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Home My WebLink About4-36-04Titu of Orhastitttt • -1517 Ur lig r t r r 19 r r NO. 22nd November 95 THIS INDENTURE. MADE Tids ...................... day of ............................................. A. D., 19......, between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Willi im.R,..&..DP.r0y..E,.Y]-. qr. 544 Wimbrow Drive ......................................... Sebastian, -.Florida -M58 ............ . ..... I .................................... of the County of . Indian River ....................... . . . sn l state of ....... Florida ....................................... as Grantee, WITNESSETHr That the Grantor for and in consideration of the sum of $ M99:00 99: 00 ............... to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee thele .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: Allof Lots) 4S`5 Block, 36 UNIT ...4.. , . , .... , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The add party of the first part has caused this instrument to be executed in its name and on Its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. City Clerk Signed, Baled and Delivered in th re cnce of: J : ............... . ... .. ........................) TATE OF FLORIDA COUNTY OF INDIAN RIVER CITY 0 s 1 Mayor (0tq'Seal) I HEREBY CERTIFY, That on this 2.2nd......... day of November ................................ .... before me personally appeared .Arthur L. Fiction andKathryn..M. ..O.'.Halloran ........ ......................... respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the Individunls and officers described In and who executed the foregoing cuaveynnee to William R. & Dorothy E. Fisher ............................................... ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed ereto, and the said conveyance Is the net and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the Tnty o ndle cr ivd $tate'of Florida, the day and year last aforesaid. / _ LINDA M. GALLEY ef W COMMISSION I CC 91572/ L ................. 81PIFft,11 ats 1S, IVA NotaFublic, State o or ida at Large. '�.• Ssaded7MaWNYPak UnOWAM My c laslon I. I_ Lin a M. Ga 1" \ Name Unit Block Lot r; V !�z Date of Mark -out ' C 1 Date of Burial /'-' Time l Name of Funeral Home` Authorized by �---. ---- CITY CLERK'S OFFICE 4575, RECEIPT Name r� t e- ❑ Cash / v ' Y_Check p `'r Y7 Date No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot/Niche , Block , Unit. t)/Q- S h er' O 001501343805 Cemetery Fees j f � Total Paid Initials White - Dept. of Origin 9 Yellow - Finance • Pink - Applicant William R. Fisher - Sebastian - William R. Fisher, 87, died on Tuesday, August 4, 2009. He was born in Montgomery County, Ohio on November 11, 1921. He was a WWII Army veteran who was decorated with a Purple Heart and a Cluster. He retired from General Motors, Dayton Ohio. He is survived by his beloved wife of 38 years, Dorothy E. Fisher; his son, William R. Fisher Jr.; two daughters and husbands with their families, Mae and Howard Littrell, and Alma and Mike Slayback. He was known affectionately as "Bill Bill" to all his grandchildren and great- grandchildren, Donna Teimouri and Rick Blackwood and her children, Amir, Ramien, and Sheva, Ben and Katie Fisher, Joe and Bobbi Moccia and their children, Vanessa, Anthony and Thomas Wildey, Dan Fisher, James Fisher and Kyle Koshinski, Jeff and Carolyn Slayback and his children, Katie, Megan, Michael, Scott Slayback and his children, Taylor, Briana, Shelton and Katelyn. Also survived by his beloved sisters, Norma Maus and children Judy, Cathy , Frank and Fred. Donna and Lester Lewis and their children, Theresa and Brian, all of Ohio. A memorial service will be held Sunday, August 9, 5 - 7 p.m. and services will be Monday, August 10th, 11 a.m., both at Brown Iie-Maxwell Funeral Home, 1010 E. Palmetto Ave. Melbourne Florida. www.brownIiemaxwel1.com William Fisher Aug. 5. 2009 1:28PM BROWNLIE - MAXWELL FUNERAL HOME PA 1010 EAST PALMETTO AVENUE MELBOURNE, FLORIDI 32901 INTERMENT ORDER FD in charge: Mike NAME OF DECEASED: William Ray Fisher, Sr. DATE OF BIRTH: November 11, 1921 SS N: No. 2715 P, 1 Phone (3211723-2345. Alternate (321) 723-3167 DATE OF DEATH: August 4, 2009 AGE: 87 NEXT OF KIN: Dorothy E. Fisher RELATIONSHIP: Wife ADDRESS: 1590 Charles Boulevard NE, Palm Bay, FL 32907 PHONE: 321-984-1635 OTHER PHONE: CEMETERY: Sebastian Cemetery DESCRIPTION: Lots 4 & 5, Blk 36, Unit 4 Please call if the description is blank or not correct DATE & HOUR OF BURIAL: Mon. Aug 10th @ Noon KIND OF SERVICE: Funeral PLACE OF SERVICE: Brownlie & Maxwell Chapel OUTER CONTAINER: Lined and sealed Tiara vault CASKET Batesville PLATINUM "GI", 1 8g SLR, Silvertone, ivory crepe int THIS IS NOTIFICATION TO THE CEMETERY FOR INTERMENT. PLESE CALL OUR OFFICE TO VERIFY THIS INFORMATION WAS RECEIVED AND IS CORRECT WITH YOUR RECORDS. A COMPLETE SET UP IS ALWAYS REQUIRED. A4 7�a589 a��'S *ad a1��0� l a1 FLORIDA DEPARTM •Mr OF IHEALTK A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of William Ray Fisher, Sr. Death August 4, 2009 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Brevard Palm Bay Inst. Palm Bay Community Hospital 3. Name of Medica David J. Weldon, M.D. Address 5305 Babcock St. NE Phone Number Certifier [ Medical Examiner Physician Palm Bay Florida 32905 321-676-9009 4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Establishment 1010 E. Palmetto Avenue 1 Brownlie - Maxwell Funeral Home Melbourne, Florida 32901 0000049 321/723-2345 5. Check a. C Appropriate Box am -Sebast;an Gomtery MON The medical certification has peen completed and signed. A completed certificate of death accompanies this application. AmandaD_ Dr Weldon's Office was contacted on 8/5/09 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that - - Dr. Weldon — - --- - evil!_camp!ete-ardsign-tbe-medical certification of cause of death within 72 hours. was contacted on He/she verified that , Medical Examiner, will complete and sign the medical certification of cause of death within 72 hours. 6. Funeral Director/ ign re FF- Nn /Ran Nn Date Sioned Direct Disposer /.elf ' F044250 August 5, 2009 B. s BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 49-2009-278 ® 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. ❑ No extension of time for filin death ce iflicate has been requested. Registrar or Date August 5, 2009 Date Certificate Subregistrar Signature Issued: Due: 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. D. CEMETERY OR CREMATORY Sebastian Cemetery Method of Disposition: Place of Disposition Sebastian, Florida ® BURIAL ❑ CREMATION Signature of Sexton or Person -in -Charge ❑ STORAGE Date of Disposition ❑ OTHER (Specify) I nls permit must be endorsed by the Sexton or person -in -charge (or by the Funeral Director/Director Disopser when there is no Sexton) and returned within 10 days to the local County Health Department in the county where disposition occurred. DH 326, 8/97 (Obsoletes all previous editions) Distribution: White: Cemetery or Crematory (Stock Number: 5740-000-0326-2) Yellow: Funeral Director or Direct Disposer Pink: Local Registrar ref FL g� Paid by CEMETERY Receipt No.... 871, , , , , , . Dated .. 11 / 17/95 List Price $ ...1 x O00. 00 Lots 4 & 5 NO. Net Paid $ ... 1,000.00 .. Maximum No. Burial spaces ............. Block 36 ...... Monument permitted .. . Unit 4 1r (Data above this line for City Record only) 77/ THE SEBASTIAN CEMETERY CITY OF SEBASZ7AN, FLORIDA RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUN_ OF: Dollars FROM: ;. 'i% �i . ✓ul� _/-,�'%i>-=< _ Tom-. ort this ' day of/��'�/_�! r) 47 19 for the purchase of the following described cametery Lot (s) /94eh= ; _; upon the terms and conditions as stated herein: Description of Property: j Cemetery Lots) �`'- ',J Block L�(D Unit Purchase Pric.. Dollars t Terms and Condition 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 conditions stated in the foregoing instrument: The City of Sebastian agrees to 11 the above mentioned property to the above named purchaser(s) on the terms and co motions stated in the above instrument. �----' Ciity of SebasItian mess November 30, 1995 City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 13 FAX (407) 589-5570 William R & Dorothy E. Fisher 544 Wimbrow Drive Sebastian, Florida 32958 Dear Mr. & Mrs. Fisher: Enclosed is Cemetery Deed No. 1517 for Lots 4 & 5, Block 36, Unit 4. Also enclosed is a form - Return for Transfers of Interest in 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, P. O. Box 1028, Vero Beach, Florida 32960. Sincerely Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:hng Enclosures