HomeMy WebLinkAbout4-36-20Nome -
Unit
-�/
Block
Lot
Date of Mark -out
Date of Burial Time
Name of Fune(al HoT' Q
—x
Authorized b
Ti#u of #ehM,s#ialt
TPritrtrrp Drrb
NO.
'1513
27th November 95
THIS INDENTURE MADE This ...................... 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
....................Mrs,.,. Merl.,Eckert ....................... ....
.............................................
1590 Quiescent Lane
....................................... Sebastian, . ,Florida . 32955......................................................... .
of the County of ....Indian. River Florida
.......................... anI State of ........................................
...............
as Grantee, WITNESSETH:
1,000.00
That the Grantor for and in consideration of the sum of $ ................... 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 , her• ... heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to -wit:
All of Lot(s) 19&?� , Block. .36...... UNIT .... 4 ....... , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat
Rook 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 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:/./.'. / l Q F LI_.� .......
v City Clerk
Signed, r ani ) Delivered
In the, '' Bence ((
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
CITY OF SEB FLORI
r
B.................................
Mayor
((lliftr Seal)
I IIRREBY CERTIFY, That on this ..... .27th.,...,......day of .November ....................................... ID.95,
before are personalty appeared . , _Arthur L. Firtion Kathryn M. O'Halloran
................................................. and ...................!.................
respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the lams of the State of Florida to me known
to be the individuals and officers described in and who executed the foregoing conveyance to
..................................... Mrs,..Merl. Eckert
..................................................................
........................................................ and severally acknowledged the execution thereof to be their free act and deed
as such officers thereunto duty authorized; and that the Official seat of said corporation is duly affixed thereto, and the said conveyance
is the act and deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the
Iasi aforesaid.
LINDA M. GALLEY
MY COMMISSION # CC 376724
. a EKPIRES: June 18, 19M
9alded Thar Notary P.I)k lln WIlVel
of Indian River and_)State of Florida, the day and year
1_ '
Notary ublic, State f,10 lorida at Large.
My co alssion expir
Lin a M. Galley
State of Florida, DepartmeHealth and Rehabilitative Services, Vital tics
APP LICATI FOR BURIAL — TRANSIT PERMIT
A. (Type or Print)
1. Name of First Middle Last
Deceased Merl Howard Eckert
DATE Month Day Year
OF
DEATH 11/10/95
2. Place of Death City, Town or Location Name of (if neither, give street address)
County Hosp. or
Indian River Sebastian Inst1590Quiescent Lane
3. Name of Medical Medical Examiner Address Phone Number
Certifier 13865 U.S. #1
Nasi r Ri zwi , M.D. Physician Sebastian, (407)589-6844
4. Name of Funeral Home/ Address Fla. Lic. No./Reg. No. Phone Number (Area Code)
Direct Disposer 1623 North Central Avenue
Strunk Funeral Homes, P.A. ISebastian, Fl 32958 1228 (407)562-912,9;
5. Check
Appro-
priate
Box
a ❑
The medical certification has been completed and signed. A completed certificate of death accompanies
this application.
b). Janet _ _ was contacted on 1- /�9y within 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 thaiNasi r Ri zwi M. D. will complete
and sign the medical certification of cause of death.
c ❑
was contacted on . He/she verified that
Medical Examiner, will complete and sign the
medical certification.
6 Place oSebastian CemeteryA.111Kcremator)/-
In state ce eter Removal
Final Disposition: n e/county: Indian River F7 from state Donation
7• Funeral Director/ Signat e F.E. No./Reg. No. Date Signed
Dio
e9;,rer 1672
ee_ ii /in /45
B BURIAL — TRANSIT PERMIT Permit N01 228-95-0500
Permission is hereby granted to dispose of this body.
❑ 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.
❑ No extension of time for filing the death certificate requested.
Date 1 Date Certificate
Subregistrar Signature �'t Issued: i q `� Due:
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA
Signature Medical Examiner Date
or
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.
CEMETERY OR CREMATORY
Methods of Disposition: Place of Disposition d,:% z �=� n✓
BURIAL ❑ STORAGE Date of Disposition 4Rf
❑ 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/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 Number5740-000-0326-21 J.