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Paid byCEMETEItYRecelpt No. ..l,U...... Dated...... ~1.U.l9.~............. Lot 22.
500.00 Block 33
Ust 'nee S.................. Mllllmem No. 8arlaI8.._................ 'Uni t 4
Ne! PaId S ..~~~:. ~.q....... Monmnent permitted.......................
NO.
1420
(D.t. ....... "'.. lhoe f", at)' Reeord _I,)
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NO.
THIS IND8NTURB MADR ...... ......~ !.~~........ d., of .........., ..~':',$~~~.... .................. A. 0.. I'..?~.,
belwem lhe Clt, 0' lIehtm.... . _Idp" eorpont.... eIlllt.... ...de. the I... of the .te 0' ......... .. Oml'" .....
Hr. Leonard Solomon
... ......,...', ............ .................11". 'R:oyltl' 'P~tln..Stt'~.t,,!.. .......,...,'... .........,.... ............., .......
..,...........,........ .................... ..S~~~~,~~~~.,..~~.~.1;~~~ ...~~9.~.~... .,........,........".......................
Indian River Florida
.f the CoentT of ............................................. ..i 81.te of ...............................,................,......
u 0..... WITNII88tn'H.
Thlt the Grmtor tor ..... In ClOIUIideratlon of the linn of S ..~. QQ , .QQ . . . . . . . . . . . . . . to It In hend ..Id. the teeeIpt whereof I. hemrlth II>
knowledted. dOlI by t.... ....._nt pant, ........ .., ....... CXI1IftF ..... _linn ...to the Gnnt.e . h 1-.". .. heln, ..I.....tet... ..... ........
the foDowhw paopeIty .........In lIeha.......,...... It.... CoUnt" FlorIda, to-wlt:
AD of Lot(.) . ~ ~. .. . 8lndt. . . . ~.~ .. . UNIT .......~..... ,of Sebaatlan manIc:Ipal_tery .. per PIlt Ntnnher t thereof..-.led In PIal
IIook 2. II .... 65 of the ,"",Be I8COIdIIn the of1lee of the Clerk of the ClrClllt Court llf It. t.adt Cct...., llf FlorIda: ... ...... IICIW .,......... beI1l8
In ,...._ It'- Count,. FlnrldL
Tll HI.. ..... to RelId the __ Ill_: pIOftled t.... aid prllpert, .... be _ 1Dlel, ..... exelutlnlJ Illt the Inte_t llf the ~ delcI ...cI ...."
be 1IIIll. bpi ..... w.lnblnlcl1I .. II-. In ....._ with the ntlII..... ....1ItIOM, llI'4n- ucI_111dn1 llf the at, of lIehastln, F........ heteto-
IllI8, _ ucI hetafter IIdC!ptelI cor pntt\dIcI ror the .,__t ..... opentIna of... -terr. The ClIlIIftIottt, mtrIetIont..... ....._t. _tolnecl
In IhIs .....ntNnt ..... be _It f8IIIIInI with the...... 'n the ...... of the ,.... of the _ llf.., pIOpett)> .....te4 within ... _tery to lib-
_ ..... comply with iueh ...... ......tlont, -'tttICl... ..... cmt......_..... the COlllIItIo... llr the .... llf .,.,...,.... thenclf then the tltle of -" __
In ...cI to aid pIOpett, .... t_....1e ..... the a_ theIl renrt to the Clt, llf lIehaltlt., FIoricIL
IN WITNESS WHEItEOF, The ... put, of the first put h.. call1lll tllll .....ntNnt tll be ,-,ell III It. n.me ..... lift h. behalf b, It. M.,or .....
.ttested b, lit CIt, Clerk ..... It. oorponte _I tll be hereto al1IxecI. the oIa, ..... year t1nt ten.
Att;'t;~l. f. .lr!.DII~~.... .
./. ~ CItT CIerIr
RIp<od. hied '"'" Dellnn"
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(flHv .,9.1")
STATE OF ".onmA
COl'NTY OF 'NDlAN tHVRR
17th August 93
I JlftRBBT eft"TlPT, ......t ... thIt ..,..,........,......,. .d., of .............,......................................, I..,...
....'nre ..... pen-n, .""mod ~mm~.~..R~. ..~~~~.U......................,........ ucI ~'.~h,;y..,.. H... ..Q.~fl"U~o.Q..
rn......II...I' M.,... .nd ell, Om of the en, of ltehaatlo.. . _..",,,..1 eorpor.t.... .nder .... ..... of the St.te or PlarhIo to IIll! ,,_
10 .... lhe h..lI~idu.l. .nd o'tkrn "-...... In .nd who eIleent.... the ,_....... eaa..q...... to
Hr. L emard Solomon
.. .. .. . .. . .. .. .. .. .. .. . .. .. .. , .. .. . .. . .. .. . .. .. .. .. .. ... end _er.", """now""''''' the eIlmat.... themJr to be t...1r I.ee .rt .nd dud
.t ..JCh ofFI<<rs themlldo d.l, ..thorbed I ..... thot the or""'.1 _I 0' ..Icl ...........t.... It ...., ern.cot the..,t.. ..... the ..Id eo....~'.nee
h t.... .rt ..... deed 0' ..Id -..-t.....
WITNUII IDJ' -'P'''''' ..... oItIeIaI _I at 8eho1t...., In the the d., ..... ,ee,
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Name
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Unit
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Block
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Lot
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Date of Mark-out
~--"-
Date of Burial
Name of Funeral Home
/i
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Authorizeci bYe "Y-,<>7 J/ '/(j'
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Time
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Paid by CEMETERY Receipt No. . .?~~......... .Dated...... !3.{J, 7.1.9J............. Lot 22
500.00 Block 33
List Price $ .. . . . .. . .. . . . .. . . . Maximum No. Burial Spaces. . . . . . . . . . . .. . .. . Un i t 4
Net Paid $ .. ~ ~ ~ . O.~. ..... Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
(Data above this line for City Record only)
a<~"
NO.
1420
.
77J
.
THE SEBASTIAN CltETERY
CITY OF SEBASTIAH
SEBASTIAH, FLORIDA
IS HEREBY ACKNOWLEDGED OF XU SUM OF:
Dollars (~)
FROM:
on this /~ day or
rollowing described Cemete
stated herein:
Description or Property:
CemeteI:!J Lot~ ~/ J-~ ~ Block
Purchase price~~~-Y
, 19a ror the purchase or the
upon the terms and conditions as
33 Unit 1
Dollars (sCitJft/ )
Terms and C;;lj1t'.5
Xhis contract shall be binding upon both parties, the seller and the
purchaser, when approved by the owner or the property above
described.
I, or we, agree to purchase the above described property on the terms
and conditions stated in. the roregoing instrument:
~~
Xhe City or Sebastian agrees
the above named purchaser(s)
above instrument.
f..
" ?z''.?l/ ./
~tness
, .
v
sell the above mentioned property to
the terms and cond tions stated in the
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City of Sebastian
POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330
FAX 407-589-5570
Auqust 23, 1993
Mr. Leonard Solomon
114 Royal Palm Street
Sebastian, Florida 32958
Dear Mr. Solomon:
Enclosed is Cemetery Deed No. 1420 for Lot 22, Block 33, Unit 4.
Also enclosed is a torm - Return tor Transters ot Interest in
Florida Real Property - which must be tilled out by you and
completed by the ottice ot the Clerk ot the Circuit Court when
and it you have the deed recorded. It you wish to have this
deed recorded, you may do so at the ottice ot the Clerk ot the
Circuit Court, 2145 14th Avenue, Vero Beach, Florida.
truly yours,
m. O~4.
o 'Halloran
KMO: j s
enclosures
"
-
State of Florida, Depart~ Health and Rehabilitative Serviees, Vltal.stieS
APPLICA11II FOR BURIAL - TRANSIT PERMIT
J.. c:2 /~ c;/ :J.-
/j 33
tI~
di'
A.
1. Name of
Deceased
(Type or Print)
First
Frances
2.
3.
N
4. Name of Funeral Home/
(')jrgf't niqpnC!!er
Middle
Marie
Last
Solomon
Month Day Year
08/19/93
DATE
OF
DEATH
City, Town or Location
Name of (If neither, give street address)
Hasp. or
Inst.
Medical Examiner
Phone Number
7744 B~y Street
Phone Number (Area Code)
m-/~
1623 N~rth Central Avenue
5. Check
Appro-
priate
Box
Permission is hereby granted to dispose of this body.
o A five clay 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 death 'ficate st
Registrar or
Subregistrar Signature
6. Place ~f Se.bastian
Final DISPOSItIOn:
7. Funeral Director/
Oicect Ci81B~Ce..-
B.
C.
b Ci liz was contacted on 08/19/93 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 l\Tnnt" M~1"<:,h~nt J M n will complete
and sign the medical certification of cause of death.
c 0
was contacted on . He/she verified that
, Medical Examiner, will qomplete and sign the
medical certification.
Removal
from state Donation
Date Signed
BURIAL - TRANSIT PERMIT
Permit No. 1228-93-0391
Date
Issued:
?-19.~
Date Certificate
Due:
AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA
Signature , Medical Examiner Date
or
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. '
D.
Methods of Disposition:
. BURIAL
o CREMATION
Signature of Sexton )
or Person-in-Gharge)
CEMETERY OR CREMATORY
o STORAGE
o OTHER (Specify)
..,
~ ~~,07
/
Place of Disposition S r- A A< I , Jf1 V
Date of Disposition ~ / ~ / / cr ~
/? --=
l./ r .dJ L.. 7 I' .If! II .
/
~~ q,
I
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)
:;