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Home My WebLink About4-34-33 ." Paid by CEMETERY Receipt No.. .~.,. ....... Dated.. J/ P/.9.L.............. LotS.& I 000 00 Bloc List Price $ ... J...... ~....... Maximum No. Burial Space.............. ... .Uni t Net Paid $ ..~ !.?~?'. ?? . . . Monument permitted. .. .. .. . . . . .. .... . . .. . . 34 NO. " "1487 , .. (Dat. .boye tllIa line for City Reeord only) mUll nf &tbasttan <1!rmrtrfY Irria 1487 NO. THIS INDENTURE MADE 'I1dI 26th ... d.y of .........~a.n.~~~r........................ A. D~ II..~.~.. b.t.....n Ih. City of Sebaatl.n, . launlelp.1 corpor.tlon alatlna und.r the I.wa of tb. St.te of Florid.. .a Gr.ntor .nd Mrs. Mildred U. O'Grady ...................................... 'l}'62' 'Ge'o~ge" Stre.e't.................. ..................................... ..~.el>lis.~.ili~ ,.. !~?~.~~li. }.~? ~.~..... of lhe Connt, of .....Indlan..Ri.ver.................... .nl SI.te of ......F.lorida..................................... u Gr.ntee, WITNESSETH. That the Grantor for and In consideration of tbe sum of $ J J.QQ9. ~ 9.Q. . . . . . . . . . . . . to it in b.nd paid. tbe receipt wbereof is berewitb.c>- knowledged. doe. by tbi. instrument grant. ba'lalD. leU. releale. COnYey and confirm unto the Gr.ntee . h ~.t; . .. heir.. Iepl repre_t.liYN and .......s the followinB property situated in Sebastl.n.lndlan River County. Florida. to-wit: AD of Lot(s) ~ ~ ~.~ ~ . Block. . . J.4. .. . UNIT ....4........ . of Sebastian munidpal cemetery as per Plat Number I thereof recorded in Plat Book 2. at page 65 of tbe pubUr record. in the omce of the Clerk of the Circuit Court of St. Lucie County of Florid.; .Id land now lyins and beiDB In Indian River County. Florid.. To Have and to Hold the .me forever; proYided that said property shaD be uled solely and exclusively for the interment of tbe buman de.d and .hall be uled, kept and malnt.iJled at an time. in .ccordance with the rule..nd ......latlon.. ordin.nce..nd resolution. of the City of Sebastian. Florid.. hereto- fore. now .nd hereafter adopted or proYided for the government and operation of.1d cemetery. The condition.. restrlctlon..nd requirements conlalned in tbis instrument .han be covenant. running with the land. In the event of the failure of the owner of .ny property situated within said cemetery to ob- lerve and comply with inch rule.. ......lation.. resolution. and ordinance. and the condition. of the dl!ed of conveyance thereof then the title of such owner in and to .Id property shan terminate and the .me .hal1 revert to the City of Sebastian, Fioricla. IN WITNESS W1IEREOF. The said party of the first put has cauled this Instrument to be executed in it. name and on its behalf by It. Mayor and attested by It. City Clerk and its corporate ..al to be hereto affixed. the d.y and year first above written. AU.st. .&4272:2=.............. nTYj[iJJ';Z~ M.,or ~,:~.~::::.~ppppp (<<ao",Q ~ 2/..Jf~.......... STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEllEBY CERTIFY, That on thla .....~.~~~...........d.y of ..........~~.~~~~.Y............................., I~.~., brfore me perlon.lly .PJlSfl!l!I .....A.~.t.h~~..~.~..f.i.r.t;;V).1'.1...... ................ and ~a,lJyj~!..Ma,~.Q................. r'"p.",tively Mayor .n.II'tf!iY'1cI.rIc of tb. CIl, of Sebastian. 0 munlelpnl .or"oratlon und.r tlM! In-. of tb. St.te of Florida to me known 10 "" Ihe Indlviduall and offi.e.. described in and wbo .,,,,.ut.d tb. for.aoln, eoney.nre to ...................................... ...MrS... Mildr.ed. .U...O!.Grady.... ................................................ . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . .. . . .. . . . ... .nd sev..ally aeknowied,rd tbe execution tb.....f to be their free .d ond deed as s"eb offle... thereunto duly outborlaed; and tb.t tbe Omel.1 1..1 of laid corpor.llon Is duly affixed tb.re and tbe said eonye,ane. I. tb. Rd and d..d of laid corporation. lItlOA M. 8AllEY MY ClJlMISSION , CC smM DI'\AES: ....18. 1tII ......-...,...... ........ tbe da, .nd ,.ar WITNESS my slan.ture .nd DlM.1 _I .t Seb.stl.n. in the I..t otorraald. ~~(:f~~ . . (y3Cj THE SEBASmR CEMF:rERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA OF XIIE SUM. OF: ollars ($! M(). f!JJ FROM: the as Description of Property: . Cemetery Lat(s) 33 t{~ Block Purchase Pric4' ~ !?f2-- 01- Unit 4- Dollars ($I./)()()~) Xerms and Condition of sal.e: Xllis con'tract shall be bi11t'H'I'1g upon both parties, the seller and the purchaser, when approved by the owner of the property above described. I, or we, agree to purchase t:he above described property on the terms and conditions stated in the foregoing ins~ene: Xhe City of Sebastian agrees to sell the above mentioned property to the above named purchaser.t..s-r on the terms and conditions st:at:ed in the above inst:rument:. P- ciJ~7 , . . ..'1y 0 , ,.. "\ IJ'" (:~ ~ ~~ - ,~ 'Yo 4 S 1 ~Q ;r,~ {,\.~ OF: PElICP.ti . City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 February 2, 1995 Mrs. Mildred U. O'Grady 962 George street Sebastian, Florida 32978 Dear Mrs. O'Grady: Enclosed is Cemetery Deed No. 1487 for Lots 33 & 34, 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. 839 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. Very truly yours, ~m. tJi/dIPA.. Kathryn M. O'Halloran City Clerk KMO: lmg enclosure (\ws-form-cem.rec) . . (y3Cj .. THE SEBASTIAN CEMETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA OP XHE SUM OP: ollars (S l.tfj{). ~ PROM: ?J on tlUsc2t) day O~.l;!f:i for t:be purchase of fo1.1.owing described Ceme rg Lo't( ~Jupon the 'terms and condi'tions s'ta'ted herein: Descrip'tiOl1' of proper~: "7 _ I Ceme'tery Lo't ( s) 33? Cff B1.ock Purchase Pricl1 ~~ the as , 0+ Unit 4- Dol1.ars (S I.L?M~) Terms and Condition of saLe: This cont:ract shaL1. be bintH ng upon botl1 part:ies, tl1e se1.1.er and the purchaser, when approved by tl1e owner of the property above described. I, or we, agree 'to purchase the above described property on the 'terms and condi'tions s'ta'ted in the fore iIJ.g ins~enr: The Cit::y of Sebas'tian agrees to sell the above men'tioned propert::y to the above named purchaserJ....s;-r on the terms and conditions stared in. the above instrumenr. ~~~~ ~tl1ess Name t",. l " ,j,,;- I") ,i,/ f.., _' /./ .. (. .,.~". f~, '.('-t ,.....,_ .'/~i ,l~': '"'..I i Unit / "./ Block / ':;:: .~/ ....1 ! Lot ~3 ~ ~ Date of Mark-out ",/'1..,)' I A. -t:., f\'')>) I V/ .r Date of Burial / / / /~\ /.n, /;. /,' I ',.' " \,..; i " ,. , Time -<>/ 'I /'~.::: /'''') rJ "I- ~'-~,; "...~ . t Name of Funeral Home "",--, f,/' .. t.:, ) ,,:.: ,( ,j / ~J "..... ,-" J'l . - Authorized by t'Y\\ Idred U.. q to~ r~e ~~ ~a0+ianl r l Cdq 6'6 ~ pO. 14-~1 lo~ 53~ ::A~I~~ ,:~A, lJ.n; ~ 1 7lJLiJut>!ZL ~U33- I --r -;:; /rJ -tJ/-clCtJ/ \" - '- ~ Paid by CEMETERY Receipt No... ..~..~9............. ...Dated... J/ ~)/..9.~......................... Lots 33 & 34 . . 1,000.00 .' Block 34 list Pnce $....,........................., Maxunum No. Burial Spaces...,..,............. .Uni t 4 Net Paid $ ....~ !.?~?:. ??.... Monument permitted, .....,." ..,..,............... NO. , 148r; (Data above this line for City Record only) Last t. 3 d' 13 3)-j t! i Month Day Year Sept. 26 2001 I'LORIDA DEPARTMENT OF State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT A. (TYPE) 1. Name of First Middle Deceased Mildred u. 2. Place of Death City, Town or Location County Indian River Roseland 3. Name of Medical Address Certifier Noor Merchant, M.D. Date of O'Grady Death Name of (If neither, give street address) Hosp. or Inst. Sebastian River Medical Center Phone Number Medical Examiner 4. Name of Funeral Homel~~;t gillilMI Establishment Strunk Funeral Home 5. Check a. 0 The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box Physician Address 1623 N. Central Ave. Sebastian, FL 13060 U. S. #1 Sebastian, FL 561-589-0879 Fla. Lic. No.lReg. No. Phone No. (Area Code) 1228 561-589-1000 b. ~ Jean was contacted on 9/26/01 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Merchant will complete and sign the medical certification of cause of d within 72 hours. c.D was contacted on He/she verified that , Medical Examiner, will complete and sign the Dillaat e:~tJu~wrr Date Signed 2 01 6. Funeral Director/ B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-01-0472 o A five (5) day extension of time for filing the death certificate (~xclusive 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. alSil'flU or 1 Subregistrar Signature M. Date Issued: (Date certificatl q ,. tel O~... Due: . a 3-1 e I 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. Method of Disposition: ~BURIAL DCREMATION Signature of Sexton or Person-In-Charge CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery D. o STORAGE Date of Disposition /0 It; I / ",./ . DOTHER (Specify) } ~ r;';(~ 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 edftions) (Stock Number: 5740-0()().0326-2) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Regiatrar