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Home My WebLink About4-36-35 ,.----'" ~ by CEMETERY Receipt No. . . ~f List Price $ .. ~ ! .C?9~... 99. .. .. . 1,000,00 Net Paid $ .................. ....... Dated... ~/.?5./.9p................. .lot 34 Block 3t. M.ximum No. Burial Spaces. . . . . . . . . . . . . . . , . 4 Unit Monument permitted....................... NO. <'lv32 (Data aboye tIlla line lor City Ikeord ooly) (!tHy of &ebasttau , 1'-........' ., uJ~ Q!rmrlrry IIrrb NO. 1'11I5 INDENTURE MADE Tlall 26th dny 01 April 96 A. D,. 19,...... bet\\"eon Ihe City 01 Sob.aUan, a municipal eorporallon .,.laUng under Ihe lawa 01 tbe Slot. 01 Florid.. 00 Grantor .nd . . . . . . . . .. . . .. .. . , .. .. . . . .. . .. . , , .. , .. . , .. . . . .l)QlQ~.es. .Diehl.. . , .. . .-. . .. .. , . . , , , , . . . . . . . . . . . , . . . . . . . . . . . . . , .. .. , , .. . , . . , " , , , . 850 Roseland Road . ... ,... . . .....,.......,.,.,. ........... .Sebastian.,. ,Flodda ......... .... . . . . . . .. .. . . ..... ."......,....., . ... . ., . 01 the County of ....... ;J;I,1~:f.AI:1. J~;I,v~r;.................... ani State 0.1 ........ .flor.i!W.................................... .. Gr.nt.... WITNESSETH. That Ihe Grantor for and in consideration of the .um of S ..1 ).~'. 99. . . . . . , . . . . . . . to it In hand paid, the receipt whereof Is herewith ac- knowledged, doe. by this instrument grant, b.rgain, seU, rel..se, convey and confirm Ullto the Grantee . .l}~~ , .. heirs, legal repreoentallves and assign. the following property siluated In Sebostlan, Indian River Counly, Florida, to-wlt: All of Lot(.~ . ~ . ~~ Block, . . ~.~ . .. ,UNIT ...~......... ,of Sebastian municipal cemetery as per Pllt Number I thereof recorded in Plat Book 2, at page 6S of the public records in the office of tbe Clerk of the Circuit Court of St. Lucie County of Florid.; said I.nd now lying .nd being in Indian River County, Florida. To lIave and to lIold the ..me forever; provided that .aid property shall be used solely and exclusively for the interment of the human dead and shan be used, kept and maintained at oil times In accordance with Ihe rules and regulation., ordinances .nd resolutions of the City of Sebastian, Florida, heleto- fore, now and hereafter .dopted or provided for the government and operation of said cemetery. The conditions, restrictions .nd requirements cont.ined 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 10 ob- serve and comply with such rules, regulations, resolutions .nd .ordlnances and the condition. of the deed of conveyance thereof then the title of such owner In and to said property shall termin.te and the ..me sh.n revert to the City of Seb.stian, Florida. IN WITNESS WHEREOF, The said party of the first part loa. caused this In.trument to be executed In it. name and on Its behalf by its Mayol and atte.ted by its City Clerk and it. corporate seal to be hereto affixed, the day and year fir.t above written. AItOst.'~~~. /lJ..0 ilaft.#q.~... City Clerk CITY OF SEnABTIAN, FLORIDA BT~..~.~k~#...,." MaTor Rlgnt.'d, SeRled IInd Delivered In the Presence ofl T~/L.;\C~(-<. . .Pc':Q~........., ,.... ... . 0 /'" ,/' )~-?I~u,.., .. ~1~4~y"" ............. / 'STATE OF FLORIDA COl'NTY OF INOlAN RIVER (GIitl! .,s~I1I) Uili ~il % t HRUEDY CERTIFY, That on thl. ....,.....,............ .doy 01 .. . .... .... ,. . ..,...,....,.',..........., ..., 19.. '" b,'I",o me person.lly a"pmod }.~~~..~....~.~~.~~~.&~,t............... and Ka.t~. ~~..9.',~g9r:~~........ ro.",'etivcly M.yor .nd Clly Cl..k 01 the City 01 Sob.atlan, 0 munlclpnl corpornll"n under the In-. 0' the State 01 Florida to me known to be the lndh'iduuls nnd offtct'rs delcrlbt-d In IInd who execult:d the fOft'going CORveYllnce to . . . PoloJ:es. . Diehl. . , . . . , . . . . , . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. , . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . ., and ...erally aoknowledged 110. e~eeullon therool 10 be Ih.lr 'roe od nnd deed as such "meer. tbercollt" duly aulh"riud; .nd thot tho Ortloi.l se,,1 0' ,aid e"r""raUon Is duly arflxed thereto, nn,1 the .aid 0"nVe)'8"0. i. the "et "nd dred 01 .ald corporaUon. - WITNESS my signature .nd otrlelal a.al at Seb.aU.n, In In.1 II roresald. .~....'. UNDA M.lIALLEY ( ~f .~\ MY lJOMM1ll8lllH, CC 87&724 . '. . . i EXPIIIfll: June 18, 1119I ". 'Ill'. ' 8oNIodlllN IlotIrJ I'UIIIIe \hIII'MlIIII "'-~.._--~-' j Name ,if;.' i)O,' i\. "I"l. ,..'-....., I /:(._> / it"' /'f L.. Unit 'I Block 3& Lot 2- ,...j .:> Date of Mark-out , I t I a ,.i ".' , ~ : ~ '. -: , , ! '...P Date of Burial i i .'\ I r' "1 j,:.:-.[ 0 I"H~ I Time ..i"ll" ~,) c} /J, /,/"-, / \ ,,;--,-., , ,. Name of Funeral Home I " ) \ \\ 'v... ii. ',', , /.:1 ,...... ..~,/ --if ), , /.~-~f\ ,/ ) /"";<~,c."-::':j'__"'-",,<,,,-,- Authorized by , 1/- .. ;/' '.._~'A.'. ,/ "T flP~] State of Florida, Depart_of Health and Rehabilitative Services, Vital.istics APPLlCA FOR BURIAL - TRANSIT PERMIT 1-.39:35 /., 3 Iv I; i A. 1. Name of Deceased (Type or Print) First Arnold Middle Last Diehl DATE OF DEATH Month Day 04/18/96 Year 2. Place of Death County Indian River City, Town or Location 3. Name of Medical Certifier Nasir Rizwi, M.D. 4, Name of Funeral Home/ Direct Disposer St runk Funeral U Medical Examiner Name of (If neither, give street address) Hosp.or Inst. 850 Rosel and Road Address 13865 U.S. Highway 1 Sebastian, Florida 32958 (407)5890-6844 Fla. Lic. No.1 Reg. No. Phone Number (Area Code) Phone Number Sebasti an 5. Check Appro- priate Box IX] Physician Address 1623 North Cent ra 1 Avenue Homes, P.A. Sebastian, Fl 32958 1228 (407)562-2325 a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b ~ Janet was contacted on 04/18/96 within 72 hours after death. He/she verified that this _ deat\1 was. from naturRI causes, that there was no accident nor other external cause of death, and that NU, r Hl ZW" M. D. will complete and sign the medical certification of cause of death. c 0 6. Place of Se ast,an Cemetery Final Disposition: 7. Funeral Director / Direct Disposer was contacted on . He/she verified that ,Medical Examiner, will complete and sign the I d. R . Removal n , an , ver from state F.E. No.1 Reg. No. ~ M:I 12'-1. Donation Date Signed 04/18/96 B. BURIAL - TRANSIT PERMIT 1228-96-0193 Permit No. 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 for filin the death certificate requested. .c"giiltrar Qr Subregistrar Signature Date Issued: 14 }J I )q (. Date Certificate 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. D. CEMETERY OR CREMATORY Methods of Disposition: iii. BURIAL o CREMATION o STORAGE o OTHER (Specify) Place of Disposition Date of Disposition ~ ~ ,,-t;-~ ~ ~.-M;,~- ~o /99fd , Signature of Sexton ) or Person-in-Charge ) ~-W;..., .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 HRS County Public Health Unit in the County where dispOSition occurred. HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be used) (Slack Number: 5740-000-0326-2) .1.