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Home My WebLink About4-38-38 - --- / Paid by CEMETERY Receipt No, . . , ,~ Lilt Price S . ,1.,.20(),. OQ..,. Net PaldS .. ~.'. ~~?,: ~?... Robert W. Vogt interred ..... D.ted... ?~~.t~~..,............... Lots Block. Maximum No. Burial Spaces .. .. .. .. .. .. .. ... Un i t 4 Ii. 38 NO. 1359 Monument permitted......,.....,....,..... 5/1/92 - Lot 38 (D.ta .hoYe dtla n.... for Ob- __... ....1') C!tUu nf &t bastian I1ttb . 1.353 C1ttmtttry NO. THIS INDENTURE IIADE ...... ..... .1s t..... ,.... da, 0' .... May.................................... A, D~ .... 9.2., bel.....n Ihe at, of Sebaatla... . ....lelpal eorporatlcnl ...I.tl... unclo. the I.... of the St.t" 0' Plo.leI.. a. Granto. and Dorothy Vogt ............................ ......"".....,.. '70S;'E;' . Gl'adialu'S' 'Drl ve'.'...........,...........,......... ......,....,. .........,............,...... ................ .~~~~.~.~~~. .~.~r.!.. .~~. }~.~!~..,' ..........................................,. of the CoantT 0' .... Jm'}'~.Q.. R1-.Y.~~................... an'l St.t" of .... .~;J,~~J!:lA...................................... .. Grantee, WITNBSSBTH, That the Grantor for Ind In c:onalcleration of the 10m of S ...\ I.~~Q... 9.q:....,...., to It In hand paid, the receipt wheroofll herewlth.o- knowledpd, does by thIJ Inltrument pant, 1mpIft, .U, relea., coftWly.and confirm W1to the Grantee .. . . . , . " heIn, lepl repre_tstJfts and a,," the followl.. property lituated In Seballlan, Indian Rmr County. FJorIcIa, tCMflt: AU of Lot(l) ~.~ ,. ~~ ~'Blode, ' ,~~, , " ,UNIT .".~......., ,of Sebastian munldpal cemetery al per Plat Number I thereof recordeclln Plat BooJc 2, at pap 65 of the pubHcrecorcla In the of8ce of the Clerk ofthe CIrcuit Court oUt. Lucie County ofFlorlcla; IeId land now Iylnaand bel.. In Indian Rm. COUllty, Florida. To ""'" and to Hold the _ fore_; proYlded that IeId property lIhaU be used aolely and exclulively for the Interment of the human dead andlball be used, kept and IIIIIntaIned at aD thnes In lCClOI'CI.nce with the rulelancl replatJolII, Orcllna_1 and reaolutJonI of the CIty of Sebastian, Florlcla, hereto- fore, now Ind hereafter adoptecl or proyIdecI for the pmm1ment IIId operation of IeId cemetery. The concIltIonl, restrictJonland teqalrementl contained In thls lnatrument IbaD be coWlRlntI runnlnl with the 1IncI. In the ....nt of the faDure of the owner of any property Iit..ted within saIcI cemetery to ob- ~e and comply with inch ru.... npJattonI, reaoIudonl Ind ordlnanceland the conditions of the chIed of c:otIWIYIIIce thereof then the title of lOch owner In Ind to I8Id property ahall terminate and the .me shan revert to the City of Seballlan, Florlcb. IN WITNESS WHEREOF, The saIcI part, of the Drst part hal cauaed thlllnltrtlll*lt to be executed In It I name and on III behalf by It. Mayor and attmed by Its CIty Clerk andltl corporate -' to be hereto affbted, the c1ay.nd year first aboWl wrItteR. Att..tsl~J.dn.:.{)d~... --..--.".- CIIr a.d, /lIp"', S..led ancl n.lI...red h-:::..~"":..... ,....'rlJ 4-:t.t.~~&? ..C~~..,.. (atilt -'tal) STA'fE OF PI..oRIDA COl'NTY OF INDIAN RIVER I HEREBY CERTIFY, Tllat OIl thla .........1 st. ., .. .... .dl' 0' ..... ..May.. ........................ ... ..... ....., ....9 Z b.ru.. me penonall, .""".recI . .Lonn:l:e. -R.... . PGwe 11. ............................ and .Ketbr."n. .M... O".}Ia.l;J,oren. ...prrtlv.ly Ma,o. Ind City C1"rk of the ClIr 0' Sebaatl.... I munl.I,..1 ...rJ'O.aUon unlit!. the l.wl 0' the lItat" or F1o.lda to me kn_n 10 b. Ih" Individual. and o'fI,,"," clne.lhecI In and who """euled the forrpln. eOllreyanee to . . .. . . . . . .. . .. . .. .. .. .. . .. . .. .. .. .. ,.. .. jlp,t.'.Q.t hy, . .v Q g t. .. . .. . .. .. .. .. .. .. .. .. .. .. , . .. . . .. . . . .. .. . . .. .. .. .. .. .. .. .. .. . .. .. . .. .. . .. . .. . ... . .. .... ... .. .... ...... ................... .... .. .nd ..n.a1I, ....nowled.... the ...eeutlon the....f to he lhel. '.ee aet <<ncI .I.ed 01 IlIch 01"".," thereunto dul, lutho.!.ed. .nd that the O'flelll ...1 0' 1.1d eorpltl'lltlon II dul, a'fllled thereto, llnet th" uld eltnyry"nee I. the <<et and deed 0' ..lei ....,......tton. WITNESS my IIp.tuPe and offJelal Hal at 8eh..tlan, In the County' or lut ofo...aIeI. ' l..IHIM M.l.OHSl. ....,......... 01 FlIlIIIfII _Ol.....Jwb..,....... _,11M COMM'OC.,,, !"~'1~' ".i.h Name f ,0- o /:j E Ie I vJ. v;; C$r. r Unit 1 Block .3 9:> Lot '3 ' B Date of Mark-out 1/;? 9 J 9 {).. . S/, Iq~. Time /f) : DO ,4,1"'1I"1" Date of Bu rial t . \, AI.i~horiz ~ F:1. ;...I I~ .e. J1 J.... HOj..,p7€ ~.,/'. J. list Price $, ,1",200-, OQ,'" . 1,200.00 Net PlI1d $ ",.".""."..., Lots 37 & 38 Block 38 Maximum No. Burial Spaces...., _.".,..,.., Uni t 4 NO, , . . 707 5/1/92 Paid by CEMETERY ReceIpt No"""",.,."", Dated",,"".".""""".,."'" 1359 Monument permitted, , , .. , , , .. , , . , , , .. , . , , . Robert W. Vogt interred 5/1/92 - Lot 38 (Data above this line for City Record only) .~J State of Florida, Departme. Health and Rehabilitativ$ Services, Vital .iCS APPLICAnON FOR BURIAL - TRANSIT PERMIT ~ 3~ 3e /?; 3~ !I~ 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 fi the death certificate re ed. Registrar or Subregistrar Signature A. 1. Name of Deceased (Type or Print) First Robert 2, Place of Death County Orange 3. Name of Medical Certifier Carlos Saenz, ~.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral 5. Check Appro- priate Box 6. Place of Sebastian Final Disposition: 7. Funeral Director / Oir:e~ Ci&j;~IW B. C. Middle Last Vogt DATE OF DEATH Month Day Year 04/28/1992 w, City, Town or Location Phone Number (If neither, give street address) Orlando Medical Examiner X Physician Address 1623 North Central Avenue Homes, P.A. Sebastian Fl 32958 122 7-? a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b III Nll1"CI~ was contacted on 9V29/199within 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 Car I os Sap-n 7. r 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, Indian River F.E. No.l<Reg ~Io. Removal from state Donation Date Signed .., BURIAL - TRANSIT PERMIT Permit No. 1228-92-0233 ~~: 4-;1.9 - 9~ Certificate AUTHORlZAll0N for CREMAll0N, DISSEcnON 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. Methods of Disposition: ~BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) CEMETERY OR CREMATORY o STORAGE o OTHER (Specify) /'"'f <1 Place of Disposition S e bas t i an C em e t e r y Date of Disposition M a y 1. 1 9 9 2 ~~ //i 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) 3".