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Home My WebLink About4-32-03 " . Paid by CEMETERY Receipt No... .11....... . Dated .... .~.9!. t~ !.~?:............ Li.t Price S . . . . ~.~9. : ~~.. . . . Maximum No. Burial Spaces. . .. . . .. .. . .. . . . . 800.00 Lot.& 4 Blo 2 Uni . NO. Net Paid S 1JBO Monument permitted. .... ... ...... ..... . .. . (Data above lhla Une lor City Record ooly) Q!itt! nC t;rbuatiun (ttrmrtrfg IIrrb "1380 NO. 19th THIS INDENTURE MADE 'lloIs .,... day 01 October 92 A. D. 18......, bet...een the City 01 Sebastian, a municipal corporation existing under the laws 01 the State 01 Florida, aa Grantor alld ...................... .J,., G... .Q.r.. .l'.<Htly. ..J.... ..~.!j..u:i-.lil... ... 534 Layport Drive .................. ........... ........... Sebas.tian,. . Fl.oxida . 329.5.8.. ..................................... 01 the eollnty 01 ...... ..~n~.:!-.I:!n..~.~~~.~................. ani Slate 01 ....... ..f.l~r:i.d.a.......... ................... as Gralltee, WITNJ.tSSETH. That the Grantor for and in consideration of the .um of S ... ~.9~: ~9. . .. . . . . . . . . . . to il in hanli paid, the receipt whereof is herewith ac- knowledged, doe. by this instrument grant, barg.m, sell, release, convey and confirm unto lhe Grantee . ~~~.~~. heir., legal representativ.. and assign. the following propert.y situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(.)3. ~ ~ . .. ,Block,. ~?: . . .. ,UNIT ...... ~ . . . .. ,of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 65 of the public records in the office 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 shall be used solely and exctusivety for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rutes and regulations, ordinance. and resolution. of the City of Seba.tian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restriction. 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, resolution. and ordinances and the conditions of the deed of conveyance thereof then the title of .uch owner in and to said property .hall terminate 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 it. behalf by its Mayor and atte.ted by its City Clerk and its corporate seal to be hereto affIXed, the day and year fu.t above writt Alt::~~/: /.. .Y/)..{)ok.t~~~....... esn-n.~.' /. City Clerk Signt.d, Sealed ami Delivered In the relienee of: (ClIitU ~elll) STATE OF FLORIDA COl'NTY OF INDJAN RIVER I HEIlEOY CERTIFY. That on Wa ........ ..l.9.to...... .day 01 .O.c;.t;p.\>.e.r..............................J I~?"J Lonnie R. Powell Kathryn M. O'Halloran b"'ure lI1e personally appeared ..................................... and ....................................... respt'e1ively Mayor and City Clerk 01 the City 01 Sebastian, a municl..al corporation under Ihe law. of the State 01 Florida to me known to be the Individuals and officerti described in ",nd who executed the tongoing cOllveyunce to ........................... .............. J.".G.,. .9.-r. ..~lH.I?Y..J::.. H~r+.~~... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . .. . . . . . .. and severaUy acknowledgl-d the execution thereof to be their Iree ad and deed as such olflcers Iberellnto duly autborbed; and tbat tbe OWcial seal of said corporation Is duly affixed tberelo, and the said conv.yance i. Ihe act and deed of said corporation. W tTNESS my signature and olllclal aeal at Sebastian, In tbe Iltsl ufo resaid. ~ ".lOHSl.. NoWy PIAllIc>$IaIa 01 FlCllIdI8 Mv CemmIo_ ExpIraJUN tI.ltll4 COMM 'CC Cl227... 01 Indian River and State 01 Florida. the day and ,ea. Linda M. Lohsl Name J., ,/"~- IV /;/l;iJi2;.i(\.; ~~ Unit 4 Block ::) "~:'~. Lot Date of Mark-out '7~ , .' :' i,~,' ';, ' i CI Date of Burial 9 . /.' ;-,. .'(,./ ,:;",.:<" ju Time .-' -, Name of Funeral Home. .. .,..J: iC, J :' Authorized by ,:,( ",~ e' ~~ift'~f!{?v; ))eed 3etxLa{.fu) J:L a:;tqOo UJ+5 3ft i 7> 1 DcJ<- 6c:2} Un i + 4 L.C4rn'::J ir7Jerye/JQ)Q/fo bJ'i- 3 /300 '- ...... Paid by CEMETERY Receipt NO.....?} ~_..... .. Dated..... ~.Q!' t.~ I.~ f:.. .......... List Price $ .. .. ?~9.: ~~..... Maximum No. Burial Spaces............. .... Net Paid $ .... ~.~?: ~?.... Monument permitted... ........ ........... . Lots 3 & 4 Block 32 Unit 4 (Data above this line for City Record only) :r NO. 1080 . ,"1V .0,,- "Ii /.~ lJ'I ,(,J. I ~, ~ - / <:<- +o~4 S i'~ ~~ o~ PF:lIC~" \s',.;. '\ . City of Sebastian POST OFFICE BOX 780127 0 SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 October 23, 1992 L. G. & Patsy J. Harris 534 Layport Drive Sebastian, Florida 32958 Dear Mr. & Mrs. Harris: Enclosed is Cemetery Deed No. 1380 for Lots 3 & 4, Block 32, 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.~r;lY yours, DeLI ~m. TIIlffi-rA~ Kathryn M. O'Halloran City Clerk KMO: Iml enclosures I~ A. 1. Name of Deceased State of F.. . aJ Department of HealthJ Vital Statistics . APPLlC. N FOR BURIAL - TRANSIT PERMIT I- !~ t; 1 ~. LI '-" I 7 -'l ....) .:.Jif-, (Type or Print) First 2. Place of Death County I ndian River 3. Name of Medical Certifier Noor Merchant, M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Home 5. Check a 0 Appro- priate Box 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 the death certificate requested. jiq_",:~l H ~. 1.. (\ ~ .~ Subregistrar Signature <...:J ~t:rJ.,.,~ -, ~ - - L. 6. Place of Sebastian Final Disposition: 7. Funeral Director/ Di,rQQt IIL,...~ww' B. Middle Last Sebastian DATE OF Harris DEATH Sept. Name of (If neither, give street address) Hosp. or Inst. 534 La ort Drive Address 1998 Month Day Year Gene City, Town or Location 16 Medical Examiner Phone Number X Physician 77 44 Sa Street Address 1623 N. Central Avenue Sebastian, FI Sebastian FI 561-589-0879 Fla. Uc. No./Reg. No. Phone Number (Area Code) 1228 561-589-1000 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b)Q Dianne was contacted on 9/16/98 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 Dr. Merchant 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. River F.E. No./Reg. No. 62 Removal from state Donation Date Signed 9/16/98 BURIAL - TRANSIT PERMIT Permit No. 1228-98"":0400 Date Issued: ~ ~ \I. \9'! g~~~ ~~el ~~ 'S 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. Methods of Disposition: .e3' au RIAL o CREMATION o STORAGE o OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition _~A h-. L L t"5 Date of Disposition .:.I' j27;_ k I~, /., '7 B Signature of Sexton ) or Person-in-Charge) :f /-,.':'~ ~ e //"~ This permit must be endorsed by the Secton 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. DH 326, 10/96 (Replaces HRS Form 326 which may be used) (Stock Number: 5740-000-0326-2) :J