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Home My WebLink About4-33-21 I- I . ' PalclbyCEMETERY Receipt No. .......... . Dated. .. .U~.Q/.9.~............... Lot zA 500.00 Block~ List Price S .. .. . . .. .. . .. .. . .. Maximum No. Burial Spaces .. . .. .. .. .. .. . .. tIni t 4 Net Paid S .. .5aO...00...... Monument permitted....................... NO. 1424 Leonard Solomon (Data above tIIla line for Clt, Reeord oaly) ~ mu" nf l'tbttsthttt (ttrmrtrfY 1424 I1rrb NO. THIS INDENTURE MADE 'I1oIa 10th ........ day of September 93 A. D~ 11......, beh,'een Ihe Clt, of Sebadl.n, a munlelpal eorporatlon nl.tlne under the I... of the State of Florid.. a. Grantor and , .. . . ..... . . ............................... . ... . ~~,Q1H:!'r.d" So.l.QroQn..........,..,. .. . ., .,...,.. ..."........................ 114 Royal Palm Street ...,.'..,............. ....................... .... ,Se.basUan,. ..F.lor,ida. .3.2.958...,................ '........,.........., of the County of .. ..f~M~.~.. R!,Y.~~.................... an:1 State 0; ....... ..fJ,Qd.d.~........,....... ...............,.. u Grantee, WITNESSETH. That the Grantor for and In coDsIcleratiOll of the sum of S ..~ 9.9... 9.Q. ... .. . .. . .. .. . to It In hand palcl, the receipt whereof Is herewith ae- knowledsed, does by thla Instrument grant, baqaiD, len. releale, convey and confirm unto the (;rantee .l,t;l;~. ... helrs,.1 reprelentaUves and assigns the followlns property situated in Sebastian, IncIlan RIver County, Florida, to-wlt: All of Lot(s) .. ~ ~ .. , Blode, . . ~. ~. .. ,UNIT ...~......... ,of Sebastian municipal cemetery aa per Plat Number I thereof recorded In Plat Book 2, at JlIl8t! 65 of the publlc recorda In the office of the Clerk of the Circuit Court of St. Lucie County of Florlcla; sald land now lying and bellll! In Indian River County, Florid.. '" To Have and to HoleI the aame fore_: provided that saIcI property shall beuaecl solely and exclusively for the Interment of the human dead and shall be uaecl. kept and malntalned at all timea in accordance with the rules and resulatlons, ordinances and resolutions of the City of SeballJan, Florlcla, hereto- fore, now and hereafter adopted or provided for the 80vemment and operation of sald cemetery. The conditions, reltrlcllons and requirements contained In this Inllrument shall be covenants l1lIlIIina with the land. In the event of the failure of the owner of any property lituated within sald celllt!tery to 00- IeMl and comply with iuch rules, resulatiOllI, resolutions and ,ordinances and the conditions of the dl!led of conve)'UIce thereof then the title of Illch owner In and to &aid property shai1 terminate and the .me shan revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The saIcI party of the first part has caused this Instrument to be execu In It I name and on Its behalf by Its Mayor and attelled by Its City Clerk and It. corporate _I to be hereto afllxed, the day and year first above written. Altes~::tI~lJJ ~ .f)d<<.ffi1,~,....,.., ...........(/... Clt, Clerk (QIitv JIltlll) STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEREBY CERTIFY, That on thla ......,J,Qt.l:t..........d., 01 ......Sept.ember................,............., 1193, b.lo.e me per.on.lly .ppe.red .~.~~~~.~.. ~.... .p~~~.~.l........ .. .. .... ...... .. .. .., and ~~ ~,l.t,17Y.~ ..~.~.. ~ ~ .~~~~,?!:~~.. re.pt'cllvel, Mayor on,l Clt, Clerk 01 the City 01 Seb..t1on, . munlel..ol eo,por.tlon under the I..... 01 the St.te 01 Florida to me Irnown to be the Individuals alld offlc... d_rlbecl In and who exeeuted the lore' going eOllvey.n... to , .,...,.. ...".....,...,..............,....... . . . . .1;..~qh~.~4.. $.9.lQ1Il9,t:l.,............ . . . ...,.,... .,'.'"..................,'. . ". , . . , , . .. , , .. .. .. . . . . . .. .. .. . . .. . . . . .. .. . .. .. .. . .. . .. .. ., and sever.lly aclrnowledeed the exec:uUon thereof to be their Iree ad and deed os ....h oln.er. the....nto dul, .uthor......; .nd that the Offlel.1 ..,81 01 ..Id corpor.Uon Is duly affllled thereto, and the said conve,anee 10 th. Ad and deed 01 said eorporaUon. WITNESS m, slp.ture and offlel.1 ..... .t Sebaat"n, In the Count, of Indian River end St.te of Plorida, the d., and ,e.r 1111 afor..a1d. H JOANNe 8AHD8ERG .....,.....,....... FlIIlllII __ CIlIMlIIIlan EllpIIw APR .. ,.. CClw.t, 0000.- H. Joanne Sandberg Name j E "~'~\."L (I ,t\ c'l'\ ~ t~ 0 (1 ':~i f' 0 ,. . ...... ,...., '- i . Unit '-I Block '2"~ .-J....) Lot ~\ Date of Mark-out d j '.'" i i....'() , ~~ 1 ,./ I' Date of Burial / i[', }',7' 1, Y/U\./ .i~OO (:). Time ' ::~'Yf'-L:: \:':'. ,,~'-.k ~ <' Name of Funeral fiJ" . ..J. ' '- .;-':'.,':'; . . v ..--.-\" / . · /1. '/1/ i! / ,1 >; /,0'1,. h} / I,,'l} j Authoril..edby \7"~-~V:f--:t. ".1/ i/ \.c. .,.... '> "",-,,-,/ ..,/ .' Q.r ~lDmonJ ~no..rd. 1/^FR.o~aJ~m $. ~e,b(Lj:J..jan) r-L,8d16~ ~J'i;J4, LtJ rill, ()/t>ek 33, UniH YeeiiP ~ /.J;f ~ ~Jd O~ tLnic/,y h-tiI?ce5lY7.~/tJm()n -i{}Wred r/cJ1 )q~ Lo+~ 1-E~/lJ) E. SoL O~C/) - /'..J+€,uU'D ~/60 L.6 T 2/ ])eed~ /~~ " 11~ J,ht'h~~ I ....., - '- --.' ..- , Paid by CEMETERY Receipt No. .... 7.?~...... .Dated.. ..~.~~.QI.~.~............... Lot 21 500.00 ., Block 33 Ust Pn'ce $ Maxunum No. Burial Spaces. . . . . . . . . . . . . . . . tJ . t 4 .................. nl Net Paid $ .. .50.0...00...... Monument permitted....................... NO. 1424 Leonard Solomon (Data above tills line tor City Record only) .~'C'~, . . 110 THE SEBASTIAN CI1E'rERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA (oS: 1/Jd 1ft/ ) - FROM.: on this da following described stated herein: 19 t?~ for the purChase of the upon-rne-'terms and conditions as Description of Property: _ / Cemetery Lot(si ~lOCk ;:53 uni.t ~ Purchase Price; . ~ Dollars ($~?; Xerms and Condition of sale: Xhis 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: ~~ Xhe City of Sebastian agrees to sell the above mentioned property to the above named purchaser(s) on e terms and conditions stated in the above instrument. 6t~ ~ / Witness . . I \ \ \ ~ ... -~:;. ,- ." .: '<:'.'~~~~t';:~,~~~ , ... ~, .~~ i\:. .0- .(0 .~ ~ - Z;r j.il..... Ooc -W-w , Oo=- ~~~it .,,~&:~ ,Q9I~~ G:..,~~ ~i! 8::.. ...,~ >-< 16 'it -I "::;1: !Lt._ Y.: i .. ........;; """0 . .''': I I I I , f 'S':?:~'J9~':'O::'> '''~c~-'-.'''''C"",,~----,- . ,"(y 0 '" " ~\ IJ'r; ~ ~ ~ (; ,~ <.1 <, ~ ,p ('hI" \'_)\.~ Pf llCp.,tlo . City of Sebastian POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 September 17, 1993 Leonard Solomon 114 Royal Palm Street Sebastian, Florida 32958 Dear Mr. Solomon: Enclosed is Cemetery Deed No. 1424 for Lot 21, 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. v~>;;.' tJ~A- Kathryn M. O'Halloran City Clerk KMO:lmq enclosures .. FLORIDA DEPARTMENT OF S.f Florida, Department of Health, Vital .tiCS APPLICATION FOR BURIAL - TRANSIT PERMIT ~@~ /3 33 1/1 A. (TYPE) 1. Name of First Middle Deceased Leonard 'Edward 2. Place of Death City, Town or Location County Indian River Sebastian 3. Name of Medical Address Certifier N. Noor Merchant, M.D. Last Date Month of Solomon Death. Apri I Name of (If neither, give street address) Hosp. or Inst. 114 Ro al Palm Street Day Year 2 2000 Phone Number Medical Examiner Physician Address 1623 N. Central AVe. Sebastian, FI 7744 Bay Street Sebastian, FI 561-589-0879 4.. Name of Funeral HomelDiNlll 91811111181 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 Fla. Lie. No.lReg. No. Phone No. (Area Code) 1228 56':-589-1000 b. E Rachel was contacted on 4/3/00 He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death, and that Dr. Merchant will complete and sign the medical certification of cause of death within 72 hours. c.D was contacted on He/she verified that , Medical Examiner, will complete and sign the &:ir~~l B;"''''''''''''!l;jl T Date Signed 4/3/00 6. Funeral Director/ B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose ofthis body. Permit No. 1228-00-0168 o Afive (5) day extension of time for filing the. death certificate (exclusive of weekends) has been requested and granted since lhephysicianhas been contacted by the funeral director and will not be able to complete the medical certification of cause ,.of -death section ofthe death certificate within 72 hours. ONO extension oftime for filing the death certificate has been requested. 8eSi.'AIr IIr Subregistrar Signature Date . ~ Issued: Lf. '2. l &...c. Date Certificate l l Due: '4,.... C. AUTHORIZA TIONfor CREMA TION,DISSECTION, or BURIAL-AT -SEA Approval Number: Date Medical Examiner, ,gave,authorization by telephone to , Funeral DirectorlDirect Disp'oser. 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 .forallcremations. D. CEMETERY OR CREMATORY ~BURIAL DSTORAGE Date of Disposition Sebastian Cemetery 'f/6/ov Method of Disposition: Place of Disposition DOTHER (Specify) } ,~~, Ir~~? 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. o CREMATION Signature of Sexton or Person-in-Charge DH 326, 8/97 (Obsoletes all previous edKionsj (Stock Number. 5740-000-0326-2) DiatrWion: While: Cemetery or Cremetory Yallow: Funeral Director or Direct Disposer Pink: Local Registrar