HomeMy WebLinkAbout4-37-31
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Paid b, CEMETERY Receipt No... .?e, ...... Dated .~Rl.W(?~................. Lots"
800, 00 '~ Block"""
Lilt Price S .. . . .... ... ..... . .' Maxbnum No. Burial Spaces..... .... .. .. .... Uni t 4
32
NO.
Net Paid S
800.00
lJ82
Monument permitted. . . .. . .. .. . .. .. . .. . .. . .
(Data abon ttola Une for Clt, R<<ord ooly)
<!lUv nf &,hastiatt
'1382
atrmrtrrg
I1rrb
NO.
THIS INDENTURE MADE nta
19th
,. d., of
October
92
A. D.. 1.......0
bet,,'een lhe City 0' Seba.tlan, a munlelpal corporation ealatlnl under the law. 0' the Stale 0' Florid.. .a Grantor and
"",.,...,.,.............. ...........P.9.n8.ld..l>....& ..J.eanne. .M....Ca~avant.....,............. .....................
731 Dempsey Avenue
",.,................. .................. ..Sebasti.an.,. .F.1orida..329.58..... '".,..,.,.,.....,....... ...................
Indian River Florida
of the Co8nt, of ....,...'.........................,.......... ad State 0' ..,...,.,....,..,.................",......,...........
u Grantee, W1TNBS8ItTH I
That the Grantor for and In consideration of the sum of S . .~~9... 9.9. .. ... .. . .. . . . .10 It In hand paid, the lecelpt ..hereof Is herewith ao-
knowledpd, does by this Instrument pant, ball.m, ..u, retea.., conyey and confirm unto the Grantee . ~.l?-!'!;~~ heIrI,lepl lepre_tallY. and assigns
the followilll propeJtfaltaated in Sebastian, Indian RIYer Co~nty, Florida, to-wlt:
51&32 37 4
AD of Lot(s) ..... .. ,Block,........ ,UNIT ............. ,of Sebastian munldpal cemetery as per Plat Number I theleOf lecorded In Plat
Book 2, at paae 65 of the public lecordsln the office of the Clerk of the C1rcuJt Court of St. Lude County of Florida; ..lei land now l)'ins and being
In Indian RI_ County, FlorldL
To Have and to Hold the arM forever; proYided that sold property shaO be uaed IDIeIy and exclusively for the Interment of the human dead and shall
be uaed, kept and maintained at aO times In accordance with the rule. and replatlons, ordinance. and relDlutlon. of the CIty of Sebastian, Florid., heleto-
fore, no.. and heteafter adopted or proYlded for the ID""lment and operation of aid cemetery. The conditions, reatrlctlons and requirements contained
In this InIlrument shaD be covenant. runnlnt with the land. In the e.ent of the faBole of the owner of any property situated within aid cemetery to oh-
...... and comply with inch rulea, reculatlons, relDlutlons .nd ,ordinances and tile condition. of the deed of conveyance theteof then the title of such owner
In and to aid property .hall terminate and the ame IhaII ~rt to the City of Sebastian, FlorldL
IN WITNESS WHEREOF, The aid party of the Out part "s couaed this Instrument to be executed In Its name and on Its behalf by Its Mayor and
attelled by it. City Clerk and Its corporate ..al to be hereto atlbced, the day and year first above written.
CITY OF SEBASTIAN, FLORIDA
Alles"
B, ....
City Clerk
Mayor
!Ilp....t, Sealed and DeJlnred
In the Preaence olr
(CUitv ~Ill)
STATE OF Ff.oRIDA
COl1NTY OF INDIAN RIVER
19th October 92
I HEREBY CERTIFY, That on thla ...................... ..da, n' .................................................... I'.....
Lonnie R. Powell Kathryn M. O'Halloran
br'ore me personally appeared ......................'.....'..........,....,..,...,.'..,., and .,....,................................
ru"".lIvely Mayor and City Clerk 0' the City 0' Sebaltlan, a munlel'JlI corporation under the law. 0' the State 0' Florida to me Irn_n
to b. Ihe Individuals and offl.... deac:rlbed In .nd who eae.utl'll the 'ar"lOln. "".veyanee to
"",.."..... ........... .......... ...... ....,P.Qm~l.c;l..P...,. .~..J.~~.Jm~..tf.,. .C.Ma~ant.......... ..... ........ .............
. .. .. .. . .. . .. .. .. .. . .. .. . .. . .. . .. .. . .. . .. .. .. .. .. . . .. ... and ....erally ..lrnowled..... the er.eeutlon thereof to be their free ... .nd deed
IS .".h offlee.. thereunto duly authorlaed I and that the Offl.I.1 aeal 0' saki eorporallon la duly a'fi.ed thereto, And the ..Id eonve,a....
II the AeI .nd dred of said corporation.
WITNESS my alpature and of tidal _I at Seba.tlan, In the Coonty of IndIan Rlyer and Stat" of Florid.. the da, and ,ear
last aforeaald.
Nota.,. Publle, State of J.PIorkla It Lar,..
My _laalon opl_,
Linda M. Lohsl
,,.,. ~ " /'/~
<:J/-" lJ;/, I b /7)1. c> it) j4' t 1.1. tl
Name ;1-' . .'., . .
/
Unit
/1
I
Block
~t
.....;
Lot
3)
Date of Mark-out '
3/6 !ff '2//
3)9Io.~~. '
Time
./ ':~}
Date of Burial
Name of Funeral Home
-;---~ . 'L'
< ~ r {.,J . .~
j I.k."',f'
r.' ! /(
Authorized by \.d..-t~/:::!'.~lt:.'(<;1
-~"-.. .
j
.. -~-~,.- ........--.-.,.--.".'"
. "'>' j)Drajd~. $ 3eanfle rYl.
13/ I emp~ Avenue
S~~Gr)1 1='1- <3QQ6o
ko-l-6 31 t{ 3;2 I "'B} oek 31 J Lln j + J{
f{)~ ~ -U307-
~ ~ -4<31-
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PaidbYCEMETERYReeeiptNo.,..?~~ Dated 10/19/92 Lots 31 & 32
Ust P' $ 800.00 ....,.............,..,................. Block 37
nee .......,..,.. ,.... Maximum No. BuriaI Spaces , ...,... ......... Uni t 4
NetPaid$ ....~?~:.~~....
Monument permitted. . . . . . . . . , . . . . . . . . . . . . .
(Data above this line tor C17 Record ollly)
NO.
1382
.
.
73,3
THE SEBASTIAN CEMETERY
CITY OF SEBASTIAN
SEBASTIAN, FLORIDA
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
gt2
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)
-d-x- -?(,L' ,
~ L ~p-1{. ~ qu'}~
-S)J-)O"~'~L/i./ :f1;.~~--ui& 3Qq ()J
on this ;C)<-tb- day or[){!~t... , 199c7 ror the purchase of the
rollowing described Cemetery Lot(s) upon the terms and conditions as
stated herein:
Description or Property:
Cemetery Lot ( s) -3 J d..~~;:L Block
Purchase price:8~~.J- r.kL-fdLJd fr'
Terms and Condition or sale:
{}kL $c!loO
This contract shall be binding upon both parties, the
purchaser, when approved by the owner or the property
described.
6, Unit "-I
Dollars ($ 2'LiO, ()!)- )
seller and the
above
I, or we, agree to purchase the above described property on the terms
and conditions stated in the roregoing instrument:
0~~ (~
The City or 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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CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
Name ~/1A1~ 64Vd
Date 0-//-t1d-.
001001208001
001501322900
001501 341m
001501 341910
001501 362100
001501 362100
001501 362150
001501343800
601010343800
001501369400
001501 369400
6B08OO 220681
680800 220682
680800 220683
Sales Tax
Garage Sales
CopiesJBid Specs.
LDClCode of Ordinances
Community Center Rent
Yacht Club Rent
Non Taxable Rent
Cemetery Lots
n~~15
-"""i .","
o Cash
X Check. ,i{/7Y
Amount Pal
Cemetery Lots
LotlNiche ,,'-3/. Block 8 7 . Unit ~
Interment Fee ~~~
Weekend Service
Yacht Club Security Deposit
Community Center Security Deposit
Riverview Park Security Deposit
/;c</Jt.
t:! Total Paid
vr Initials
White - Dept. of Oriain. Yellow - FI_nee . Pink. Applicant
/tX,M
F'
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
~Yc-'
[;~
FLORIDA DEPARTMENT OF
A.
1. Name of
Deceased
(TYPE)
Jeanne
Casavant
Date
of
Death
(If neither, give street address)
Month
Day
Year
First
Middle
Last
M.
March
6
2002
Name of
Hosp. or
Inst.
2. Place of Death
County
I ndian River
3. Name of Mefj~
. Certifier ro A. Espat, D.O.
Medical Examiner Physician
4. Name of Funeral HomelDi5tiit Billp'-:'sat Address
Establishment 1623 N. Central Ave.
Strunk Funeral Home Sebastian, FL 1228 772-589-1000
5. Check a. D The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
City, Town or Location
Address
8005 Bay Street, #3
Sebastian, FL
Phone Number
772-589-5600
Fla. Lic. No.lReg. No. Phone No. (Area Code)
b. ~ lna was contacted on 3/6/02
He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death,
and that Dr. Esoat 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
Direst Eli6~o~wl -
use of death within 72 hours.
F.E. No.lReg. No.
~~
Date Signed
6. Funeral Director/
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-02-0111
DA 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.
D No extension of time for filing the death certificate has been requested.
RegiatlYI or-
Subregistrar Signature
Date
Issued: 3/6/02
Date Certificate
Due: 3/11/02
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
DCREMATION
Signature of Sexton
or Person-in-Charge
o STORAGE
o OTHER (Specify)
}
Date of Disposition
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 editions)
(Stock Number: 574CHlOO-0326-2)
Distribution: While: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrer