Unit# 4
Dollars ($ 1aYJ.~ )
Terms and' conditions of sale:
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 condi tions
stated in the foregoing instrument:
X~t?
~
The Ci ty 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.
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C::Wi tness
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City of Sebastian
POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330 0 FAX (407) 589-5570
June 10, 1992
Olive A. Crompton
1024 Royal Palm Drive
Barefoot Bay, Florida 32976
Dear Mrs. Crompton:
Enclosed is Cemetery Deed No. 1366 for Cemetery Lot 31, 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.
We are enclosing two copies of Receipt No. 714 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,
.~m.D'/lwMa--
Kath~';.'~'Ha110ran
City Clerk
KMO:lm1
enclosure
(\ws-form-cem.rec)
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First
Last
I- '31
13 33
{,J 1
Month Day Year
Sept. 17 2001
FLORIDA DEPAR
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
A.
1. Name of
Deceased
(TYPE)
Middle
Date
of
Crompton Death
Name of (If neither, give street address)
Hosp. or
Inst.
1024 Royal Palm Drive
2. Place of Death
County
Brevard Barefoot Bay
3. Name of Medical Address
Certifier Pa 10. Vasallo, M.D. M.E.
Medical Examiner Physician
4. Name of Funeral Home/liMest Bi!.~osai' Address
Establishment 1623 N. Central Ave.
Strunk Funeral me Sebastian, FL 1228 561-589-1000
5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
Olive
City, Town or Location
Phone Number
1750 Cedar Street
Rockledge, FL
321-633-1981
Fla. Lie. No./Reg. No. Phone No. (Area Code)
b. 0 was contacted on
He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death,
and that wilt complete and sign the medical
certification of cause of death within
c.O
was contacted on
He/she verified that
, Medical Examiner, will complete and sign the
6. Funeral Director/
D,",~l ulsposer
Date Signed
9/18/01
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose ofthis body. Permit No. 1228-01-0459
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.
ONo extension of time for filing the death certificate has been requested.
Subregistrar Signature
Date ~ \
Issued: 9 ,.. 0'
Date Cert~<:afe I .
Due:~
ftayl;,ucu or 11
C.
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
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.
Method of Disposition:
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
D.
~BURIAL
o CREMATION
Signature of Sexton
or Person-in-Charge
DSTORAGE
DOTHER (Specify)
} ,(t 1- ~k0-
Date of Disposition
qj11.o,/o )
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 retumed
within 10 days to the local County Health Department in the county where disposition occurred.
DH 326, 8/97 (Obsoletes all previous eclilions)
(Stock Number. 5740-000-0326-2)
Distribution: VllhKa: Camatery or Crematory
YeUow: Funeral DIreCtor or Direct Disposer
Pink: Local Registrar
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