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Home My WebLink About4-36-14 - -- ~ P.id by CEMETER Y R.ceipt No. . ?: List Price $ 0 0 o~ !~:0?o 0... N.t Paid $ .. o~ ~~:??o.... 5/23/96 lots I" . 0 0 . . . 0 0 D.t.d . 0 0 0 0 . 0 0 . . 0 . . . . . 0 . 0 0 . 0 0 0 0 0 . 0 0 . Block _ M.ximum No. Buri.1 Spaces. 0 . . . . . 0 . 0 . . . . 0 oUni t 4 14 NO. Monum.nt permitted. . . 0 0 0 .. .. 0 0 . 0 .. . . 0 . 0 . 0 1{jJ3 (D.ta abo". this IIn. for City Jl<<ord ooly) Q!Ul1 Df &thUBlhtn Q]:emetery 1!Jeeb "1530 NO. THIS INDENTURE MADE TIoIa 24th day of May 96 Ao D~ 19......, b.tween Ihe City of Seba.tlan, a municipal corporation al.tlng under the law. of the State of Florida, II Grantor and Joan Mahoney . . . . . .. . . . . . . . . .. 0 . . . .. . . . ... . .. . .. .. .. . . .. . . . . . . '226"Del' Monte 0 Road" . . . . . . . . . . . . . . .. .0. . . .. . . . . . .. 0 .... 0 .. 0 . .. 0 .. .. 0 . Sebastian, Florida 32958 of the County of In~~n. ~ Y:~F. ; 0 .. 0 .. .. .. .. .. .. 0 .. 0 .. 0 ... an'l Slat. of .... f+~:r;~~~ .. . .. .. .. .. .. .. 0 .. .. .. .. . .. 0 .. .. . .. .. .. 0 .. Grantee, WITNESSETH. That th. Gr.ntor for .nd in consid.ration of th. sum of $ ~. ~ ~: 0? 0 . 0 . 0 . . . 0 0 0 0 .. . to Ibin h.nd paid. the receipt whereof Is h.r.with .c- knowledg.d. does by this instrument grant. b.rgain. sell. r.I..... conv.y .nd confirm unto the Gr.nt.. . o':'? . 0 . 0 0 h.irs. l.gal r.pr.sent.Uves .nd .sslgns the following prop.rty sltuat.d In S.b..U.n. Indl.n River County, Florid., to-wit: All of Lot(s) .~~..~ . ~'Alock. . ~?. 0 0 0 ,UNIT o.~ 000. . 0 . 0 .. . of S.b.stlan municip.1 cem.t.ry as p.r PI.t Numb.r I th.reof recorded in Plat Book 2. .t page 65 of the public r.cords in the oence of the CI.rk of the Circuit Court of St. Lucl. County of Florid.; said I.nd now lying snd b.ing in Indi.n Riv.r County. Florida. To H.v. .nd to Hold the sam. forev.r; provid.d that said prop.rty shall b. used sol.ly and .xclusively for the interment of the human de.d .nd shall be used, k.pt and m.intained .t .U times in .ccord.nce with the rules .nd regul.tions. ordin.nces and r.solutions of the City of S.b.stian, Florid., hereto- fore, now and h.re.fl.r adopted or provided for the governm.nt and oper.tion of said cem.t.ry. Th. conditions. r.strictions .nd requirements cont.ined in this instrum.nt sh.1I b. coven.nts running with the Iando In the event of the f.llur. of the owner of .ny property situated within said cemet.ry to ob- serve .nd comply with Such rules, regulations, resolutions .nd ordinanoes .nd the conditions of the de~d of convey.nce ther.of then the title of such owner in .nd to said property sh.U termin.te .nd the same sh.1I revert to the City of S.b.sti.n. Florida. IN WITNESS WHEREOF. Th. said party of the rust part has caused this instrum.nt to be .x.cuted in its n.me and on its b.h.lf by its M.yor .nd .ttest.d by its City Clerk and its corpor.t. seal to be h.reto .ffix.d, the d.y .nd y..r first .bove writt.no CITY OF SEIJABTIAN, FLORIDA Att::i~~ .fYI..Q ;/a-L(~~..... . '-'{'" . City C1.rk By ~I' ~.~...~~~#..o.... , "::?~HHH - '7 / .Q(4d'~...............o.... (q;:itl! "iiJ~llJ) ,.,....C1f..?V'L<:C 0 . C/o STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEUEDY CERTJFY, That on thl. ...... o4~o~l:t.. .... .... ..day of ....... .. 0 ~y....... 0.... 0.... .. ....... 0...' 1.96.., louise R. Cartwright Kathryn M. Q'Halloran h..fure lI1e persooally appeared 0" 0 . . . . . . . . . . . 0 0 . . . . . . . . . . . . . . . . . . . . . . . . and ............ 0 . . 0 . 0 . . . . . . 0 . . . . . 0 . . . . . . 0 0 rcsp,oeUvely Maynr nnd City Clerk of the Clly of Sebnstinn, . munlclpnl corllOrntloll under Ihe I.... of the Slale of Florida to m. kllown to be the Indh'iduuls Ilnd ofrlcrrs described In find who exe~tlh:d the 10rl-goil1lJ cIJRvcynnce to . . . . . . . . . . . .. . .. . . .. . . . . .. .. . .. .. .. 0 . . . . 0 .. . .. . . . ,.,J~~I~L ~hC?~li!y. . .. . .. .. . . .. 0 .. . . .. 0 .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. . . . . . . .. . . .. . . . . . . . . . . .. . . . .. .. . . . . .. 0 . . . . .. . . . .. 0 . . .. ., .lId severally ncknowledged Ihc execIIUoII thereof to be their free .ct nnd d.ed liS such o'ncer~ thereunto duly authorized; and that the Orrlciftl sell I of said corporation's duly Rffb;rd thereto, And the said conveyance Is the net Ilnd d~ed 01 said eorpor.Uon. UNDA M. BAlLEY MY COMMISSIOII , CC 375724 EllPIRFB: .hn 18, 19l18 _nw MalIry NIlIa UIdIrMIIoII WITNESS ony signature .nd oWclal .eal at S.bastlan, In Iflsl ulares.ill. Name 1) A,.,), f3~ ::r fU,fih()h<flf .;<4c.... , Unit ~ Block 3lt> Lot ---.l:f Date of Mark-out f'boh (, : ./ 5/'..2~I/f (, I / Time II.!:J. (; f:.J /:';;-/1. Date of Burial Name of Funera~ Home, <--I.....';.' ',. " 1'< "..J I I, L! ,f\..." ' I ,: "--".".\.__,._,."l,~.,-.'--:' ,/ Authorized by '\;;.-7 //j,'//;'l; " .^ ,// ::r [~~I State of Florida, Departm.f Health and Rehabilitative Services, Vital .'stics APPLlCAT FOR BURIAL - TRANSIT PERMIT I-- 13 u j";X /7jJ -' / '-<.:!/ 3~ ~ A. 1. Name of Deceased (Type or Print) First Daniel Middle Joseph Last DATE OF DEATH Month Day Year Mahoney, Sr. 05/18/1996 City, Town or Location Name of (If neither, give street address) Hosp. or Inst. Phone Number 2. Place of Death County Oran e 3. Name of Medical Certifier Orlando Medical Examiner 4. 500 E. Coloni~l Drive Fla.lic. No.1 Reg. No. Phone Number (Area Code) Strunk 5. Check Appro- priate Box Funeral Home a 0 P.A. The medical certification has been completed and signed. A completed certificate of death accompanies this application. 1623 Nqrth Central Avenue b Q Jodi 9 was contacted on OS/20/19geithin 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 that AndrAW ~ T~IJ~~; g, M n will complete and sign the medical certification of cause of death. was contacted on ' He/she verified that , Medical Examiner, will complete and sign the c 0 medical certification. 6. Place of Sebasti an Final Disposition: 7. Funeral Director / Ci~et 9i61!'Mar ~ Indian River ~o./Reg.No. Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No. 1228-96-0238 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 extension of time fOf filing the death certificate requested. ~ t A 1''''. in C.'lrI-A ~".i8tr~r er ~ Subregistrar Signature Date _,. ... \ A 6 Date Certificate Issued:~ Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature ' Medical Examiner Date or Medical Examiner, ' gave authorization by telephone to Funefal 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: 00. BURIAL o CREMATION o STORAGE o OTHER (Specify) Place of Disposition Date of Disposition J. ~-;:;. _ ~.-r ;G~ "fn"? 2~1 /99 (; Signature of Sexton) or Person-in-Charge ) 7".4,~~ (~ 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) 3.