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Home My WebLink About4-36-06 . mitv of l'fhastian Qttmtttry Ittll 01820 NO. THIS INDENTURE MADE 'l1dI .... .l.9.th.......... day of :... Q~ t:.Q.b~J::............................ 'A. D.,J1J.. ~9pl between tile City 01 SeboatJa... a munlclpal corporation alatin. under the lawaof the State of Florida, aa Grantor and EVA D. SHRADER. ............................................ '76i" WAi'NUT' .jiB-IVE............................................................. ....................... ... .... ...............MEl.BDURNE.,.. .FlORIDA. .3.2.9.35... ....................... ..... ........ ........ 01 the County of ..... J.J;l.Q.;i,All. ..E.;i, Y:~.J;................... aD.J State of ... ..fJQJ:::j..c;l.~.................... .................. u Grantee. WITNESSETH. . That the Grantor for and in coDsideration of the sum of $ .~. J A?~ !.Q Q . . . . . . . . . . . . to it in hand paid, the receipt whereof iaherewith ac- knowledged, does by thiainstrument grant, bupiit, sen, release, convey and conium unto the Grantee .... . . . .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: AD of Lot(s) ... .~ .. ,Block,.. ~ .~ . .. ,UNIT .... A . . . . . .. ,of Sebastian mUDidpal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the pubHc 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!lDd regulations, ordinances and resolutioDs of the City of Sebastian, Florida, hereto- fore, DOW and hereafter adopted or provided for tho government and operation of said cemetery. The conditions, restrictions and requirements contained inthia instrument shall be covenants running with the land. In the event of the faDure of the owner of any property situated within said cemetery to ob- serve and comply with iuch rules, reguladons, resolutions and .ordlnances and the conditions of the deled 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 said party of the first part has caused thia instrument to be executed in its name and on its behalf by its Mayor and att~sted by its City Clerk and its corporate seal to be hereto affixed, the'day and year first above w.rltten. At~...... .rlm.~..~...:..................... ':".-c. y' City Clerk . CITY OF SEBASTIAN, FLORIDA BT W.~..W.f:?~~........:..... MaT!)r Signed, Sealed and Delivered In the Preaenee 011 ;-, I fYl ^ 1/1 J I 4 (J /J \. . .7.J.t.~.............. ......~~............. (QIitu Ji~aJ) TATE OF Fr..oRII:>A COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this .......:J:? ~.q... ....... .day of ....... Q~~.<?J:?~F...... ......................... ..Xii. .7:901 belore me personally appeared..... :WlilJ.~~t:".. J!.... .~.~.l;"n~.~......................... and . ~lil.l.J.Y.. .~.~. . Mlil,i.Q. .............. respectively Mayor and City Clerk 01. the City 01 Seb8,!ltlan, a munlelpal corporation under the laws 01 the State of Florida to me known to be the Individuala and olllcers described in and who neeuted the lorf'golng eORveyanee to Eva D. Shrader ........................................................................................................................................ .. .. .. .... . .. .. .. .. .. . .. .. .. .. .. . .. .. .. .. . .. .. .. .. .. .. ... and severally aeknowledged the execution thereof to be their free act and deed as such offleers thereunto duly authorized; and that the Ofllelal seal of said corpot"&tion la duly alllxed thereto, and the said eonveyanee Is the act and deed of said corporation. ., WITNESS my algnature and olflela1 IIe&I at Sebaatlan, in the County of Indian River and State of Florid.. the day and Tear last aforesaid. W .' ~ H..JONfESMDBEfl'3 -~. fJ" d~"t\ M't COMMISSION * CC 725~ '. \ . EXPIRES: AprIl :iO. 2002 . " . BIJnl!ed TIIru NolBJy PuIllIc UndelWraers ~~... "~~..' ................... Not bUe, State of Plorlda at Lar . . My mmlsalon esplrei I ~ Name ,." ~"'.'': .I.,....' ,.-.; ~ '........ / A. /.- I /......~ / / l'. 1../ . ,...,...---'. /5 jCd. i (,'-(;; .-- //. .. r t l_ . I I n :;: .,;;"~ Unit If' , Block '. i.~ Lot ./ i {~,i ""... Date of Mark-out Date of Burial I i." ./ ~/<' / .' /~) , " :" ~,: " ..'~, / ...,__^ l Time ~i l ~ '/ . ()'o.. l) / Name of Funeral Home -. / ,. "I I C,., () ,,'! I" ..-'" ,t;".' , - r; , .../ ,.~,...,.. , ,0'.' .-,,' /;,lCj,. If;'~!) Authorized by r'" SHRADER, EVA D. 761 WALNUT DRIVE MELBOURNE, FLORIDA 32935 DEED 1101820 LOT 6, BLOCK 36, UNIT 4 JAMES D. BAGGETT INTERRED 10/21/01 LOT 6 '- - '-. - Paid by CEMETERY Receipt No... 9.1~.Q....... . Dated. .~9i .~?~9.~................ List Price $. .l.~ t~?: ~9.... Maximum No. BurialSpaoes................. P 'd $ 1 l"5. 0" Monument permitted....................... Net 31 . . ...,. .~ . t . . Y. . . . EVA D. SHRADER LOT 6, block 36, UNIT 4 NO. 01820 (Data above dlLs Une for CUy Record ooly) October 24,2001 Eva D, Shrader 761 Walnut Drive Melbourne, Florida 32935 Dear Ms. Shrader: cmor SEISAS:gAN ~ HOME OF PELICAN ISlAND Enclosed is City of Sebastian Cemetery Deed No. 01820 for Cemetery Lot 6, Block 36, Unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office, SAM:js enclosures The Sebastian Cemetery City of Sebastian, Florida Receipt is acl<nowledged in the sum of: ~~~ ~ Dollars($ /1,;lS;~O ) From: EI/Il A), S/l~Il-j)ER 7/' / 1LJ~J.,,vur V~. u. ~ on this /~ dayof , 20t1 / for the purchase of the following described Cemetery Lot{s)jNiche{s) upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)/Niche(s) ~ Block ~'1 ~ . Unit - - ~ / Purchase Price ctNA'~~A;f 6~ Dollars .($ I/,l- 0-110 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: Purchaser signature ._ __. ___ __0- __....._.~.... _._._.__._.____.____._ -... -- .---------.-..- .-.- ~.. ---.--.. .- .....-... -..--.-.--.-- ---~....- ----.---.....--. -- ..-- ---- --.-.----....-------.- -.... Purchaser signature The City of Sebastian agrees to sell the above mentioned property to. the above named purchaser(s) on the termS and conditions ~tedin the above instrument, [~~dA"~J tiCity of Sebastian Witness ~. . .. crrv OF SEBASTIAN crrv CLERK'S OFFICE RECBPT 0110 Name /J1'7/lJEJlJ H/lJ/L y' /tJ - ~/J-(/ / o Cast! A"Check...1c1.d %5 AmountPlld . Date 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 CopieslBid Specs. 001501 341910 LDCICOde of Orcinances 001501 362100 Community Center Rent 001501362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501343800 Cemetery Lots S/, 2./:J) 601010343800 Cemetery Lots (t;/":J,,- 51) LotINiche t.. ,Block. ,tt Unit .i-- 001501369400 Interment Fee 001501369400 680800 220681 680800 220682 680800 220683 Weekend Service I. ~J41 Yacht CIIb Securily Deposit Communily Center Sect.!rily Deposit (jZi;ff~) .,d,/M Total Paid 1.1 :l5'.J/) Initials White - Dept. of Origin. Y 11I0. - FI_.. · Pink. AppIIClnt .. . u.s. PATENT NO. __1113',5785353 . , .. 8 CITY OF SEBASTIAN CHECK RE VEST Input Date Document # Document Amount Accounting Use Only Fiscal Period Entered By #m~~ fuWHCH~h To Be Completed By Department Due Date I J -bl~- tJ / Single Check C3 N Document Organization Reference Code Vendor Number LN TC Description ~~G Number of Lines Amount NAME ADDRESS CITY ~ ZIP CODE DRAW CHECK FROM APPROVED BY DATE BUDGET APPROVAL (534000 AND 535450 ONLY) C=:J MAIL A'ITACHED DOCUMENATION (Except for remit slips, requesting department should attach ~ a copy of documentation along with e riginal) L-..A-J 0 INSTR en NS . ry HOME OF PELICAN ISlAND October 26, 2001 The Ammen Family South Brevard Funeral Home P.O. Box 1346 Melboume~ Florida 32902 On October 19,2001 a check was issued from your funeral home in the amount of$1~325.00 (copy attached) for the burial of James Daniel Baggett. Enclosed is City of Sebastian check #043930 in the amount of $50.00 being returned to you for the Burial After 4PM charge that you included in your check. We do not make that charge in our burial, If you have any questions, please contact our office. /11h.-- )&de. SAM:js enclosures ~ ~ ..,., ; '. ...... . ~: ...~:. . ...~.jiIool o trl~.; ~..~..~. F~'~ )>. ~.. t!j . 8~':. .0.Orn'. '@'S:3' . >>. . ~" ('): ...... ">-1 '.,~' Q ..".. 'CI.l --. I ~~~ '. ~. >~ CI.l ....j. ~, ,'". . ';i :~ !f ';,.' ::~- ""'" -0 ra 0- ra 01 o .... . i e , ~ g ... '0 J.. C, /!) 3& u1 State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT A. 1 . Name of Deceased (TYPE) First Middle Last Date of Death (If neither, give street address) Month Day Year James Daniel City, Town or Location Ba ett October 18, 2001 2. Place of Death County Brevard 3. Name of Medical Certifier S. Qaiser, MD X edical Examiner 4. Name of Funeral HomelDirect Disposal Establishment South Brevard Funeral Home Melbourne Address 1750 Cedar Street Rock1edge, FL 32955 Name of Hosp. or Inst. Holmes Regional Medical Center Phone Number Physician Address 1001 So. Hickory St. Melbourne FL 32901 {321} 633-1981 Fla, Lie. No.lReg. No. Phone No. (Area Code) FH-937 {321} 724-2222 5, Check Appropriate Box a. The medical certification has been completed and signed. A completed certificate of death accompanies this application. b. D was contacted on He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death, and that 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 Permission is hereby granted to dispose of this body. Permit No. 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. DNO extension of time for filing the dtJath c 'icate Registrar or b1 ~ Subregistrar Signature 1/ o. Date SignQd / / 10 19 01 6. Funeral Director/ Direct. Disposer B. ANSIT PERMIT FH-937-36301 Date ssued: 10/19/01 Date Certificate Due: 10/29/2001 C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA 8459 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 0, IlSURIAL DCREMATION Signature of Sexton or Person-in-Charge o STORAGE o OTHER (Specify) } (~9' ;r:L:o? Date of Disposition Sebastian C@BIeter::y ~JA//O) 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 County Health Department in the county where disposition occurred. Distribution: White: Cemetery or Crematory Yellow: Funeral Director or 0IrecI Disposer PInk: Local Registrar DH 326, 8197 (Obsoletes all previous edlIIons) (Stock Number: 5740-000-0326-2)