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Home My WebLink About4-36-05Titg of ophastialt moi' r M e t t r y B e i t NO. 7'II19 INDENTURE MADE Title22nd day of..November 95 ....:...................................... A. D., 19......, between the City of Sebastian, a municipal corporation existing under the laws oyf, the State of Florida, as Grantor and ................................. W num. R,. A .DPrtby . F4, _ jjshper............... . ..... ................................... 544 Wimbrow Drive .......................................... Sebastian, ZLorida• 32958............................ I ........................... Of the County of . Indian RiYer...... . ............. . ..... ani State of ....... FlOI; Ida .......................................... to Grantee, WITNESSETHe That the Grantor for and in consideration of the sum of S 1 ? : ............... to it y� hand paid, the receipt whereof Is herewith so- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee their heirs, legal repmsentatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: AB of Lot(s) 4&t .. , Block, .. 36 ... , UNIT ...4......... , of Sebastian municipal cemetery as per Plat Number I 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 shalt revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said 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. Attest i . r....... CL.. .....t: ....... . v City Clerk Signed, Sealed and Delivered inlh r once oft 1,'�i. G? ............... . r ... ......................... TATE OF FLORIDA COUNTY OF INDIAN RIVER CITY 0 s / Mayor (dltig Seal) I HEREBY CERTIFY, That on this 22ndNovember I9 day of ...................................... 95 brfore nee y appeared Arthur L. Fiction Kathryn M. O'Halloran peroonalla .......................................................... and ....................................... respectively Mayor still City Clerk of the City of Sebastian, a munfelpel corporation under the laws of the State of Florida to me known is be the Individuals and officers described to and who executed the foregoing coaveynnee 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 sold corporation Is duly affixed ereto, and the said conveyance Is the net and deed of sold corporation. WITNESS ivy signature and official seal at Sebastian, In the last aforesaid. LMA M. GAMEY W COWAMM/CC war I olPailM leafs t0. Ing ' IVAbd lira Maury /Ugs WO ratim of Florida, the day and year . ................... Public, State o orlda at Large. mlaslon ex fres M. Galey Name I f -F 14 c1 Unit t Block �2 Lot Date of Mark -out Date of Burial Time ' Name of Funeral Home / ` ! MU U Ful iLVU vy I CITY OF SEBASTIAN CITY CLERK'S OFFICE /, C� n RECEIPT 4 7 U Name� ro wn�l ji e ►1�1 t,�c,�'l o Cash Date -3 ~/" r heck# 146 1y� No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copieald Specs. 001501341910 LDC/Code of Ordinances 001501341930 Elecdon Qualifying Fees 601010 343800 Cemetery Lots F1 5 r lu LoVNiche 5 Block 3 (0 Unit --'�_-15000 001501343805 Cemetery Fees W Total Paid 1 5y. Initials White - Dept. of Origin • Yellow - Finance 9 Pink - Applicant Fisher, Dorothy Dorothy Ellen Fisher - Sebastian - Dorothy Ellen Fisher was born in Jackson County, Kentucky and lived a life of joy and laughter until passing from this Earth on Friday, August 28, 2009. She joins her husband of 38 years, William R. Fisher. Dorothy is survived by her two daughters and their husbands, Mae and Howard Littrell, Alma and Mike Slayback. Loving Grandma to seven grandchildren and fourteen great-grandchildren, Donna and Rick Blackwood and her children, Amir, Ramin and Sheva Teimouri; Ben and Katie Fisher; Joe and Bobbi Moccia and their children, Vanessa and Anthony Moccia and Thomas Wildey; Dan Fisher, James Fisher and Kyle Koshinski; Jeff and Carol Slayback and his children, Katie, Megan, Michael; Scott Slayback and his children, Taylor, Brianna, Sheldon and Catelyn. Dorothy is also survived by her two sisters, Lola Cox and Addie McIntyre. The memorial service will be held on Monday, August 31, 2009 from 5-7 p.m. with the Funeral service on September 1, 2009 at 10:00 a.m. Both arrangements will be held at same location, Brown I ie -Maxwell Funeral Home, 1010 E. Palmetto Ave. Melbourne. www.brownliemaxwell.com. Lf 36 5 RUX�Ef A. (TYPE) 1. Name of First Deceased 2. Place of Death County Brevard State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT Middle Last Date Month Day Year Or Dorothy Ellen Robinson Fisher Death City, Town or Location Name of (If neither, give street address) Hosp. or Palm Bay Inst. 1590 Charles Boulevard NE 3. Name of Medica David J. Weldon, M.D. Address 5305 Babcock St. NE Certifier August 28, 2009 Phone Number L_ Medical Examiner D< Physician Palm Bay , Florida 32905 321-676-9009 4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No./R7NoPhone Number (Area Code) Establishment 1010 E. Palmetto AvenueBrownlie - Maxwell Funeral Home Melbourne, Florida 32901 0000041/723-2345 5. Check a. r The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate l— application. Box b. Beth Dr. Weldon's Office was contacted on 8/31/09 He/she verified that this death was from naturae causes, that there was I to accident nor other external cause of death, Sebastian Cemetery and that Dr. Weldon will complete and sign the medical certification of cause of death within 72 hours. c C was contacted on He/she verified that medical certification of cause of death within 72 hours. Medical Examiner, will complete and sign the 6• Funeral Director/ Sig r F F Nn Man Nn Direct Disposer Date Signed 515K F044250 August 28, 2009 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 49-2009-327 ® 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 filing the dea •h ' if ate as b n re s d Registrar or f Date Date Certificate Subregistrar Signature III Issued: August 31, 2009 Due: C. AUTHORIZA ION 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 ❑ STORAGE Date of Disposition ��42 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton or Person -in -Charge This 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