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Home My WebLink About4-34-35Paid by CEMETERY Receipt No... ....... Dated ..... 3 / 8 / 9 5 Lots & 36 ........ 1 000 0 Block List Price S .... ?......'.. 0 0... Maximum No. Burial Spaces ................ Unit 4 Net Paid $ 1' 000.00 ........... Monument permitted ....................... (Data above this line for City Record only) Chu of #Phastian Trutt ttry ID PPb NO. NO. 143 143 THIS INDENTURE MADE This ....,_.I.th... ...... day of ... March .. ............................... A. D., 19......, between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Mrs. Opal Clemons ......... ............................... P:. O.:.. BO. X.. 1. 1. 2 .................... ...... ................. ...................... Roseland, Florida 32957 ...................................................................................................... ............................... of the County of .... Indian „River .................... sal State of . Flcir. Ida.......... ............................... as Grantee, WITNESSETHr That the Grantor for and in consideration of the sum of S ...1., OOO : OO , , , to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee her, . , , hews, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: AB of Lot(s) 3 5 & 3 6 Block, .. ;3.4... , 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 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. 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 inch 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. Attests ..L.C-fiK'I-.�!.! 1LG- .L..�tilc�.;L;....... City Clerk CITY OF SEBASTIAN, FLORIDA .............Mayor Signed, a and Delivered In tb reseo a uR % .. ............... (Mitg "Seal) (/....r.. .... ........... STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That oa this ........th .............day of ............. March 95 .............................. Ig , bcfare me personally appeared .Arthur L. Firtion ........ and Karyn . ...M. .. O.'.Halloran . . . . ... ........ .. ....................... ....t..h.. ................ respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the individuals and officers described in and who executed the foregoing conveyance to ...................... I .......................... Mr. r.. Qpa.i.. C1. ampnq......................... ............................... ......................... ............................... and severally acknowledged the execution thereof to be their free act and deed us such officers thereunto duly authorised; and that the Official seal of said corporation is duty affixed thereto, and the said conveyance is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the unty of Indlan aver and 7cTit o Florida, the day and year last afaressid. 1 ' n A W COWBSSION I CC V5724 i.. ar -�. f.. u..... r.:...0 ............ . EVM: i m M tyM trry Pubilc, State of rids at rge. ftnbd Ibu Nobly pips ILn�asMas M cormulsslon expires inda M. Galley C �_�: x l l � �!� �c��ar�E, G�- ��'S7 �� <3 � �E�,� ,3 �,1�,� � ��5 �� EIPT IS FROM: *ME SEBAS77AN CEA# TER Y CITY OF SEBASTIAN, FLORIDA w�-, Y ACKNOWLEDGED OF THE SUM OF: EI-xJ& Dollars on this V-4- day of lLL i; 19 for the purchase of the following described Cemete y Lot(s) / "!44;& upon the terms and conditions as stated herein: Description of Property: / Cemetery Lot (s) / (C> Block Unit Purchase Price Dollars Terms and Condition of sale: This contract shall be binding 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 stated in the foregoing instrument: The City of Sebastian agrees to sell the above mentioned property to the above named purchaser(s) on the terms and Condit s stated in the above instrument. t �/ / City of Witness • Vy 4 lam' :�•M '= 'z �F PELICAN City of Sebastian 1225 MAIN STREET o SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589 -5330 0 FAX (407) 589 -5570 March 13, 1995 Mrs. Opal Clemons P.O. Box 112 Roseland, Florida 32957 Dear Mrs. Clemons: Enclosed is Cemetery Deed No. 1493 for Lots 35 & 36, 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. 846 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, f �n. 0 " A.— Kathryn M. O'Halloran City Clerk KMO:lmg enclosure ( \ws- form - cem.rec) FROM: '4WIHE SEBASTIAN CEIATERY CITY OF SEBASTIAN, FLORIDA PT IS EREBY ACKNOWLEDGED OF THE SUM OF: �Z � Dollars ($ �• ) ,-7 -r— on this V'7-12- day of i 19 for the purchase of the following described Cemete y Lot(s)/ upon the terms and conditions as stated herein: Description of Property: Cemetery Lot (s) / - 3 _ �C', Block Unit Purchase Price �L �.C� Dollars ($ Terms and Condition of sale: This contract shall be binding 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 stated in the foregoing instrument: f,. The City of Sebastian agrees to sell the above mentioned property to the above named purchaser(s) on the terms and conditi, s stated in the above instrument. City of Seba t, n- L /Wi tness S50'i�L.•. �3" `- �fSaUi�'uZ}7.'S r;S:d'YBS.+' INVOICE CITY OF SEBASTIAN TO: Ms. Opal Clemons INVOICE: 05 -064 P.O. Box 112 Date: 10/25/2004 Roseland, FL 32957 Amount: $ 225.00 AMOUNT DESCRIPTION DUE 1 Repair of marker at Sebastian Cemetery Unit 4, Block 34, Lot 35 225.00 DUE UPON RECEIPT TOTAL AMOUNT DUE 225.00 Remit To CITY OF SEBASTIAN Finance Department 1225 Main Street Sebastian, Florida 32958 Account Numbers: Dr: Cr. 010059 534685 CRY OF ow ��2-4& HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, FL 32958 • (772) 589 -5330 — Fax 772 - 589 -5570 October 21, 2004 Ms. Opal Clemons P. O. Box 112 Roseland, FI 32957 Dear Ms. Clemons: Re: Sebastian Cemetery Unit 4, Block 34, Lot 35 It is with regret that we inform you that the marker and /or vase on your Sebastian cemetery lot was damaged during the recent hurricanes. The city has made arrangements with a local monument company to repair the damaged markers at $225.00 per marker and $20.00 per vase. According to the rules and regulations governing the cemetery (copy enclosed), interment site owners are responsible for damage to markers and /or vases, therefore, we are enclosing an invoice for the reimbursement of this fee. Thank you in advance for your cooperation in this matter and I would like to assure you that the upkeep and maintenance of the cemetery is very important to the City. If you have any questions regarding this matter, please do not hesitate to contact me at the cemetery or by telephone at 772 - 589 -2545. Sincerely, Kip G. Kelso, Jr Cemetery Sexton Enclosure _ N� -qtr � ...... .. .....r ...�..�� CITY OF SEBASTIAN CITY CLERK'S OFFICE 3974 RECEIPT Jame 4� F FL (.�1 11 C ❑ Cash )ate _ a a6 � VO C / heck #SQ (D Jo. A Amount Paid )01001208001 S Sales Tax )01501 322900 G Garage Sales )01501341920 C CopiesBid Specs. )01501 341910 L LDCICode of Ordinances )01501341930 E Election Qualifying Fees 101010 343800 C Cemetery Lots � �4 LOUNIche 5 , Block Unit )01501 343805 C Cemetery Fees dl� j6—j Total Paid ( 50.0 Initials White - Ut. of Origin • Yellow - Finance • Pink • Applicant r o c cZi 0 . 0 � C =r 3 m m o co ' 0 0 N O0 a W w CD 0 1 y c 0 \ `ha t, �✓i '' n � 1 3 co tr I C Z D w 3 co i U. 1 Lor 3s' i t CAA.A. ! 4q 3 i #- i� ii n � 1 3 co tr I C Z D w 3 co i U. 1 Lor 3s' i t CAA.A. ! 4q 3 i #- i� ii FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY HOME OF PELICAN ISLAND 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) 388 -8215 or 388 -8214 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home ADDRESS: 1623 North Central Ave., Sebastian, FL 32958 PHONE #: 772 - 589 -1`000 (Check One) XX OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME Lot 35 Block 34 Unit 4 Lot Block Unit Niche Block Unit N S E W March 25, 20U U--- 2:00 P.M. FOR DECEASED: Opal Clemons Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) AaZAUJ Name Signature Date 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 DIREVtOR: Name Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: Cemieferytexfon Date This form to be. provided to Clerk's Office by Sexton for permanent record upon completion. Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1 OPAL CLEMONS Opal Clemons, 89, died March 22, 2008, at Sebastian River Medical Center, Sebastian. She was born in Bulan, Ky., and lived in Roseland for 23 years, coming from Wapakoneta, Ohio. She was a homemaker and of the Baptist faith. She was a former member of the Roseland Women's Club, Roseland. Survivors include her daughters, Jean Sidey and Charlene Becker, both of Roseland; 13 grandchildren; and nine great - grandchildren. She was preceded in death by her husband, Jason Clemons; son, Billy Clemons; and daughter, Lucille Turner. SERVICES: Visitation will be from 1 to 2 p.m. March 25 at the Strunk Funeral Home and Crematory, Sebastian. A funeral service will be at 2 p.m. in the funeral home chapel. Interment will follow at Sebastian Cemetery, Sebastian. Published in the TC Palm on 3/24/2008. Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Powered by L,egracy.com obituaries nationwide Back http:// www .legacy.comltcpalmlObituaries. asp? Page= LifeStoryPrint &PersonlD= 10625... 3/24/2008 FLORIDA DEPARTMENT OF HEALT rrvr5a State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased Opal Clemons of Death March 22 2008 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or 1 ndian River Sebastian Inst. Sebastian River Medical Center 3. Name of Medical Address Phone Number Michael Venazio, M.D. 8005 83rd Avenue 1 Certifier Medical Examiner Physician Sebastian, FL 772- 388 -2110 4. Name of Funeral HomeQreat�Diepeeaf Address 1623 N. Central Ave. Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment Sebastian, FL 1228 772- 589 -1000 Strunk Funeral Home 5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Christina was contacted on 3/24108 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Venazio will complete and sign the medical certification of cause of death within 72 hours. C. was contacted on He /she verified that Medical Examiner, will complete and sign the medi5g certi ti of cause of death within 72 hours. 6. Funeral Director/ / S' na F.E. No. /Reg. No. Date Signed Llirnrt rlicnnear A /I�� 44048 3/22/08 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -08 -0136 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. []No extension of time for filing the death certificate has been requested. Date Date Certificate pwisua =r Subregistrar Signature �. 1� 1 rL `� v4• , e- A,,e ,, Issued: 3/22/08 Due: 3/27/08 C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL- AT-SEA [il 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: JBURIAL CREMATION Signature of Sexton or Person -in- Charge STORAGE OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition 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. Distribution: white: Cemetery or Crematory DH 326, 6/97 (Obsoietes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740.0000326 -2) Pink: Local Registrar ,-OW `I Fv-