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Home My WebLink About4-33-09 ~ Paid by CEMETERY Receipt No. ,U? .... . Dated .... .~{P/~~...,..... ..... H~~ ~ . List Price $ ... .... ?q~: ~~.. Maximum No. Burial Spaces............. .... n1 E 4 500.00 NO. Net Paid $ Monument permitted. , . , . . . . . . . . . . . . . . . . . . . .1 .'~ ,', 3 (Data aboye tltl. line for City Rec:ord ooly) Q!Uy nf l'rbustiun ',,-.. ClLemetery I eell 14'" .:.:.. \j NO. THIS INDENTURE MADE TlIII .,." 23rd dRY of .. August A, D., It, 93 hetween the City of Srbaltlan, a munlelpal eorporatlon ezl.tlng und.. the law. of the State of Florida, al Grantor and Catherine Gingerich ,'..........., '''158"'5'; 'Wimbrov' Drive....' ......." "",,'...' ,......... .............. Sebastian, Florida 32958 ................................ .,.,. .....,.................. ........... .................. of the County of .. Grant.... WITNESSETH. That the Grantor for and in consideration of the sum oC S ..~ ~~.'. 9.Q.. . ... " . ... " . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, seU, rei...., convey and confum unto the Grantee.. ~~.r:., heirs, legal representatiyes and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . ~ . . . .. ,Block,) ~ . . .. ,UNIT ..~.......... ,0C Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 65 of the public records in the offlce of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida. '" ,In.M,~n.. ,R~,v~~, ,........... ani State of fl.or::id.a.. 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 .U 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 thereoC then the title of such owner in and to said property shall termin.te and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the fust 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 abov ritten '''"', ~~:cCL;, {,");I= '-. bl/flJry City Clerk (GIitu ~elll) STATE OF FLOnInA COl'N'fY OF INDIAN RIVER I IIEUEDY CERTIFY, That on thl. 23rd , , , , ,day of August 93 It, bl'f"re me personally appeRred .l:o.n,n.i~..R.~..r.ow~l1.. and Ka.tl1rX,n..~:..()'.~a,~.~?r,a~.. reRpf'('tivf'ly Mayor and City Clerk 01 the City ot SehRstian, 8 munkipa) corllOrntion lIndt'r the laws of thl' State of Florida to m~ known to b(. the fndi\'iduuls und o(ficrrs described In and who (>xecuh.d tht' fon'going cORveyunce to Catherine Gingerich . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowlerfgt'c) th~ execution thereof to be their frf"f' Ret nnd deed 8S sudl officers thut'unto duly authorlzrd; and that the OUld1l1 sen) of said corporation Is duly affbrd therdo, Rnd the sairl ("onvryance is the IIct Ilnd dt"ed of said corporation. WITNESS my .Ignature and official .eal at Sebastian, In the County of Indian Rlyer and State of Florida, the day ond ,.ear Inst ufort!'satd. H JOANNE SANDBeRG No-, PuIllIc-SIlI.. cf FbIda ~ CommInIon Ellplra APfI 30,1"" : OOWA, cc ooeoa ,..k~l?:.e", ,kr:'~~?.,....".,...,.,.,.". Publle, State of Florida at La.." omml8slon explrn I Joanne Sandberg Name V\(/', / ,C1~ ,("__" l~." c. // c~ _',';""l~ /... , , ,J j-,!"\. / /{ Unit 4 , Block ":':';' '> ..J.) lot /1 ! I, Date of Mark-out p< ,l~, (, ' ' '-') Date of Burial <:>/-, ';, c.:) ,..I"'\_~., / ~ , I ',; < f ), ,.J /~. . j-'i''''\ Time Name of Funeral Home ,::: ~;-;; v i.1 1/' I'" ' Authorized by ""-,,,.J..lf : L / I i J ! / 1- j ,~ ~eirle )j . a5/mbrol0 :})r: 3e~;aJ11 FL 0c9tl6(f /J;+a.) J3ioeL 33, LJrJ; ~ 4- ~ /1);/ /iWl (;',~erieh - /r/'/-er red '8/ C23 J'l3 lJeeo/*/Aj~ s Paid by CEMETERY Receipt No. . l.T? . . .. .. .. . . Dated. . .. . ~ t.~;3/~.~. . . . . .. , , . . . .. i~ ~ c~ 33 o Unlt 4 List Price $ .. .. , .. ?~~ ~ ~ . . . Maximum No. Burial Spaces.. . .... . ... .. . .. , 500.00 (}dk~ Monument permitted. . . . . . . . . , . . . . . . . . . . . . _ (Data above this line for CUy Record only) NO. 1 4 ~'~ 3 . . 775 THE SEBASTIAN CEME:rERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: r~ Cl:L~,,1 C If TrlE"c//l/e r;://lJa:E--e Ie/! . ~\ . /....,<?' .:;, 11)//>1 A/ft1/o V-ell/E \..C:;E ,lQ/lS /;/1 ~ . /l.. t:J R I.LJ /1 3 ,;;'J;S g on this ,;(3J day of '~r ,1993 fo,," the purchase of the following described Cemetery Lot(s) upon the terms and conditions as stated herein: Dollars (S So CI , tf7:1 ) FROM: Description of Property: Cemetery Lot(s) 9' , Block 33 Unit ~ Purchase Price: F--u~ ~/,,/ Dollars (S odzt, tfG) ) Terms and Condition of saLe: ~ fI.. c:if;; / (~h"/LiU,-f~ J 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: x ~) 14~~/L~A ) The City of Sebastian agrees to sell the above mentioned property to the above named purchaser ( s) on the terms and conditions stated in the above instrument. ~V~ _cL~~ Ci:ty of Sebastian ---, ;/ . ,-1Y 0" "\ \( "'" CJ ~ (('~,- ,"< 100 V "1 S ~ ~<:) :.t,(" ,s\-~ or: PEUC~~ . City of Sebastian POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 September 3, 1993 Catherine Gingerich 158 S. Wimbrow Drive Sebastian, Florida 32958 Dear Mrs. Gingerich: Enclosed is Cemetery Deed No. 1423 for Cemetery Lot 9, Block 33, 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. 775 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. ~UI: y~~z:s, I ~m. tJ'I/~A.. Kathryn M. O'Halloran City Clerk KMO:lmg enclosure (\ws-form-cem.rec) . . 775 THE SEBASTIAN CEMETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: r~ C:<~,:).L Dollars (SStJd.d7:J FROM: C /9T#E.-c:. //!/E r;::/AJ~E"e let"! . r. /...~ <? S'. II )/ /Yj A /Cd j(} )() ~ / II E \...<:::;;:.(-1/1sr/~/J,J " /'2t:JR/):;/9 3;l9SJ> on /:hi.s ,'J3J day of /1~ ,199-3 for /:he purchase of following described Cemetery Lot(s) upon the terms and conditions stated herein: ) the as Description of Property: Cemetery Lot(s) 9' . Block 33 Unit ~ Purchase Price: hA/4!..... ~~../,/ Dollars ($ StfZ/, th:} ) Terms and Condition of saLe: ~ -/;t c:if0l1 (dead h~/~~ J 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 conditions stated in the above ins trumen t . ~ fLUL -cL4 PJ:ty of Sebastian ~ (/ [~~] State of Florida, DepartmWf Health and Rehabilitative Services, Vital .stics APPLlCAT FOR BURIAL - mANSIT PERMIT '7 1- 833 4'1 A. (Type or Print) 1. Name of First Deceased Wi 11 iam 2. Place of Death County n ian River 3. Name of Medical Certifier 4. 5, Check Appro- priate Box b Q Middle Last Gingerich DATE OF DEATH Month Day Year 08/19/1993 A. City, Town or Location Name of (If neither, give street address) Hasp, or Inst. Sebastian Phone Number Medical Examiner Physician Address 13855 V.S.#l 1623 North Central Avenue 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 filin e death certificate re ueste Registrar or Subregistrar Signature 6. P!ace ~f S.ebastian Final DISpOSItIOn: 7, Funeral Director / DirGet 8;"'l-'u",er B. C. Signature or Medical Examiner, -? The medical certification has been completed and signed. A completed certificate of death accompanies this application, Lrace was contacted on 08/20/1~9o!ithin 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 PeNro 1\ E'lipat, D 0 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 medical certification. Removal from state Donation Date Signed BURIAL - TRANSIT PERMIT Permit No. 1228-9~-O~9~ Date Issued: c: '} ",., q.2 Date Certificate CJ ;' P" v -/ ,:;:;1 Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL -AT-SEA , 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. Methods of Disposition: . BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge) CEMETERY OR CREMATORY o STORAGE o OTHER (Specify) /(' -r 9 )( -""~ '7' -A - (7 - ,.".....,.-".. A Place of Disposition ;").G .4 ~ / J>>.Jot ~ r N"'l ,- / I<:.-'=' Y . I / 'I Date of Disposition ~;< -3 9 ~ ' 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) (Stock Number: 5740-000-0326-2) ~ J ~l