HomeMy WebLinkAbout4-33-11
. ~
Paid by CEMETERY Receipt No.. ..~9.l}. ..Dated... .~/.?M.~~............... Lot 11 .
500 00 Block 33
Ust Price S .. . . . . . . .: . . . .. . . . Maxlmum No. Burial Spacea..... . .. .. . .. .. . Un! t 4
~j!/:;_~?': ~?""'. Monument permitted.......................
~~~~,~~oo.)
N.o.
1457
(lHtu Itf &tbasthtu
<1!rmrtrry mrrb
NO.
1457
THIS INDENTURE MADE 'ftlI
26th
000 day ..f
May
94
A. D. I...... oJ
bet.....n the City of S.ba.lIan, a municipal eorpo.atlon exlstlnll undc. the lawa ..f the St.tc of FI...lda, .1 Otant... .nd
. 0 0 0 0 0 0 0 0 0 000000000 o. 0................ .Ge.orge.. Douglas..................... 0....................... .... ...... ...........
7935 129th Place
...................... ................. .Roseland).. .Fl:.or.ida. .J2.95 {...... ..... .................. ...... ..............
of the County of ;J;~.dJ.An..~;i.~~.t'........................ .n-J St.te .., .....F.lo,t;';i.d~............'.'.........................
u O..ntee, WITNESSETH I
That the Grantor for and In consideration of the sum of $ ......... .~9.Q ...9R. ...... to It in hand paid, the receipt wh~...f Is herewith io-
knowledged, does by this Instrument grant, barga1ft, seU, release, convey and confirm unto the GranteJ1t ~ ... .. heirs, Jeplreprellentatlves and assigns
the following property situated in Sebastian, Indian River County. Florida, to-wit:
All of Lot(s) .~~.. .. ,Bloet,..~. ~. .. ,UNIT ...... ~ . . . .. ,of Sebasilan munldpal 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 Clrcult Court of St. Lude 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 shalt
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 fallure 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 snd the same shall revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of the first part has Clused 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.
A"",4m{)~
City C1e.k
CIT:,7l1h~?~
MII7'"
~:~~~4~~~....................
,.. OF ..~"m~~PPP
COUNTY .oF INDIAN RIVER
26th May 94
I HEREBY CERTIFY, Th.t 011 thll ...................... ..day ot ...................................................J I.....j
b.fll'. me personally appea.ed ..t\~.~~~~..:t .... .F.~~ ~.io~...... .. . .. ..... .. .. . .nd K~ ~~.~y.~ ..~. ~.. 9: .1.I.~gC?~~~..
r..p....lI..ly Mayor an,l City Cle.k of tbe City of SebAStI.n, a mun"'I"., eorroratlon und.. the In'' of tb. St.te or F1o.lda to me known
to b. the Individual. and oHl..... des...lbed In ond who exe..ut.d the fO"lIolng CORV.yan..e to
George Douglas
(CIlitv $rllJ)
....................................................................................................;..................................
. . . . . . .. . . . . . . . . 0 . 0 . . . . . . . . 0 . .. . . . . .. . . . . . . . . . . . . . . . . . ., .nd ......IIy acknowledg<d tbe exe..ullon th....., to be their free ...t Ind deed
IS s..ch oHl..... the....nto duly authorbed; .nd that the .orfl<l.1 .eal of .ald ..orpur.lIon la duly .fflxed the..to, and tbe .ald I:On..,.""e
I. th.. 01'1 and d.e<! of said I:OrpotaUon.
WITNESS my .ip.lu.. .nd offlcl.1 _I at Seb.sUln, In tbe Coun
I.st dor...ld.
i\~'~. UNDA M. 8ALlEY
I . ,.\ MY CllMMISS10N , CC334817 EXl'II\ES
_ 18. t984
_THAl/11'lII'FMI_.IIIC.
---.-"
~
~
,-
"
..;;.:: ~
:''\
". '. ~
'\8
~ ~
~
-
s::: 0
Q) ~
.......- E ~.~
.. " i= (()' ~ ~
~".,.i
"0..) \'\) ~
'.. '-.i
~ ~
''Z \.[. -- ~ A
rf) "()
~ u
~ ""-!
11 \ro
A :-:- ~
".,~.... '" ~
~ ~
<::: ~ ..,J
.~
\4 ~
, '"
\ ~
~
[,.' \ ~ -'"
......... :; to ~
<-~....", ~~ 0 Q) ~
.x ~ >- ~
/--... ... c: .0
as ::l >:~
. ~j ~ ::l U. '0 ~
ID Q)
- a a .!::!
Q) ~ 0 Q) 0
F- - 0 Q) Q) E .r. ~ ~
as c: 0 15 1ii 1ii as :;
Z ::J iXi ..J 0 0 z <(
~~ /~ Georze.
7Q8o /dtfib-~f1~
N?-/an:( FL 0!1CJ57 CfY'A--
~j I~ tJ/od 3~ tlni) 1
:j;hnJftvid La..~~e.. ~ 4J;;o/9m
,))eaj AJD. 1/-01'
'- -
~
~ ~ ~ ~
~ ~ ~ ~
~ Po g' n
~< ~ ~J
~~o:o><
~:o:o :;d
.. .. G
~ ':0:0 ~.
6 .0'0 'l:l
. . ....
. . z
. . ?
.......
t:l
~
III
g.
<
"
~
'"
: (Xl
:0
. (Xl
rs::: rs:::
0 ~ t:l
='
I gr ~
= (Il
a Po
z
"g ? :V1
...
e. tc
.... I:i :-
.... E 'N
(Il
Po :0'\
V>
1l '-
:\0
8 :~
'"
-
5'
"
...
c
..
o
...
'<
i
..
Q..
c
Cl
-<
-....
C:t:Or-t
~f-'O
1-" 0 ('"t
('"to
~I-'
~ I-'
V.J
V.J
z
o
\--I'
~
en
-.1
.
.
City of Sebastian
1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958
TELEPHONE (407) 589-5330 0 FAX (407) 589-5570
June 1, 1994
George Douglas
7935 129th Place
Roseland, Florida 32957
Dear Mr. Douglas:
Enclosed is Cemetery Deed No. 1457 for Cemetery Lot 11, 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. 808 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.
yours,
m. t)~A-
r
;
Kathryn . O'Halloran
City Clerk
KMO:lmg
enclosure
(\ws-forrn-cem.rec)
.
.
?o?
THE SEBASTIAN CEMETERy
CITY OF SEBASTIAN
SEBASTIAN, FLORIDA
FROM:
OF THE SUM OF:
( ~~^^- ~./
Dollars s....)fd:::!~
)
on this ,~It.,,, day 0
following described Cemet
stated herein:
the
as
Description of Property:
Cemetery Lot(s) /1 , Block
Purchase prica:. :iu'li1I./i d 1Z~~
Terms and Condition of sale:
\_,,"3 Unit j
Dollars (~O~)
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 conditi ' stated in the
above instrument.
1~~~~ ~-/~
(JIitness
I
I
I
i
i
I .
IR!"""
n
r-
. ('V')
~
('V')
....
co
'"
~
w
:E
Ow
:z:: :;) co
ZIl'l
.... W '"
c:I: :;( ~
a:: ...J ...J
We( u..
a: -
Z I- Z
_ Z c(
-w-
u.. (.) tii
~Z~
Z '" UJ
NCIl
::):e
a::
....
fn
OM
.....""
""n
;;'-5
~ i ..:\\
~cis '4 en
~~~
~I lh 01
.
1
I
I
I
~
t
~I
~I
~;
~;
\ ~!
g.
r'-~
~I
~: t co ~ ~.
~I . "' ;;. ~
\ ~~~Il Ii ~ II
"I ~ ~.~ 0
~~nl ~ ~I
. ~~~ I
~~i~ · ~ I
-
'ie H\'~Il:l3W't 3)1l:l1fl1
.u3::l't'S @N'f'IOl:lVnD
,~~~~i w..
.
~.
.-
(I'l"tl)f
<-i~l ~ t<;% $~ 1ft':< T.If.AJ' if
:-~*.>~:)~'i>:9~~~'~. " -::. ~?~:.
~
tlOME OfPELlCAN IStAND
INVOICE
CITY OF SEBASTIAN
TO: Mr. George Douglas INVOICE: 05-076
7935 129th Place Date: 10/25/2004
Roseland, FL 32957 Amount: $ 225.00
AMOUNT
DESCRIPTION DUE
1 Repair of marker at Sebastian Cemetery
Unit 4, Block 33, Lot 11 225.00
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
'""'?C;:'::':~~~~:~:-:~","'~'R>'~~~~-:_~~~~~.:Oii"'~~'~::~~'~~~"..,:.-:.."
OTY OF
~
-,~::~::,,,';"";"__ _ "":'~._,r"_.:.~;'--.
----"~,. "~--- " '.
---_.- ---
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, FL 32958. (772) 589-5330 - Fax 772-589-5570
October 21, 2004
Mr. George Douglas
7935 129th Place
Roseland, FI 32957
Dear Mr. Douglas:
Re: Sebastian Cemetery Unit 4, Block 33, Lot 11
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 J/ /' Y
IS .L) \ f-'
Cemetery Sexton
Enclosure
t~:~~"~.:;~ ~-~r~~;:' ~'-~~
Iii" i_1i _~_, ~_.-._.,-' ----
,~.,.~"', -~,~;t~f<:-t:;~...,,:~.:- .-...~~-
"'__:>:\-~~:-::,;;b:,.o.'C ~-::: ~'-
_''''-:::...,.~--::'::::,:''''-;::-~~~~~::
[ln~1
State .of Florida, Departmen.4lll Health and Rehabilitative Services, Vital St. tics
APPLlCATI.OR BURIAL - TRANSIT PERMIT
1- 33-//
A.
1. Name of
Deceased
(Type or Print)
First
John
Middle
David
Last
LaRose
DATE
OF
DEATH
Month Day
OS/20/94
Year
2. Place of Death
County
City, Town or Location
Name of (If neither, give street address)
Hosp. or
Inst.
3, Name of Medical
Certifier
Charles A, Diggs,M,D.,A,M.E,
Medical Examiner
Address
2500 S. 35th. Street
Fort Pierce, Florida 34981 (407)464-7378
Fla. Lie. No.lReg. No. Phone Number (Area Code)
Phone Number
4. Name of Funeral Home/
Direct Disposer .
Strunk Funeral
Physician
Address
1623 North Central Avenue
Homes, P.A. Sebastian, Fl 32958 1228 (407)562-2325
a 0 The medical certification has been completed and signed. A completed certificate of death accompanies
this application.
5. Check
Appro-
priate
Box
b 0
was contacted on 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 will complete
and.siqn the medical certification of cause of death,
l'1e'rv
Charle~ A. Di&g5,M,D"A.~.E.
was contacted on OS/22/94 . He/she verified that
, Medical Examiner, will complete and sign the
c EJ
6 PI f Fuuu L.;I.:ullt'.;I.J
, ace 0 Park
Final Disposition:
7. Funeral Director/
Qirl3Elt Di6l3e~a
Brevard
FE No.mc~. ~Jo.
1672
Removal
from state Donation
Date Signed
OS/22/94
B.
BURIAL - TRANSIT PERMIT
1228-94-0235
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 e death certificate requested.
Registrar or
Subregistrar Signature
Permit No.
Date
Issued:
S "?/-?'?
Date Certificate
Due:
C.
AUTHORIZATION for CREMATION, DISSECTION or BURIAL -AT-SEA
Signature , Medical Examiner Date
or
Medical Examiner, , gave authorization by telephone fo
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.
CEMETERY OR CREMATORY
Methods of Disposition:
. BURIAL
o CREMATION
o STORAGE
o OTHER (Specify)
<f2 ~~ ,,(~ ~
Place of Disposition
Date of Disposition
:;;E.t3 ,;. 5;;.4 >.f C L,H1 ,(;,) I:-;e y
:)/~ <) /9i I
Signature of Sexton )
or Person-in-Charge )
This permit must be endorsed b, y the Sexton or person-In-charge (or by the Funeral Director/Direct Disposer when there is no ~on)
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)