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Home My WebLink About4-33-31 " Paid by CEMETERY Recei~t~~............ Dated....... ~.~!. ~.~~?........... ~~~~k_ List Price $ .. .~ 9.9~: ~9... .. Maximum No. Burial Spaces...... ....... .... Uni t 1000.00 32 NO. Net Paid $ Monument permitted....................... '1430 (Dala .bove thIs line ror City Reeord only) Q!Uy uf &rbnstinu C!rttttrtrry IItt~ , 1430 NO. THIS INDENTURE MADE TIaIa .......... 5th day or ........... October 93 A. D~ 1......., bet,,'e.n the City or Sebastian, a municipal eorporaUon e.I.Unl! under the laws or the Slate or Florida, .. Grantor and . ,B~s.~.:i.~. .Johns.o.o... .........,.....'.. 1053 S.W. Blossom Drive ,Seba,s.t.ia.n.,. . Flo.:r;ida. . 329.58 of the County of .. :r!,\(;IJ!'HL~.:i,y:~.J;............... ani State of ............... .f:J..o,r:;I,<;l,l;t...............,........... as Grante.. WITNESSETH, That the Grantor for and in oonsideratlon of the sum of $ .......~ 9.Q9.: ~9. . . . . . .. . to it In hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, seU, release, oonvey and oonfmn unto the Grantee .1:1 ~~. . .. heirs, legal representatives and assigns the foUowing property situated in Sebastian, Indian River County, Florida, to-wit: AU of Lot(s) . ~ ~. ~.~ ~ Block, . . ~ ~. .. ,UNIT ......!+...... ,of Sebastian municipal cemetery as per Plat Number I thereof reoorded in Plat Book 2, at page 65 of the public reoords in the ofOce 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 shaU be used ""lely and exclusively for the interment of the human dead and shan be used, kept and maintained at aU times In acoordance 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 oonditions, restrictions and requirements oontalned In this instrument shall be oovenants running with the land. In the event of the failure of the owner or 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 oonveyance thereof then the title of such owner in and to said property shaU terminate and the same shan 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 oorporate seal to be hereto affixed, the day and year fust above written. (GIitll $eal) 5th I HEUEDY CERTIFY, That on this.. . . . . ' . . . . "day or October 93 I.,.. ., b,r".. me personany app...ed ......J?':l.n~e..R....Po.w~1.l, and Ka~~~XI1..~.~..~.'.f:I.~.~~?r.aI1.. re.p"cU...y Mayor and City Clerk or lhe City oi Seba.tian, a munkll,al torporaUon under the I.... or the Stale or Florida to me known to bt, th~ indi"itluulli utili o(flcrr8 described In und who rxecutl'd tht! lorc-going cOAveyanre to Bessie Johnson . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and s.verally acknowledl!rd the execution thereof to be their rree art snd deed as slIch otfie... ther.unto duly aUlhorised; and thai lhe Ottieial s..1 oi .ald corporation Is duiy .m..d tbereto, and the s.ld .onveyane. is the Het 8ntl deed of Bald corporation. WITNESS my signature and omclal ..al ..t Sebastian, In the County of Indian Klv.. and St.te of Plorlda, lh. day and ,ea, 18st Blurt"sald. -00'...00 No *1- lUV ~ lItlIItIIINIIO WI 1IIl!lCI:l /0 "'IllS."""", ~ H Vll390NYS 1NNyC'r '" . P~bllt; Si~l~ .~;~.................. mmlsllon t!xplreol' Joanne Sandberg " Name I':: 0 or' 1<' , f, "1 i'Y ,II! .....' '" ~ ) () t'\ ," ; ~....)-:) j~-.."" Unit -i Block ,~ -j Lot ~' f Date of Mark-out , , " ; C / ! Date of Burial / ," Ii _ j/,') ';':- i 1,.__..',' ,,-, "';' _;, Time '") i}' l'../-, ,( Name of Funeral Home, 'j I /, ":/' /' ..' " ," ._-.\~~~ ,~<., /~~;;; t;~::;;::' )I Authorized by.....~:t-V~..,r (.:t~-c./'--:"v "i '-- " -I" , J ',/ :r JJ~iJ)~ ~ ~oh()son,--;he;s:s ie /D5:!3 0:w.~/o(!/som"JJr: \3f2h~a.n J F1. 0;;< Cf5 '8 LDh (5/<t~1 B/~ B3,lLrJ;.J-1 f(an/J,'f) Y;hn~n"... )l1lerred' Jt>/..I9'-:5 b.) 0/ (O/~/Y'~ " 782 10/5/93 Lots 31 & 32 Paid by CEMETERY Receipt No..""........,.. Dated.......".."................. Block 33 List Price $ .. .~ ~.9~ = .~~.. '" Maximum No. Burial Spaces... . . . .. '" .. .... Uni t 4 1000.00 Net Paid $ ...........,...... Monument permitted. . . , , , . , . . . . . . . . . . . . . , . ~, " -'. --- \,~ if (Data above this line lor City Record only) NO. '1430 . . 7 ocSL THE SEBASTIAN CEMETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA d t14 /' Dollars (S / b.. fJ ~) FROM: on this,~~}---- day of t - following described cemetery Lot(s) stated herein: , 19~ for the purchase of the upon the terms and conditions as Description of Property: Cemetery Lot(SfiJ~!~ ,d Block Purchase Price ~~ L~\3 Unit ~ Dollars (S /~? ) Terms and Condi tiop of sale: "J \ )A /O[)O I &--' b*s / .j~:ftJ, 00 ;>>--tL&J t9fM~~ hi ~~4~)(JJ.,i{ 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: ~~~~~, Witness ' . ~v 0 L~ ~ I v, 8 I / ~ I, ( I ' ;:; .l ' ::>> "'Jt IJII~i ..a..... ~ ~ - I~ -I< ~ -'1 S 1 ~~Q O.f,~ '. ,s\,,'i'" Of: PEllCp..~ . Citv of Sebastian / ,J ~s / 1J /J / /v s;;F-. 3~ 9.5'"8' P'68f ~I"FICl! 8J:< 160127 0 SEBASTIAN, FLORIDA ~ TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 October 20, 1993 Bessie Johnson 1053 S.W. Blossom Drive Sebastian, Florida 32958 Dear Mrs. Johnson: Enclosed is Cemetery Deed No. 1430 for Cemetery Lots 31 & 32, 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. 782 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. Veq .!!:J.Y ..yo~..:. O.LI 'f1~irl. 'Ittftu~ Kathryn M. O'Halloran City Clerk KMO:lmg enclosure (\ws-form-cem.rec) GJ~1 State of Florida, Departna>f Health and Rehabilitative Services, Vital.sties APPLlCAT~ FOR BURIAL - TRANSIT PERMIT I-- 3/)3:J- /3 ,,33 L! /1 A. 1. Name of Deceased (Type or Print) First Franklin Middle Thomas Last Johnson DATE OF DEATH Month Day Year 09/30/1993 2. Place of Death County Indian River 3. Name of Medical Certifier City, Town or Location Medical Examiner Name of (If neither, give street address) Hosp. or Inst. 1053 S. W. B Address Phone Number Sebastian Michael Zimmer M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Homes 5. Check a 0 Appro- priate Box Physician Address 1623 North Central Avenue P.A. Sebastian Fl The medical certification has been completed and signed. A completed certificate of death accompanies this application. 2300-5th Ave. Vero Beach b Q Dr ZiIBBler was contacted on 09/2Q/19!1-3ithin 72 hours after death. He/she verified that this death was from natural causes, that there was no accident nor other external cause ofdeath,and that Mil"'h~~l 7.imm~,., M D 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. 6. Place of Sebastian Final Disposition: 7. Funeral Director / Direct Disposer ~~ Indian River F.E. No./8eg...blo. 1672 Removal from state Donation Date Signed 09/30/1993 B. BURIAL - TRANSIT PERMIT 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 he death certificate requested. Registrar or . .rt!... ~ Subregistrar Signature . ~ Permit No. 1228-93-0434 Date Issued: 7-3t/ -9~ Date Certificate Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA Signature or Medical Examiner, , 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. CEMETERY OR CREMATORY Methods of Disposition: . BURIAL o CREMATION o STORAGE o OTHER (Specify) Place of Disposition .~ /z.!.5 A- '5 ;; /hv Date of Disposition t D /:2.. /:; '3 ) c:;, r/1 L-J:i.c ~/' Signature of Sexton ) I/~, Q. < ,(, '--,:n. or Person-in-Charge ) 6-'( 'f" fu ~~ r 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: 5740-000-0326-21 J: