The URL can be used to link to this page

Home My WebLink About4-37-29 .. Ii .r4 Paid by CEMETERY Receipt No... .:...... Dated... .~.~ (.~ ?~.~~.............. UIl Price S.... ~.~ ~~.q :.q~. Maxlmum No. BurlaISpaces................. 1,200.00 Net Paid S .................. Monument permitted. .. .. .. . .. . .. .. . .. .. . . . LotS.& 30 Bloc Unit NO. lJ81 (Dat. .boy. tltla line 'or Clt, R<<ord only) Glitv of &tbasttatt atrmrtrty I1trb (11381 NO. THIS INDENTURE MADB ...... 19th ..,... d., of October 92 A. D.. I......., "", between lhe Clt, 0' Sebastl.n, a lDunlclpal eorpo,.tlon esl.tlnl under the I... of the State 0' Florid.. aa Grantor and Kenneth G. and Marjorie D. Schake ,..,...."................................, '504"' '3e8gnll"Cir~te'''''''''''''''''''''''''''''''''''''''''''''''''''''''' .",,'................ ....... ................ "Bl!J:e.~~~~.. .~l!r.? .~~?':.~~~. .~.~9!6.,............,........................, Indian River Florida of the Coanty of ......,...............'........,............. a...1 State 0' ..,....,......,...,.......,.........,......,.,......... aa Gr.nt.... WITNBSSETH. 1 200.00 TNt the. Grantor for and In consideration of the sum of S ...,...................... to It In hand ~' the lecelpt ..hereof Is heteWlth ao- knowledged, does b, thillnllrvrnent pant, ba...m, ..n, retea.., convey and confirm unto the Grantee ...~ ~.~ . . rhein, .1 lepre_tatly. and asslzns the followlns property a1tuated In Sebastian, Indian RMt County, Florida, to-wit: AD of Lot(s).~ ~~.~ ~ Block, . . ;3. ? .. ,UNIT ...~......... ,of Sebastian municipal cemetery.. per Plat Number I theleOf lecorded In Plat Book 2, at pap 65 of the public lecords In the office of the Clerk of the C1rcuJt Court of St. Lude County of Florida: said land no.. 1)'inK and being In Indian River County, FloridL To Have and to Hold the ame fo.._; proYlded that aid property shan be used IDIeIy and exclusively for the Interment ofthe human dead and shall be uaed, kept and maintained at aO lime. in accordance with the ruleland replatlons, ordinances and lelDlutlon. of the City of Sebastian, Florida, heleto- fore, now and heteafter adopted or proYided for the lO.ernment and operation of aid cemetery. The conditions, reatrlctlon. and requirements contained In this InIlrument .haO be co_nta runnlnt with the land. In the event of the failure of the owner of any property a1tuated within aid cemetery to Db- _ and comply with inch rules, replatlons, reaoIutlonsand ,ordinances and the conditions of the dl!ed of conoeyance thereof then the title of such owner In and to aid property shall terminate and the ame shall teYert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The aaId party of the first part N' coOled thla instrument to be executed In Its name and on It. behalf by Its Mayor and atteated by Its City Clerk and It. corporate ...1 to be hereto affixed, the day and year first abooe written. CITY OF SEBASTIAN, FLORIDA Allesit By.., City Clerk Mayor Sl~"", Se.l.... and Dellyered In the Preaenee of I (QIitv ~al) STATE OF FI.oRIDA COl'NTY OF INDIAN RIVER 19th 92 October I HEREBY CERTIFY, That on thla ...................... ..d.y 0' ...".............................................., I.,..., b..rore me penon.lI, .ppellred .~.<?~~~.~.. ~... ..p~~~.~.l.............,......,.." .nd K~ t.l,t.t;1.~ ..f:I.~..9. ~ ff!!g<?t;~~.. r.......U.rl, M.yor .nd City ('Ie,k 0' the CII, of 8e.....tl.n, 0 mun"'I".1 corporatlon under the la... of the State of Florid. to me Irnown 10 be 'lie Indl.klunl. alld offl.... d..crlbed In ond who e"<<ut.,,, the fOIl',oln, ."""y"nee to Kenneth G. & Marjorie D. Schake . . . . . ' . . . .. . . . . . . . . . . . . . . . . .. , . .. .. . .. . . .. .. .. . . .. . . .. .. and severally ..lrno..led,.... the es<<utlon thereof to be thel, 'ree ad and deed .. all"" office.. tllereunto dul, authorbed I and that the Om.lal ""01 of .ald rorporatlon la dulf affixed thereto, ond the said eon.eyon.., ,. the lIet .nd deed of I8Id emporatlon. WITNES.... my al~.ture .nd offlcl.1 aeaI .t SebastIan, In the County of Indian Rlnr and Stat. of Florida, the d.y .nd ,... la.t aforeaald. Notary l'ublk, State of PIorId. at !Ar,.. My _........ nplrea. Linda M. Lohsl Name ,. r; '~-'i~ /. /.r...! I': ," .-t/ .~ ,_ ,/'". 1/:" .."..-" '.,~ .'; j"'!,t:-. ..(;. Unit / Block -(' .' Lot < ".;;' "1 Date of Mark-out I ! '1 /f-l.~ Date of Burial '/ I '0 / ;;:;- Time J { ,'::....~) ~( _/1) t Name of Fune{~1 Home /:5r"",~.-{",- ~;K . . '-__: ,'~-->7"~~"->} ~><_~;_- ./~?:<~) Autho'tized bi> ,'><~-;d-/)/ ~,/ 'c~"..(.:e./.., ..'..'-....-1 "..._~,.~_..- . t.~'-'~' . 1 ~f Kenn~GMY(ai6Dy'ie)) 604 ~etX-;~ I ~~~\e fure-Poo+- ~J r:L :?:iYi7fo WucJQ4<50) 15Jrek 3~ Un; + 4- ~~ ~ J/ID/ttQ Lo+~1 -'-'__ ____.5. )ee~ 13D) '" ~ - ...... - 732 10/19/92 . Dated. . , , . . , . . . . . . . . . . . . . . . . . . . .. . . Paid by CEMETERY ReceIpt No. . . . . . . . . . . . . . . . . 1 200.00 Maximum No. Burial Spaces..........,.. ... . List Price $..,...~........... 1,200.00 Monument permitted...... ,................ Net Paid $ ...............,.. Lots 29 & 30 Block 37 Unit 4 NO. 1381 (Data above tbll Une for Cit)< Reeord only) ~ . . r-7 ......... r) ;:Jc;X THE SEBASTIAN CEMETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA ($ ~~~,P' ) FROM: on this ;9f!l- day of ~~~ following described Cemetery Lot(s) stated herein: 9710 for the purChase of the terms and qonditions as Description of Property: Cemetery Lot(s) ~qi 30 Block 37 Unit 4 Purchase price~_d~~~Dollars ($J/2t~.~) Terms and Condition of sale: ~#cP~yO 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 conditions stated in the foregoing instrument: ~~-Jdl~ . The City of Sebastian agrees to the above named purchaser ( s) on above instrument. . PA~ ~r' - S~ll;the above mentioned property to the terms and conditions stated in the ~ (] , Wit~ ~-/ ~ . . W ~ ~ CJ o Q W if o ., c: <:e ~! .crct OBit c;:l> %5~ f- :igf- Ww Z '11. ZZw ~~i . . (D - ~ Q) Iii ~ ~ <(\J ~ f .!l ~ ~ i -= to .or nJ !: A. 1. Name of Deceased (Type or Print) First Kenneth Middle' ) rP~ 3{) /337 tli - State of Florida, Depama of Health and Rehabilitative Services, VIta.istics APPLICAft!N FOR BURIAL - TRANSIT PERMIT Last Schake DATE OF DEATH Month Day 01/07/95 Year 2. Place of Death County Brevard 3. Name of Medical Certifier Muhammad Siddiqui, M.D. 4, Name of Funeral Home/ Direct Disposer Strunk Funeral Homes, 5. Check a 0 Appro- priate Box City, Town or Location Medical Examiner Name of (If neither, give street address) Hosp. or Inst.S04 North Sea Address Phone Number Barefoot Bav . Physician Address 1623 North Central Avenue P.A. Sebastian FI 32958 -~ ? The medical certification has been completed and signed. A completed certificate of death accompanies this application. bJB was contacted on 01/g~:/93 within 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 thatMuhllmlllAd S i dd i qJl i, 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 otSebastian Cemeter~ Final Disposition: 7. Funeral Director/ ~!t ~~I Indian River F.E. No.lReg. No. Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No.1228-95-0015 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 extensi~ of time for filing t ath certificate reQues~ Registrar or . ~ Subregistrar Signature Date Issued: / _ y,. fS- ~~ 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: [XI BURIAL o CREMATION t\ ~ _ d'''^&... \ ~ CP.....,..... D";;..I. " ~ ... \ \0 I \o,Cl, o STORAGE o OTHER (Specify) Place of Disposition Date of Disposition \..,~~~ Signature of Sexton ) or Person-in-Charge) .J., .L." /... ) e J,..J 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) J.