HomeMy WebLinkAbout4-36-23
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Paid by CEMETERY Receipt No. ..~...... ..Dated.... '!/?f>/?~... ...... ....... lots .24
1 000 00 Block -
Ust Prlce S...!....:......... Maximum No. Burial Spaces................ Unit 4
1,000.00
Net Paid S .................. Monument permitted. . . .. . .. .. . . .. .. .. . .. . .
'15J4
NO.
(Dat. .bove Ihlo line lor City Re<,ord only)
OHty nf &rhulIttuu
(!ttmtttry
1115J.i
II t tb
NO.
TillS INDENTURE MADE 'I1a'-
26th
day of ......
April
96
A. D., II.......
bet",een Ihe Clly 01 Seb.oll.n, . munlelp.1 corporation .,dollng und.. the I.wo 01 Ihe St.te 01 Florid.. II Or.nlor .nd
Darcel ThOOlpson
'12540' 'Roseland . Road' ...............
P.O,. ~?X.. ~.~~, .R~se.la.n?... .~.. 3.~957.
of the County of . ..Inc;l;i,~. R:iY:~!'.. .. .... .. .. .. ...... ..... .nl St.te 01.. .... nQ:r;;i,o.a.... .. .. .. .. .. .
II Gunte.. WITNESSETH.
That the Grantor for and In ""nsideration of the sum of $ .1, m.. qq. . . . . . . . . . . . . . . to It In hand paid, the receipt whereof is herewith ac.
knowledged, does by this Instrument grant, bargain, sell, release, ""nvey and ""nfirm unto the Grantee . .l!t~. . .. hehs, legal representatives and assigns
the foDowlng property situated In Sebastian, Indian River County, l'Iorlda, to-wit:
All of Lot(s~~. ~. .?~ Block, . . ~.~ . .. ,UNIT ...~......... ,of Sebastian municipal cemetery as per Plat Number I thereof re""rded in Plat
Book 2, at page 65 of the public re""rds In the office of the Clerk of the Chcult Court of St. Lucie County of Florida; said land now lying and being
in Indian River County, Florlda.
To IIave 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 .ccordance with the rules and regulations, ordinances .nd resolutions of the City of Seb.sti.n, Florida, hereto-
fore, now and hereafter adopted or provided for the government and operetlon of said cemetery. The ""nditions, restrictions and requirements contained
in this instrument shall be ""venants 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 ""nveyanre thereof then the title of such owner
in and to said property shall terminate and the same sh.n 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 ""rpor.te seal to be hereto affixed, the day .nd year first above wrltten.
CITY OF SEBASTIAN, FLORIDA
Allest~~j71 odat01.~~..
Clly Clerk
By ~I I" ~~. . 't?~tAA~~':I'a:....... .
(X.~ MaJor t7
Signed, Scnlerl and Dellv~rtd
In the Presehce of t
fl... ~"~f",,~,.....e. o:~
lJ / /'.
... .~r?t.-:'(.€---..S4 .t;v(..,d~......
4TT'. OF FLOnmA
COl'NTY OF INDIAN RIVER
I IIEIlEDY CERTIFY, Thet on thl.
(QIitv ~eal)
26th
April
96
.. ..", 10.....
.... .do)' 01
bl'lllre lIIe person.lly ."pmed .l.o~~.~..~~..~~r.tw;l'i~h.t. .nd Ka.t~.I1:..9.'.~~~9r:~~...
".",','lively M.ynr and elly Clerk of the City of Seb.dl.n, . munlel".1 cor"orallon under 'he laws of the St.le of Florid. to me known
to bt, the Indh'idulIls IInd oHlerr. des(:rlbed In ond who executl~d the lon'goln<< cORveyance to
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P.9:r:c;:~:J.. .ThQ!l!P~QP' . . . . . . . . . . . . . . . . . . . .. .
. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. and .everally .cknowledged the execullon theroof 10 be their free .r! .nd deed
as stich officers thertunto duly authorized; and that the OHfclal sell I of said cnrporstJulI Is duly afflxf'd thereto, And the said cnnvtYBIICC
I. the "r! "OIl deed of ..Id corpoullon.
WITNESS my .Ignature .nd offlcl.1 ...1 .t Seb..U.n, In.~Ihe Co~ty 01._ Jndi~'_lllv.r S .Ic 01 Florid., the day and ye..
18.t ",,,re..ld. "'- _ I ( ~ ~ _ /YJ
Gl~" ,. MY~~~4 \ . t!~M !' lJfJ11!!/.l..................
. _ EXI'lAES: Juno II. I. 01. Public, St.le Florid. et Le(~.
'. _l1lnI",*"NIIIc\hllN!tln My comml.sion ex" II '
Linda M. Galley
tJ
~E SEBASTIAN CEMARY
CITY OF SEBASTIAN, FLORIDA
'tJ~
LEDGED OF THE SUM OF: ~
Dollars ($ t JJt), ~tJ. )
FROM:
on this c;{ in day of
following described Cemet ry
conditions as stated herein:
for the purchase of the
upon the terms and
Description of Property: ./
::::: ::~~~~Lf
Terms and Condition of sale:
Block
~31()
Dollars ($~tJtJLJ. ~
Unit
1-
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
the above named purchaser(s)
above instrument.
~;'dCQ.<~. ~
sell the above mentioned property to
he terms and conditions stated in the
.
.
, '1 Y ,0
'-' .' "-
\
lJ': (,~ ~ ~
~' /~
,~ .... ,'(
+0.;,,4 S ~ $.~
~ O~PiiUi:J.'" ,,>
.
City of Sebastian
1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958
TELEPHONE (561) 589-5330 0 FAX (561) 589-5570
April 30, 1996
Dorcel Thompson
P.O. Box 122
Roseland, Florida 32957
Dear Mr. Thompson:
Enclosed is Cemetery Deed No. 1534 for Lots 23 & 24, Block 36, Unit 4.
Also enclosed is a form - Return for Transfers of Interest in Real Property - which must be filled out by you
and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded. If you
wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, P. O. Box
1028, Vero Beach, Florida 32960.
We are enclosing two copies of Receipt No. 888 and ask that you sign and return to us the copy marked with
an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided for your
convemence.
Sincerely
~m. [)'/f~A-
Kathryn M. O'Halloran, CMC/AAE
City Clerk
KOH:lmg
Enclosures
~E SEBASTIAN CEM&RY
CITY OF SEBASTIAN, FLORIDA
68~
OF THE SUM OF:
Dollars ($ t JJ(). ~
FROM:
on this diD day of
following described Cemet ry
conditions as stated herein:
for the purchase of the
upon the terms and
Descrip~ion of Property: ,/
:::::: :::~~~ffi~
Terms and Condition of sale:
Block
~ 11()
Dollars ($~;J{)(). ~
Unit
4
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:
~~/ ~~<r"~ ,
The City of Sebastian agrees
the above named purchaser(s)
above instrument.
sell the above mentioned property to
he terms and conditions stated in the
::R:J.:1Jd~C . ~mtd_
~~~~.
\6~
Name
~fJ 1 1ft ~ mf J "AI
1
3!P
;3
Unit
Block
Lot
Date of Mark-out
11-/,D-,8
II - l:l.. - '19
Time .
; /) : () ,) 1,1 . /Yi ...
E',.,
Date of Burial
,--,........ ". .
-." '"~~'.1",,-' :-/ j,. ",".
Nam~_~~"':~i) l<:~l ://)L,.
, d b "1 /"//';/( . (.d!(] .,:.-".. ,...-\
Authorize ..~._/., \ .j .... ....; // .. ' . ,.. \.
J.
~~~J~
1?o,-ZV~ ld~' '
~Dse.)and) ~L 3;2.CL51
Loh o?-3i~ 13/och3lo, Un/+4
)
~~. IhoYYl(X'bn- "n+ev-red ~I((lo
I ~ IlU'fltp:sen - i rl+er-I'el "I, ~q '6
1kd 15~'
4!;J4/q&
\... ..
L>>~~f
. .
mOi
SEBAST!!\N
~~.
.."......,..........,.,..,~,....'''..
.~ "",. .~mf:~~~~~~~~1w~t~~~~~..;. :":;~:i~:::';:""
HOMf. . 01 PELiCAN ISlII.ND'
INVOICE
CITY OF SEBASTIAN
TO: Mr. Doreel Thompson INVOICE: 05-081
P.O. Box 122 Date: 10/25/2004
Roseland, FL 32957 Amount: $ 20.00
AMOUNT
DESCRIPTION DUE
1 Repair of marker at Sebastian Cemetery
Unit 4, Block 36, Lot 23 20.00
DUE UPON RECEIPT
TOTAL AMOUNT DUE 20.00
Remit To . CITY OF SEBASTIAN
.
Finance Department
1225 Main Street
Sebastian, Florida 32958
Account Numbers:
Dr:
Cr. 010059534685
';~~~'-lf rniiw-~~~.. .'C...... 'ce.:'
'.~'~~,:",~,,~,~~
.~
01Y OF
1225 Main Street, Sebastian, FL 32958. (772) 589-5330 - Fax 772-589-5570
October 21, 2004
Mr. Dorcel Thompson
12540 Roseland Rd.
POBox 122
Roseland, FI 32957
Dear Mr. Thompson:
Re: Sebastian Cemetery Unit 4, Block 36, Lot 23
It is with regret that we inform you that the marker and/or vase on your Sebastian
cemetery lot was damaged during the recent hurricanes. The city has made
arrangements with a local monument company to repair the damaged markers at
$225.00 per marker and $20.00 per vase.
According to the rules and regulations governing the cemetery (copy enclosed),
interment site owners are responsible for damage to markers and/or vases, therefore,
we are enclosing an invoice for the reimbursement of this fee.
Thank you in advance for your cooperation in this matter and I would like to assure you
that the upkeep and maintenance of the cemetery is very important to the City.
If you have any questions regarding this matter, please do not hesitate to contact me
at the cemetery or by telephone at 772-589-2545.
Sincerely,
Kip G. Kelso, Jr /. ft. r
Cemetery Sexton />'
, "{i
" ._" L.,. , ,:-c,P c'"
. ~",-,'. -0==""=
~~~
L:ri~.. ~,__
~ -=~~-~~~< -
!II-
'-'~-"._~'~!~~~-~,":
" ~ ~ ;J/f
13 3(;
!Ii
123-
E OF BIRTH
w. v.
WAS,DECEASED EVER IN
U,S, ARMED FORCES?
(Yes or No) No
STATE FILE
NUMBER
CERTIFICATE OF DEATH
STATe~ MISSISSIPPI
Middle
'R
';
Sa, AGE PiT LAST ~
IWUHDAY
8u Years I
I _.
HOSPITAL OR OTHER INSTITUTION.NAME AND NUMBER (If not
either. give street address. route number or other location)
9, DECEDENT'S EDUCATION ~em/Hi
(Specify only, highest -
grade comp eted) (0-
13,
First
4, RACE (Specify White, Black.
America'WM fel
7b, CITY OR TOWN OF DEATH
Richton
FILING
DATE
1, NAME
TYPE OR PRINT
WITH BLACK INK
DECEASED
If death occurred in
an instituUon. see
HANDBOOK. regarding
completion of
RESIDENCE items
12,
15b, KIND OF BUSINESS OR INDUSTRY
r Coal Mining
169, STREET AND NUMBER OR RURAL LOCATION
#54 Alma Edwards Drive
- -
First Middle
tSa, USUAL OCCUPATION (Kind of work don
gngUOipMn~~t Operat
16d, INSIDE CITY LIMITS
N~eCilY Yes or No)
14, SOCIAL SECURITY NUMBER
COUNTY , 116c, CITY OR TOWN
ORIGIN OR DESCENT (Specily Cuban.
Afro-AmericaniMeXican. etc,)
Amer can
16a,
Mississi
17, FATHER-NAME
For RESIDENCE Iteml.
enter ecluel IDea lion
of home nlthe, than
mellfng add,...
PARENTS
Richton
Last
Maiden
Cyrus
J.
MOTHER-NAME
Martha
18,
Middle
son
19a, INFORMANT-NAME (Type or
Bonnie McLain
20a, BURIAL. CREMATION. I 2Ob, CEMETERY. CREMATORY-NAME
..RF.MOI"'-L (lipecily)
ljUrl.al.
Feed Thom
INFORMANT
.
box number. City or town. State. ZIP code)
Richton, MS 39476
19b, MAILING ADDRESS (Street and number or route and
64 Alma Edwards Drive
print
EMBALMER-SIGNATURE AND NUMBER
20c LOCATION (City and State)
Sebasti
DISPOSITION
an,
and numbll;:;,
MAILING ADDRESS (Street
0.. .BQ~;",4"'9
". :2;b, '
Cemeter
,0, NUMBE~-~,
Sebastian
21b, FUNERAL HOME-NAME AND MISSISSIPPI
Jone~, FunE!ral, Home 56J,
. ., ~ .-.L--
22a, PERSON WHO PRONOUNCED DEATH-NAME AND TITLE (Type or
m,
death
ON
~ I t 0 h-Rkb' htot" d/" 4~--
I 49. n t e aSIS 0 examlnarron an or Investigation, In my opinion.
This occurred due to the cause(s) and manner as stated,
section I SIGNATURE ~ ..'
to be com-~- -----____
pleted by I 24f, TITLE
medical I .'
examiner I -':1
ONLY I 24g, DATE SIGNED (Month. Day. Year) '::--
I \
I
B.
...........
print
owledge, death oClAur d
d, _
--------,
: '" "'," " -;;~"~~;':-el,;"
I NouMbH 9 1 n'l~a,
I 24d, NA OF ENDIN~ PHYSICIAN IF <'lTHEJfTHAN CERTIFIER
I (Type or print)
I
IMMEDIATE CAUSE (Enter one cause only)
23b,
This
section
to be com,
pleted by
physician
il NOT a
m.,dical
examiner
PRONOUNCEMENT
Mississippi State
Board 01 Health
Form No, 511
Revised t-I-89
CERTIFIER
Interval between onset
and death
PART I.
DEATH
CAUSED
BY:
25,
CAUSE OF DEATH
.
(a)
DUE
{
Conditions. il any.
which gave rise to
immediate cause
stating the
underlying
cause last
~ --
DUE TO. OR AS A CONSEQUENCE 'OF (Enter one cause only)
Interval between onset
and death
(c)
OTHER SIGNIFICANT CONDITIONS-Conditions contributing to death but not
given in PART I
28. WAS CASE REFERRED TO
MEDICAL EXAMINER?
(Yes or No)
29<1, DESCRIBE HOW OR BY WHAT MEANS INJ:"lY OCCURRED
27, AUTOPSY
(Yes or No)
resulting in the underlying cause
26, PART
DATE OF INJURY; 29c, HOUR OF INJUR
(Month, Day. Year)1
m,
LOCATION
29b,
ACCIDENT. SUICIDE. HOMICIDE. PENDIN
INVESTIGATION. OR UNDETERMINED
(Specify)
Use if . 29a,
death I
NOT I
due to L_
natural I 2ge,
causes I
I
I,
Stale
City or town
-...~
Street or route numlier
..
......
29g,
-
Home. Farm. Street
.~
.L
PLACE OF INJURY (Specify
Faclory, OIIice building. etc,)
291,
INJURY AT WORK
(Yes or No)
BURIAl. TRANSIT PERMIT
-. -, "'- ~'":. ---