HomeMy WebLinkAbout4-34-23 Name Ci,eo L s. . y,x 8 eg,1,4, s) j. //yes.
Unit 1
Block
Lot ,Z 3 /N / u,,I«tigt
Date of Mark-out A/b/
Date of Burial 1./26//‘,• Time 7•3 o
Name of Funeral Home ,i/APL, 7.,,e1A]amo
Authorized by r
I, Ii,' J:";: /vl .tJ IV N, i/ X S
Name tV I f '11Jm' _r_~ G _ ~!'L
.
Unit if
Block 3 'I
Lot ~ 3
Date of Mark-out
"11141'/03'
f118/ o~
f
Time
/ " 00 fJ r
r
Date of Burial
"
Name of Funeral Horne ',~ "5' eo Ii 0/ 1':.1 /) S'
, /:..
.I
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Authorized by
lA
D~I 1601
6/tlq6
'e;, ,',.,',',,',,',',', ',. .,..".~,""'<"',' <} I "/ / ' i/\
:. .:. ;>"':~':.'iin',W k I am H
JJQ , tV'/ Carol C-.
,~ 1 Lf :barber 3t
3eb~~an,~L\~5~
~h ~3~d~' {)l~~~k Un;,~1
-- -
'0
p
5<t~r5
Paid by CEMETERY Receipt No.... .~.~?...... . Dated. ....?/ ~/??...............
List Price $.. ~.~ ~~.q ...9~...
. 1,000.00
Net PaId $ ..................
Maximum No. Burial Spaces. . . . . . . . . . . . . . . . .
Lot 23 & 24
Block 34
Unit 4
NO.
Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
15\~:1
(Data above this line for City Record only)
. '
Paid by CEMETERY Receipt No. . .... ., . . . . Dated. ... .?/~. (.~? .. .. . . . . .. . . . . .
List Price $ . . ~. ~ ~~~ : .~~ . . . Maximum No. Burial Spaces. . . . . . . . . . . . . . . . .
1,000.00
Lot~&
Blo.4
Unit 4
24
NO.
,
,., .
Net Paid $
Monument permitted. . . . . . .. . . . . . . . . . . . . . . .
, .1501
(Data above this line 'or CIty Record only)
atUy nf 19rbustiuu
Q!rmrtrry
111 r r b
1501
NO.
THIS INDENTURE MADE TIaJa ..,.., ,4,th,
dRY 0' """ May.
A. D., 19.9.~..,
bel...<<n Ihe City 0' Sebastian, a municipal corpontlon ex'stlng under the laws 0' the Stale 0' Florida, os Grantor and
William A. & Carol C. Hoffmann
.., ' ..' , .......".. .... '1614 ' 'Bar her ' 'Street......... . ..' , , ..' .., , .. ..'.... ..'.....
Sebastian, Florida 32958
D' the Counly 0' Irld,i,aI1..R,t ,,~r..,
IS Gnntee, WITNESSETH,
That the Grantor for and in consideration of the sum of $ .., ~ .'.?~~. : ~~. . . . . . . . . . . to it hthanfl paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee .~ . .r: ~ I? heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
All of Lot(s) .~ ~.~ ?4, Block, . . ~.~ . .. ,UNIT ... ~. . . . . . . .. ,of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat
Book 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.
onJ Slole 0' ""
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 rust 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 rust above written.
Attest, .~~ ,ff), oll~./{;fl,~""",
~~',-c/~ City Clerk
Si,g~'{:':ll un,d DCII:,,"e'''7d ",,'~
In;the ~nce 0'1 / n
.~)/J~~
C)r~0l'7(.V~,......
CITY O~96FZ~~~~~'
~""""""',.,.,"",..,.,...,..
Mo"or
(QIitl! ~enl)
STATE OF FLORIDA
CUl'NTY OF INDIAN RIVER
I I1EIlEDY CERTIFY, That on thl. ,.., .~.th,.."",. .day 0' ,M?.Y....."",..............".....",.."" 199. 5"
Arthur L. Firtion Kathryn M. O'Halloran
before Ille personally Appeared .................... .......... .. and . . . . . . .. . . . " . . . . . . . . . . . . . . . . . . . . . . . .
resp1'rtivrly Mayor and City Clr.rk of the City of Sebadinn, H municipal corporation under the 18".s of the State of Florida to me known
to bl' the indh'iduuls oml officus described In lJnd who executt~d the fon"going COHV.~Y8nce to
,..",."",'.',..,..., ,~~pia,m" A,." .~., ~~,r;.C?1.. ,Y.:. .H~X~!I)?:~.n",
" " . . . . . . . . . . . . . . . . . . . . . . . . .. and severall)" acknowledged the execution thereof to be their fref'; act nnd deed
as snch officers thereunto duly Huthorlzed; Bod that the Official senl of said corporation is duly affixed thereto, "nd the said conveyance
is the net unll deed ot said corporaUon.
LINDA M. GALLEY
MY COMMISSION , CC 375724
EXPIRES: ...... 18. 19l1ll
_TltnI~_~
lhe day and 1ta,
WITNESS my slgnatnre and official .eal at SebuUon, In the
IBst doresald.
(C~lPr
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~~_';..~,...t>~<...)""'''''.."'....... ,..,......,....,~_h....__""'\"i '
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
REC8PT
'7
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,/ ~-?,<,,-.._,-;j/ /~" EI Cash L"
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Date .. /,.:;;,,-, c../.........'
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AmountPaId
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 CopieslBid Specs,
001501 341910 LDC/Code of Ordinances
001501 362100 Community Center Rent
001501 362100 Yacht Club Rent
001501 362150 Non Taxable Rent
001501 343800 Cemetery Lots
601010343800 Cemetery Lots,
LolINiche . Block , Unit ,l/
<j"a
Interment Fee - (J 'I (.:...~ J";1':;;' l(i
001501369400 /" EO.'
001501369400 Weekend Service
680800 220681 Yacht Club Security Deposit
680800 220682 Community Center Security Deposit
680800 220683 Riverview Park Security Deposit
.
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White - Dept. Df Origin. Vellow - Fhlllnce . Pink. Applicent
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-:?:~ ~'17,
TDtal Paid /.,-~ F (/ I.,
C HARLAND STYlE XKJ
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35:)
. .
~E SEBASTIAN CEMIlERY
CITY OF SEBASTIAN, FLORIDA
.
..'
on this --~ day o_~_ .
following described Cemete
conditions as stated herein:
the purchase of the
the terms and
Description of Property: ~
Cemetery Lot(~c{<3ia
Purchase pric . ~~7,' fi..:Jt/..d ~
Terms and Condition of sale:
/] /J 1 7 / ~ , /, Q /::<'t?\ /
L,ML-.I(, ,/{ Lf)/Y't-IJ.// I ,-...L' (f'
This contract shall be binding upon both
purchaser, when approved by the owner of
Block ~ Unit 4
Dollars ($! j(}(J. ~
'---:I{CfJ {fi (,l L \) _~( (!.( 'Lt2+
. Hr. )\.:L'Y
parties, the seller and the
the property above described.
I, or we, agree to purchase the above described property on the terms
and conditions stated in the foregoing instrument:
------
property to
stated in the
The city of Sebastian agrees
the above named purchaser(s)
above instrument.
~ )l(Ua~
, ~tness
~ .
.
",'1Yo"
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City of Sebastian
1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958
TELEPHONE (407) 589-5330 0 FAX (407) 589-5570
May 10, 1995
William A. & Carol C. Hoffmann
1614 Barber street
Sebastian, Florida 32958
Dear Mr. & Mrs. Hoffmann:
Enclosed is Cemetery Deed No. 1501 for Lots 23 and 24, 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, 2000 16th Avenue, Vero Beach, Florida, 32960.
We are enclosing two copies of Receipt No. 855 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 convenience.
V~);;: O"f/tdI#,--
Kathryn M. O'Halloran
City Clerk
KMO:lmg
enclosure
(\ws-form-cem.rec)
~ >
esE SEBASTIAN CEMftERY
CITY OF SEBASTIAN, FLORIDA
35:)
t
THE SUM OF:
($ / (}tJ,~)
. '
, Ii/-
on this --~ day 0 ,
following described Cemeten
conditions as stated herein:
the purchase of the
the terms and
Description of Property: ~
Cemetery Lot(~C{<3if)
Purchase pric . ~~7,. . :;;~d!9----
Block & Unit 4
Dollars ($ / J/JO. fP)
,
. '-:"R 'jJ LfU:LL 'J _ ~t cl''-t2f
. )([. ~(:Ly
parties, the seller and the
the property above described.
Terms and Condition of sale:
/.1 j) 1 7 /:/ /'VI I I ~ /' -;(1\ I
L,/t.)L r/C /' I u:J/YXOI/ I <-..L' ((1
This contract shall be binding upon both
purchaser, when approved by the owner of
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.
~ )l(U~
~tness
. .
· THE SEBASTIAN CEIeTERY
CITY OF SEBASTIAN, FLORIDA
8$7
OF THE SUM OF:
($/Ci?O ft-J
FROM:
on thisq7~day 0
following described Ceme
conditions as stated herein:
for the purchase of the
upon the terms and
Block
,35 Unit -<I
Dollars ($/~~.~)
Purchase pric :'
I, or we, a ee to purc
and conditions stated in
th parties, the seller and the
of the property above described.
property on the terms
t:
\\'
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,J1tj!:A~
6m-~-~~
FLORIDA DEPARTMENT OF
1-3f-:<3 rr>fifB)~
State of Florida, Department of Health, Vital Statisti~ Y r u
APPLICATION FOR BURIAL - TRANSIT PERMIT
A.
(TYPE)
1. Name of First Middle Last Date Month Day Year
Deceased of
WILLIAM A. HOFFMAN Death APRIL 14, 2003
2. Place of Death City, Town or Location Name of (If neither, give street address)
County INDIAN RIVER SEBASTIAN Hosp, or 1614 BARBER STREET
Inst.
3, Name of Medical Address Phone Number
Certifier NOOR HERClIANT, M.D 777 37TH ST. I C-104A
nMedical Examiner mPhysician VERO BEACH, FL 32960 772/567-2332
4, Name of Funeral Home/Direct Disposal Address Fla. Lic. No.lReg. No. Phone No. (Area Code)
Establishment 735 FLEMING ST.
SEAWINDS FUNERAL HOME SEBASTIAN, FL 32958 2617 772/589-1933
5. Check
Appropriate
Box
a. I!I
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 external cause of death,
and that will complete and sign the medical
certification of cause of death within 72 hours.
c.D
He/she verified that
, Medical Examiner, will complete and sign the
was contacted on
B,
medical certification
Signature
~
eath within 72 hours.
F.E. No.lReg. No.
3114
Date Signed
4/15/03
6, Funeral Director
Direct Disposer
TRANSIT PERMIT
Permission is hereby granted to . ose of this body.
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,
QgNO extension of time for filing th
Registrar or
Subregistrar Signature
Permit No. 03-2617-049
Date
Issued:
4/15/03
Date Certificate
Due: 4/18/03
ath certificate has been requested.
C,
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT -SEA
Approval Number:
Date
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, '
DBURIAL
o STORAGE
CEMETERY OR CREMATORY ,
Place of Disposition S /,;-13 /if 5 T;A. H (3,;.1.111 ~T.L e y .
Date of Disposition 1" / / ~ Ie 5
.
D,
Method of Disposition:
DCREMATION
Signature of Sexton
or Person-in-Charge
DOTHER (Specify)
} ~ 7- ~A9<'
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.lJOO.lJ326.2)
Distribution: \i\lhite: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
srrauw
• ,a/At Od
?WON KUNO
For information contact:
Kip Kelso - Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589-2545
City Clerk's Office
City Hall, 1225 Main Street
Sebastian, FL 32958
Office(772) 399-9215 or 388-8214
Fax: (772) 589-5570
FUNERAL HOME: f�,rjr! , Ly t) ,/��JV � •
ADDRESS:
PHONE #: / (B o3 Z8 3 - 6.4, X
(Check One)
,_OPEN BURIAL LOT Lot Block Unit
_,Y OPEN CREMAINS LOT Lot BlockUnit 'y•
_OPEN COLUMBARIUM NICHE Niche Block Unit
BURIAL DATE AND SERVICE TIME: A/G/6• 7:349 A•
FOR DECEASED: eie o,L. 'S. �, e:
� �
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
/ FjC�,i,n�✓�./ x,-74 /0-0
w2_If• CA ieo./._ Date
Name Signature
I certify that I have determined the ownership of the above described site that all site fees and
administrative fees have been paid and authorize opening of same
NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR.
/17/ - Date
Name 'Signature
Cemetery Sexton Certification:
I certify that I have checked the ownership informahon by viewing the owner's deed and confirming
with Clerk's office and that all fees have been paid
4 - ie-,4-e-)? •
AA&A„
Cemetery Seton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
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CITY OF SEBASTIAN
FINANCE DEPARTMENT RECEIPT
Name Fred Littenberg y7 Cash
Date Feb. 25, 2016 �]Check#
LJ Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit-
001501 362100 Taxable Rent-
001501 362150 Non-Taxable Rent-
450010 369900 Airport Badge
001501 329500 Alarm Permits
001001 218010 CobraServe
001501 354100 Code Enforcement Fines _
001501 347557 Community Center Revenue _
001501 341920 Copies
001501 369900 Miscellaneous Revenue
001501 359000 Other Fines/Forfeitures
001501 351140 Parking Citation
001501 342100 t oroI Heot itr n ertt enberg
001501 343805 Fred Littenberg — 5 a)
001501 343805 U4, B34, L24 prepaid 50.00
Total Paid 100.00
fitials
White-Dept.of Origin • Yellow-Finance • Pink-Applicant
Statemen DATE l TERMS - ]
TO 1
Aja. -
E.,-1_14;+Aa-�.. ¢• C.'4.;61,,L. 6 'rte ____ -_
IN ACCOUNT WITH •
5d4:45t .// eGwre71.-aey-
Ti
ill ce,./lv2 N 77- O f
L''E,d •
,4, 7rilr„ez,e7 .
/
s - (.3' ./- '.3 /h' ����bo /�.,, ,.,oi -E
1 D. 44r ' N /eke
Re/44/A/5)
Dq)_ C45 /1/ 1-2,
• o0
1 L t*11Y-' 1490 ii P - c:, , D -
490_/__H__47 . !-2Z4 _-
,-4 __i-.
v SSr ` i
'AIR OVE 30 DAYS OVER 60 DAYS �,
TOTAL AMOUNT iD 0
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