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Home My WebLink About4-34-19 ~ Paid bYCEME~~R;,R~;IPt No. ...1....... Dated.. ..~!.~ ~.Y?~.............. List Price S . . . .. . . . . . . . . . . . . . Maximum No. Burial Space. . . .. .. .. . .. .. . . . . Loti Blo . 4 Uni NO. Net PaidS .. 5.00 ,DO....... Monument pennltted .. . .. . .. .. . .. . .. . . . . . . . 1484 (Data aboye tltls line lor Clt, Reeord onl,) QUIU Df &. bastiau <ttfmftfry it ffb "1484 NO. THIS INDENTURE MADE..,. ...... .1.2.th........ day 01 ............. JanUar;1................... A. 0.. I'.. .95, between Ihe Clly of SebaotJan, a municipal corporation al.tln, under the law. 01 the State of Florlel.. al Grantor and . . . . . . . . . . . . . .. . . . . . . .. . . . . .. . . . . .. . . . . . . .. . . . HI'! r.y. . S t <i.1kl'l r. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. . . . .. . .. . .. . . . . 425 SW Thomas Street .................. ........................ .. Seba.ts:Lan.f. .F.loz;:Ldli.. 329.58. ................. ..................... of Ihe Count, 01 ..... ;I;~.9..:t~n ..~.:l:y~.:r;................... ani Slote of .... .f)..Q;r:;I..c;l.~...................................... II Grantee, WITNESSETH, That the Grantor for and In consideration of the sum of $ ........... ~ RI? '.9.9. . . . . . to It in hand paid, the receipt whereof Is herewith oc- knowledged, does by thi. inotrument grant, balloln, seU. release, convey and confirm unto the Grontee ~~.t;.... heirs, legal reprelelltatlveI and asolgns lhe following property slluated In Seblotlsn, Indian River County. Florldl, Io-wlt: All of Lol(s) .. ~.~.. ,BIoc:k,. }.~... ,UNIT.. .~......... ,of Sebaotlan municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, It page 65 of the pubHc records in the offtce of the Clerk of the Circuit Court of St. Lucie Counly of Florida; IBid land now lying and being in Indian River County, Florida. To Have and to Hold the ..me forever; proYided lhat ..Id property shan be used solely and exclusively for the interment of the human deod Ind shall be used, kept and maintained It 10 times in accordance with the rule. Ind regulations, ordinances and resolutions of the City of Sebastian, Florids, hereto- fore, now and hereafter adopted or provided for the government md operation of said cemetery. The condltionl, restrictions and requlrementl contained In this Instrument shaO be coyenants runnlng with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- ieI'Ve and comply with iuch rule., regulations, resolution. and ordinance. and the conditions of the deed of conyeyance thereof then tbe title of such owner in and to IBid property shall terminate and the ..me shall revert to the Clly of Sebaotlan. Florida. IN WITNESS WHEREOF, The said party of the first put has cauled Ihls instrument to be executed in its name md on Its behalf by It. Mayor and alteRed by Its City Clerk and It. corporate _I to be hereto afftxed. the day and yeor first abo"" written. Attestif~. JYl..f).t!a.~... v-"'-'~' . (j' . . City Clerk ..... ....N,.~~.. Ma1Dr B, .. Signed, Sealed .'KI Dellve..d ">>:.~................... ~../",.//~........ ( STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEREBY CERTIFY, That on tltll ............... .lZ.th .doy 01 ....... ..J.anuar.y.............................., 1...9.~ befo.e me penonally appeo..d .. ~~~.~~~ ..~.~ J~.~.~~?n..... .... ......... and ~a.~~r:y.t:1.. ~.'.. .<?~ ~~~.~~~~.t:1... respt'('lIvely Mayor and City Clerk of the City of SeM.lIon, a municll,al corporation under the I....s of the State of Florlela to me known 10 be the Individual. and officero described In and who execuled the fort'lJnln, ""aveyanee to (alitv .$~al) . . ...... ..... ................................. ...... H~:r;'y.. ~ t:.~.J,.kl!.:r................... . . . .... .................................... . . . . . . . .. . .. . . . . . . . . . .. . . . . . . . . . .. . . .. . . . . . .. . . . .. .. .... and seyerally aeknowledgM the execution thereof to be their free act and deed .. snch nfflcers tllereunto duly authorlsed; and that the Offlelal ..al of said corporation II duly affixed thud and the IBid eonveyanee I. Ihe ael and deed of IBid corporation. WITNESS my oiJl1lalure and official ...1 at Sebastian, In the I..t ofor...ld. ""i!f:;j:!:g Name Er9e./... :51<:</ f<~R. d Unit .:J Block 3 Y Lot I '1 Date of Mark-out 111'2..115 1 ' Date of Burial , 1113 J 9 '5'" I f Time \ (): 00 A. t11 , ./'''"'. " /' ,'- Name of FUI)eral Home . \:)~;:o(~)01 "1 . .,r/\cl... x uH \\ " ./ <,..J :///;' ,.' . "'_. "- .---" \ 'f ( '. - ~ / .,.~, /'///i//'//1 AutfiorQ.ed ~"..>/1!'.,J>.~ /'-..<-:/ [/..1../' / '__<I -... ) - ,/ ,- \ ~~w~~s+ ~etu:si-;~(\ FL ~q6~ ......,"-. .' 5, _.__,_ .___ _ __,,_,,'__'___'~__'~__ ..__~.,_.___..__, ._.._.-__._...'____ ._.__.... _". __..' _._.n._'_'__"'__'_ . ~ Mo. /414' Lo-l--lg ,'1)1 cxJc04, Un J~ ',- - I '- - Paid by CEMETERY Receipt No. . . . . ~.~? . . . . . . . Dated List Price $ .. ?9~: .Q9.. ... .. 1/112/95 .............................. Lot 19 Block 34 Unit 4 NO. Maximum No. Burial Spaces. . . . . . .. . .. .. . . . . 1484 Net Paid $ ..5.00..00....... Monument permitted (Data above this line lor Cay Record only) .' . . 030 THE SEBASTIAR cm'TERY CITY OF SEBASTIAR SEBASTIAH, FlORIDA FROM: Dollars (~~Y)~ } on t:b.:i.s g;tJ;- day 0 Iollowing described C seated herein: Des=~pt:~on. of Pro~: . ~ .j Cemet:erg Lot:~ ~, Bl.oc1c \ ~ vni.t: o<j , . Purc:1lase pr:i..~..y;j--V . t..4odl'c!. ~ Dollars (6'".1)".$--) Xerms and contjie:i..on ox sale: {J Ax1,J( Xhis cont:ract: shal.l be binr'f-f '"g upon bo'th part:i..es, t:l1e seller and 'the purchaser, wb.en approved by 'the owner ox the property above described. I, or we, agree eo purchase t:l1e above described propert:y on 'the terms and cond:i.t:i..ons seated in t:l1e xoregoin.g inst.""'tZment: \........., ( - .~ ,~ I?.."A , . I ) 7::L.6/J I '" :r:he C:i.. t:y ox Sebase,ian agrees to sell 'the above mene,ioned propert:g to 'the above named purcl1aser{ s) on t:l1e terms and con~~ns. stated in. t:..'J.e above inst:=ent:. ~ ~ C-. /'A j..~ C,i~ or S'eb 'tt~;(n ,i . I ' . Lu- ~V V ~t;n.ess "' ~/ ~ . ,-1" 0" ".. \ ,,\ ., \ '\ ,,,,i ;",.l ..1 ::',' '1,\":fI ""- <<', . - /~ ~(,; /I S~ \Q 't,f" ,c,""'" 0" PElICl'l' . City of Sebastian 1225 MAIN STREET 0 SEBASTIAN. FLORIDA 32958 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 January 18, 1994 Mary Stalker 425 SW Thomas Street Sebastian, Florida 32958 Dear Mrs. Stalker: Enclosed is Cemetery Deed No. 1484 for Lot 19, 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. Very truly yours, ~~~~/2:1jtdlHk: City Clerk KMO: lmg enclosures [ln~] State of Florida, Depart.t of Health and Rehabilitative Services, Vitlatistics APPLlC N FOR BURIAL - TRANSIT PERMIT ;/11 II~ A. 1. Name of Deceased (Type or Print) First Middle Last Month Day Year Sebastian U Medical Examiner 407-589-8992 13855 Us Hwy #1, Sebastian, FL 32958 Fla. Lie. No./Reg. No. Phone Number (Area Code) DATE OF Stalker DEATH January 10, 1995 Name of (If neither, give street address) Hosp. or Inst. Sebastian River Medical Center Address Phone Number 2. Place of Death County Indian River 3. Name of Medical Certifier George Mitchell, D.O. rxl Physician 4. Name of Funeral Home/ Address Direct Disposer 1010 E. Palmetto Avenue Brownlie-Maxwell Funeral Home Melbourne, Florida 32901 0000049 407-723-2345 5. Check a IJ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application, priate Box Earl Emery City, Town or Location b 0 was contacted on 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 that will complete and sign the medical certification of cause of death. c 0 was contacted on . He/she verified that , Medical Examiner, will complete and sign the 6. Place of Sebastian Final Disposition: 7. Funeral Director / Direct Disposer Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No.495C42 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 th Local Registr of the County in which death occurred. It] No extension of time for filing the certifica q sted. Registrar or Subregistrar Signature . Date Issued: 1/12/95 Date Certificate Due: C, AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature or Medical Examiner, , Medical Examiner Date , 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 o STORAGE o OTHER (Specify) Place of Disposition Date of Disposition Sebastian Cemetery Sebastian, Florida Methods of Disposition: IZI BURIAL o CREMATION 1/13/95 Signature of Sexton ) or Person-in-Gharge ) /....,. J /!/~ / 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) (Slock Number: 5740-000-0326-2) J,