HomeMy WebLinkAbout4-34-06
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Paid by CEMETERY Receipt No. . ......... . Dated. ... ... .~('!:~/?~....... ,...
. List Price $....... ~.'. 9.q~: ~O Maxlmum No. Burial Spaces.................
LO. & 7
Bl 34
Unit 4
NO.
f
1467
NetPaid$ .......1.,000.00
Monument permitted. . . .. . .. .. . .. . . .. .. .. . .
(Data aho.. thl. line lor CIty Reeord ooly)
(!titv nf l'fbasttau
Q!rmrtrry
ilrrlt
1167
NO.
24th
THIS INDENTURE MADE '1111I ...................... day 01
August
94
A. D.. 19......,
beh....n the City 01 &butlan, a monl.lpal corporation exl.tln. undor the law. 01 the State 01 Florida, a. Grantor and
".......... ........ ...... ............ ...H&'U:'.t~~. .&, ..lo.~,T.1..L~RQm~.......,
155 Midvale Terrace
,.................. ........ ............... Sebastian.,. .F.l.odda.. 329.58.. ,,'........'....... ............. .......
01 the County 01 .. ..:tm~,:!..I;l.Q...Rt.v~r..................... an:! Stat. 01 ....... ..Ji'.l,.~~J.Q.~................ ..................
u Grantee, WITNESSETH,
That the Grantor for and In consideration of the mOl of $ . ~ I.q9.9...9.q............ to it in hand paid, the receipt whereoCllherewlth ac-
knowledged, does by this Instrument grant, bargaiD. seD. r.l..... convey and confirm unto the Grantee .~h~.~~. heirs, Iepl representatives and assigns
the foUowiftJl property situated In Sebastian. Indian RJver County, Florida. to-wlt:
All of Lot(s) .. ~.~7. ,Block... ~.4... ,UNIT ......;...... . of Sebastian municipal cemetery as per Plat Number I thereofrecord.d in Plat
Book 2. at pap 65 of the pubUc records In the office of the Clerk of the Circuit Court of St. Lode Coonty of Florida: said land now lyins and being
in Indian River County. Florida.
To Have and to Hold the_me forever; provided that ssid property shaD be used IOlely and exclusively for the interment ofth. human dead and shall
be used, kept and maintained at all times in accordance with the rules and reJ11latlons. ordlnance. and relOlutlonl of the City of Sebastian, Florida, hereto-
for., now and hereafter adopted or provided for the I'lvernment and operation of said cemetery. The condition.. restrictionl and 1Cq01r.ments contained
in this instrument shaD be covenants running with the land. In the event of the fallure of the owner of any property situated within said cemetery to ob-
..rve and comply with inch rules, reJ11lations, reaolution. and .ordinances and the condltlonl of the deed of conWlyance thereof then the title of such owner
in and to said property shaD terminate and the same shall reWlrt to the City of Sebastian, Florida.
IN WITNESS WHEREOF. The said party of the flrst part has cau..d this btstrument to he executed In its name and on Its behalf by its Mayor and
attested by Its City Clerk and itl corporate seal to be hereto affix.d, the day and year flrst above written.
Att.SIrC~jA!i1~,.. )7:1.. .fJ.t! at4!..~~.....
'~7'~ City CI.rk
C<T::m'z~..
Mayor
Slllnod. S..led and D.llver.d
'~'.~1....uu.......
f/L,a:.....~~..
STATE OF FLORIDA
COl'NTY OF INDIAN RIVER 4
2 th August 94
I HEREBY CERTIFY. That on thla ...................... ..day 01 ..................................................., I.....,
bolor. m. p.rsooally appeared.......... ..~~~~.':l,t;.. ~~.. ~~~.~.i~I1............., and ... ~~.~h!-:y.I,1.. ~.'. ..c;>.~ ~~g~~~.n
r.tp<'CUvrly Mayor and City Clrrk 01 the City 01 S.basllan, a municipal corporallon under the I..... 01 the State 01 Plorlda to me kno..n
to b. th. Indlyidual. and offlcr.. described tn and ..ho executl-d the lorollOlnl l!OIIveyance to
Maurice & Joan LaRosa
(GUill j&fal)
. ' . . . . . . . , . . .. . . ' . . . . .. . .. .. . .. .. . . . .. .. . . .. .. . .. .. . . . .. and ....rally aekno..lcdllrd the execution tl1ereol to be their Ir.. aet and d.ed
as such officers th.r.unto duly aulhor!sed I and tbat the Offlelal ...1 01 I8Id eorporatlon I. duly aUbcd th.reto, and the ..Id eonv.ya....
I. the act and deed 0' I8Id col']>01'atlon.
WITNESS 111)' .Ipato.. and offl.lal ...1 at Seba.tlan, In the County
last alo.......d.
Q) I.INlM M. Ml.LEY
UY~'CCsmM
ElIPIB: _18. ,.
...._..., NIIID........
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Name ,A./! Ii u !
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Unit '#i
Block <,L/
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Lot "
Date of Mark-out
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./ L/, / 1/':'" "1.../
Date of Burial
/ 0 / ,;, 1./0' '.' ,
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Time
/1'01:> /1
Name of Funeral Home
,..- A>-'"
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~ I Ie::.. ,l.l.l';/ ',"" .,1
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Authorized by <---:f ·
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8ebClcllan. rL e:0CieP
W+6 G~r7
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iJn', -\- 4
~eCJ DD. )407 '
'- -
Paid by CEMETERY Receipt No. ..... .~~.~..... . Dated. ....... ~(~~/~.~...........
List Price $....... ~." 9.q~ = ~O
Maximum No. Burial Spaces. . . . . . . . . . . . . . . . .
Lots 6 & 7
Block 34
Unit 4
NO.
1467
{ /1"T'..Jet Paid $ ....... .1.,. Q2Q (~. Monument permitted
'(f' J(~ 19a.-'f--5:Ta- 'A.pX24- ......................
(Data above this line for City Reeord only)
-____._ 'm_~.______"_.__
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en i
a: I CITY OF SEBASTIAN
r ct i ~~j' 44
.....I I CITY CLERK'S OFFICE
.....I i
0 RECEIPT
('J c i
~ I
0 I
I
j Name o Cash
Date ~4&~
Amount Pal
I
w I - 001001 208001 Sales Tax
l- I
ct l ! 0
c !
'" ~ 001501322900 Garage Sales
'I ru
001501 341920 CopieslBid Specs,
001501 341910 LDC/Code of Ordinances
001501 362100 Community Center Rent
0 001501362100 Yacht Club Rent
001501 362150 Non Taxable Rent
.. Cemetery Lots
- 001501343800
Z t'-
<t U1 601010 343800 Cemetery Lots
i= 0
'tJ) ru LoVNiche , Block ,Unit_
~<t -
Q.m iil 0 Interment Fee
~W '" t'- 001501369400
tJ)tJ) ~
W, I! t.ll 001501 369400 Weekend Service
:i I- l5 0
..
Oz gJ", ., - 680800 220681 Yacht Club Security Deposit
J: ....:"'t\1 U
;:) en...J~ N 0 ~
~ ..~ Community Center Security Deposit
-'O::cLLN ~~ []" 680800 220682
<tO~:i'~ ? ru
a: 0 ~u.,.:. 680800 220683 Riverview Park Security D~it
W<t~LS~ t.ll O~'~7r:~ 7..5-: t1~
z ~CQ:i M.I
;:)wcnOD... 0
u.. 0 ffi
~z > 0 ,-
z~ ~ ~ ~:J7/~JG
;:)0
a:<t (),J2 C?~... 75:tJt.
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<t Initials
0 White - Dept. 01 Origin. Yellow - Fill8nce · Pink - AppllCllnt
a:
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~Sl:l 3xrn3O.;,
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Of: PELICto.~
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City of Sebastian
1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958
TELEPHONE (407) 589-5330 0 FAX (407) 589-5570
August 25, 1994
Maurice & Joan LaRosa
155 Midvale Terrace
Sebastian, Florida 32958
Dear Mr. & Mrs. LaRosa:
Enclosed is Cemetery Deed No. 1467 for Cemetery Lots 6 & 7,
Block 34, Unit 4.
Also enclosed is a form - Return for Transfers of Interest in
Florida 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, 2145 14th Avenue, Vero Beach, Florida.
We are enclosing two copies of Receipt No. 819 and ask that you
sign and return to us the copy marked with an "X" and retain
the other copy for your records. The previous receipt you
received had an incorrect Block number listed. A stamped,
self-addressed envelope is provided for your convenience.
Very truly yours,
~m. ()'/ftd6-tA-
Kathryn M. O'Halloran
City Clerk
KMO:lmg
enclosure
(\ws-form-cem.rec)
.
.
.
oR
.'
THE SEBASTIAN CEMm:RY
CITY OF SEBASTIAN
SEBASTIAH, FLORIDA
OF X1lE SUM OF:
s (sj;MiJ, ~ )
FROM:
on t:h:i..s
the
as
Description of Property:
Cemetery LotlSh'I 017 :lOck
Purchase PriceU/Jf..1:lZ~<1a4-~ ~
Xerms and Condition of sa1.e:
31
Unit
Dollars (s(~,~
~~ .
Xhis contract sha1.1 be biPd-fng 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 s"tated in. the foregoing ins"tn;ment:
The City of Sebastian agrees
the above named purchaser(s)
above ins"trument:.
~~~~ ~
?~
~~~--
tVsel1 the above mentioned ~rty to
e terms and conditio stated in the
i#
tn-/U
tfAitness
CLcL~LdJ
y
"'"
.
.
oR
,
4
THE SEBASTIAN CEMETERY
CITY OF SEBASTIAN
SEBASTIAN, FLORIDA
s (S~(J. flV )
FROM:
, 19 ~ for the purchase of the
upon the terms and conditions as
Description of Property:
. Cemetery Lo~ (S?J\ ~ :10Ck
Purchase Pr:r.ceU/J(_~~
Xerms and Condition of sa1.e:
31
Uni t
Dollars ($(~J~
~-
Xhis contract shaLl be biI:JtH l'1g upon both parties, the seller and the
purch.aser, wh.en approved by the owner or the property above
described.
I, or we, agree to purchase the above described property on the terms
and conditions stated in. the foregoing inst.n;ment::
The City or Sebastian agrees
the above named purch.aser( s)
above instrument.
sell the above mentioned property to
e t:erms and conditio st:ated in cae
~~'!U.
tf"itness
CLLLhL~
y
First
f/$tJt
State of Florida, Department of Health, Vital Statistic~O 0
APPLICATION FOR BURIAL - TRANSIT PERMIT ~ ~
Middle Last Date Month
of
Death
(If neither, give street address)
Day
Year
FLORIDA DEPARTMENT OF
A.
1. Name of
Deceased
(TYPE)
Maurice
Paul
laRosa
Oct.
17
2002
2. Place of Death
County
indian River
!. Name of Medical
Certifier Ch rles A. Diggs
Medical Examiner
4. Name of Funeral Home/8it",,[ OI<.J.lu:;1J!
Establishment
Strunk Funeral ome
City, Town or Location
Sebastian
Name of
Hosp. or
Inst.
155 Midvale Terrace
Address
M.D., A. .E.
Physician
Address
Phone Number
2500 S. 35th Street
Fort Pierce, FL
772-11611-7378
Fla. Lie. No.lReg. No. Phone No. (Area Code)
1623 N. Central Ave.
Sebastian, FL
1228
772-589-1000
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
6. Funeral Director/
~ct !;;liSI!8S8r.
on of cause of death within 72 hours.
F.E. No.lReg. No.
1862
Date Signed
10/17/02
was contacted on
He/she verified that
, Medical Examiner, will complete and sign the
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-02-01127
o A 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.
ONo extension of time for filing the death certificate has been requested.
I*il!liiltrlilr ir .
Subregistrar Signature
Date
Issued: 10/17/02
Date Certificate
Due: 10/22/02
C.
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT -SEA
Approval Number:
Date
Medical Examiner, , gave authorization by telephone to
Funeral DirectorlDirect 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:
~BURIAL
DCREMATION
Signature of Sexton
or Person-in-Charge
CEMETERY OR CREMATORY
Place of Disposition
D.
o STORAGE
Date of Disposition
Sebastian Cemetery
IV/AI/O"L;
,
DOTHER (Specify)
} /f j .-;(,~2>0
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.
DH 326. 8/97 (Obsoletes all previous editions)
(Stock Number: 5740-000-0326-2)
Distribution: White: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar