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Home My WebLink About4-34-30 ---- QHtll of f'rbusthttt .15"19 OIrmrtrry irrll NO. TJ-IIS INDENTURE MADE Tlda 29th dRY of November 95 A. D., 19. ...... between Ihe City of Sebastian, a municipal corporation exlRtlng under the Ilws of the Stnte of Florida, .R Grantor and ....................... .Domenick. Ces.iro............................... 729 Carnation Drive ..,................................ .Sebastian.,. . Flo:r;ida .J29.5S................. .,...................................... of Ibe County of.... Jnq.;i,~n . Rt Y.~t:".. . .. .. .. .. .. . .. .. . ... In:l SI.te of . flRJ;;i.c;la. . .. .. .. .. .. .. .. .. . .. .. . .. .. . .. .. . .. .. .. .. .. aa Grantee, WITNESSETH. That the Grantor for and in consideration of the sum of $ ..\, ~Q9...Q9. . . .. . . . .. . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by thb instrument grant, bargain, sell, release, convey and confum unto the Grantee ~I? . . . .. heirs, legal representatives and assigns the following property situated in Sebastian,lndian River County, Florida, to-wit: All of Lot(s) .~?.~. ~~Iock, )~. . . .. ,UNIT ..4.......... ,of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the ofllce of the Clerk: of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever: provided that said property shaU 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 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 corporate seal to be hereto affixed, the day and year first above written. All<St~/n.:..{).'.~(~..... CIty Clerk C1T:,&l5Z~HH Ma10r Rigned, Sellled IInd Delivered In tI'Unee of. I f~r.(.. D4f"'''HHH.... H.... H t;A~....~..:?)c~. STATE OJ' Fr.OIlIDA COl'NTY OF INDIAN RIVER I IIEllEny CERTIFY, That on thla .... ..29th........... .do}' of ....... .November:..............................., 1,95., (QIit\l ~elll) bl.fure me personnlly appmed .~~.~~. !-:~. .f~r.~~~~...........,...,... ......,. nnd .~~~. .t:1:..~~~;q~.:t;{'I;I?...... re.pl'etivoly Mayor An" Clly Clrrk of the City of ScbuUAn. A IIlllnidl'AI COrJlnrlltloll IIml.r Ihe I".... of tbe Stnle of Florl"a to me known 10 be lhe indh-i"""I. lllltl "ffkers descrll....d In "lid who execul",I the fo"'goillg CORvey"nc. to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PoIneni~~. .C~e:lro. . . . . . . . . . . . . . . . . . . . . . ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severn\l)- neknowledged thc exeeullon thereof to be their free net "nd deed us slIch ,,(ficers Ihereunto duly onlhor!zcd; and thnt the Officio' sc,,1 of said corporlltlon la duly affixed tbereto, nnd the 58ld e"nveyance i. the "et IInd ,le."I "f snld corporation. ~._' WITNESS lilY signnture and official seal at d tnt~, of Florida, Ihe day and 1ea. IlIst .ror.aahl. ' MY':=::;' "::;:;"'..... N"~",' 'bi,,; ";"" i'!fI&~.. .. .. .. . .. .. . . . .. .. My corm Isslon expire ,/ ( ....... Linda M. Galley --.....-----. Name /I '-1-.. ~I/ :e::. /-1 r.,) ! _J- 010 t;: c . {! E 5:;;: Ko Unit (I Block ~. ~, Lot 30 Date of Mark-out !' i '1' j '( <, ! "'.... l 1') J Date of Burial ;' ;L. '-{ / 7"- Time /0.' O:'.l A. II } ~ Name of Funeral Home ~. -".....:;,....-or "''- .\ i:, J.,(" ~ f ~.'I: t~( 1~J 1"\ ,,;;; " _. . "..,";.~:~':..::"'.:::'~~::,...^'. J ~;,.. . .p Authori:zed I:>.y,.,/<;' (/:<,,'-: '" <12:, " "~,-:",::::~.a~~,!,~,,<~',~c.:< <'e.. ' :J: = .., - L ;29"; :3 {J ,6 3if 01 State of Florida, Depa_nt of Health and Rehabilitative Services, ViWtatistics APPLI~ON FOR BURIAL - TRANSIT PERMIT 2. Place of Death County Indian River 3. Name of Medical Certifier David DePutron 0,0. 4. Name of Funeral Home/ Direct Disposer Funeral Homes a 0 A. 1. Name of Deceased (Type or Print) First Strunk 5. Check Appro- priate Box 6. Place of Sebastian Final Disposition: 7. Funeral Director/ eillUl1 [L...~~2.l Middle Last Cesiro DATE OF DEATH Antionette Month Day 11/20/95 Year City, Town or Location Name of (If neither, give street address) Hosp. or Inst. Sebastian Medical Examiner Phone Number Physician Address 1623 North P .A. S s i The medical certification has been completed and signed. A completed certificate of death accompanies this application. b ~ Dorothy was contacted on 11 /20/~S 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 nJ'lvi rl [)~Pllt ron, D 0 will complete and sign the medical certification of cause of death. c 0 was contacted on . He/she verified that , Medical Examin8r, will complete and sign the medical certification. Removal from state Donation Date Signed Indian River F.E. No.1 Reg. No. ,,2. B. BURIAL - TRANSIT PERMIT Permit No. 1228-95-0512 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 filing the death certificate requested. r1....loI;"L YO b,. ~ "'" M ^ /I /I Date ~ Date Certificate Ltw.: ~_.L. \'" <II -- ~ Issued'. J ao Due'. Subregistrar Signature ~ ~ - -u- C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature , Medical Examiner 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. D. Methods of Disposition: . BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge ) CEMETERY OR CREMATORY o STORAGE o OTHER (Specify) ~17" :<t~'?r- Place of Disposition Date of Disposition c,; ~;1J;~ f/ ,.v; "~/ 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) IStock Number: 5740-000-0326-21 :r