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Home My WebLink About4-32-29Paid by CEMETERY Receipt No... IJ,t Price S 800.00 Nat Paid 8.0Q.00. Atte Signed, Sealed and Delivered In the Presence oft G7 (U/ City Clerk A fatioc..„4„, STATE OF FLORIDA COUNTY OF INDIAN RIVER bated 3/22/93 Lots 30 Bloc Maximum No. Burial Spaces Unit 4 Monument permitted (Data above this line for City Record only) (Situ of Ovbttottatt rmrterj fli'Pb 22nd March 93 THIS INDENTURE MADE This day of A. D if between the City of Sebutlen, municipal corporation existing under the laws of the State of Florida, as Grantor and Jobn P, 4 Rose..Rltxi 450 Memorial Avenue Sebastian,-Florida• •32958 of the County of Indian River anal State of FlgrAda u Grantee, WITNESSETH That the Grantor for and in consideration of the sum of 800 .00 to it in band paid, the receipt whereof is herewith as knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee thei hairs, lepi reproeentativea and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) A29630 Block 32 [)NlT 4 of Sebastian municipal 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 Circuit Court of St. Lurie 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 exclusively for the Interment of the human dead and shall be used, kept and maintained at all times In accordance with the roles and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government Ind operation of said cemetery. The conditions, restrictions and requkements contained in this instrument dull be covenants running with the land. In the event of the failure of the owner of any property situated withbs said cemetery to ob- xrve 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 and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has caused this instrument to e ted 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 abo, ;ten. CITY 1 F 9E11 T1A LORI NO. (City $eat) Nora Public, St of Plc a at Large. My laalon expl n Linda M. Lohsl NO. 1395 1395 22nd March 93 I HEREBY CERTIFY, That on Ms day of 1g...., before me personally appeared Lonnie R Powell and Kathryn M. O'Halloran respectively Mayor and City Clerk of the City of Sebastian, s municipal corporation under the laws of the State et Florida to me known to be the Individuals and officers described In and who executed the foregoing conveyance to John P. Rose Olivi and severally acknowledged the execution thereof to be their free aet and deed es such officers thereunto duly authorised; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance Is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the County of Indian River and e of Florida, the day and year last aforesaid. 1- 01,a i 01,r; 'X8 ✓cr 3 /ies- Unit Name Block Lot 9, Date of Mark -out Date of Burial Name of Funeral Home Authorized by J/ !.A. 0 y /,3/,p WAitcduov P Time I 3t 641 0 o o g g o 0 01 01 C. O c o o 0 0 0 O O A A W j N CO CO Co CD CD CO O O 0 La C O O O O 0 CD t0 0 rt' ry 0 Q m CD 3 z 3 n co m 0 m to T o y o 0) H o z d co 0 G1 3 0 d 0. 0 0 0 a 0 n 1 m mO m X CO yCf CD o y T T_ C m m A. B. 5. Check Appropriate Box 6. Funeral Director/ sireet- 24speser (TYPE) a. b c 01-1326, 8/97 (Obsoletes all previous editions) (Stock Number: 5740 000 0326 -2) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL TRANSIT PERMIT The medical certification has been completed and signed. A completed certificate of death accompanies this application. Sonja He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, will complete and sign the medical certification of cause of death within 72 hours. and that Richard T. Penly, M.D. medical certification of cause of death within 72 hours. i natur zv S l� nC our) BURIAL TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -10 -0388 A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and wit not be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. N o extension of time for filing the death certificate has been requested. or Date Date Certificate Subregistrar Signature Iiti(/`, Issued: 04/11/2010 Dye: 04/15/2010 c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA Approval Number: Date 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. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition was contacted on April 11, 2010 was contacted on He /she verified that Medical Examiner, will complete and sign the F.E. No. /Reg. No. Date Signed F044048 04/11/2010 EIBURIAL STORAGE Date of Disposition DCREMATION DOTHER (Specify) Signature of Sexton or Person -in- Charge 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. Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar Recycled Pap Name of First Middle Last Deceased John P. Olivi Date Month Day Year of Death 04/11/2010 2. Place of Death City, Town or Location County Indian River Vero Beach Name of (If neither, give street address) Hosp. or Inst. VNA Hospice House 3. Name of Medical Certifier Richard T. Penly (Medical Examiner (Physician Address 1265 36th Street Vero Beach, FL 32960 Phone Number 772/567 -6340 4. Name of Funeral Home /Direct Disposal Establishment Strunk FUneral Homes Crematory Address 1623 N. Central Avenue Sebastian, FL 32958 Fla. Lic. No. /Reg. No. F041870 Phone No. (Area Code) 772/589 -1000 A. B. 5. Check Appropriate Box 6. Funeral Director/ sireet- 24speser (TYPE) a. b c 01-1326, 8/97 (Obsoletes all previous editions) (Stock Number: 5740 000 0326 -2) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL TRANSIT PERMIT The medical certification has been completed and signed. A completed certificate of death accompanies this application. Sonja He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, will complete and sign the medical certification of cause of death within 72 hours. and that Richard T. Penly, M.D. medical certification of cause of death within 72 hours. i natur zv S l� nC our) BURIAL TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -10 -0388 A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and wit not be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. N o extension of time for filing the death certificate has been requested. or Date Date Certificate Subregistrar Signature Iiti(/`, Issued: 04/11/2010 Dye: 04/15/2010 c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA Approval Number: Date 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. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition was contacted on April 11, 2010 was contacted on He /she verified that Medical Examiner, will complete and sign the F.E. No. /Reg. No. Date Signed F044048 04/11/2010 EIBURIAL STORAGE Date of Disposition DCREMATION DOTHER (Specify) Signature of Sexton or Person -in- Charge 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. Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar Recycled Pap OI ;v, Jhri aVd o irk/nor/al %e 644aikei), FL X245 S 4245 &g.450 a U .t Paid by CEMETERY Receipt No 746 Dated 3/22/93 List Price 800.00 Maximum No. Burial Spaces Unit 4 Monument permitted (Data above this line for City Record only) Def J Lots 29 30 Block 32 NO. 1395 RECEIPT IS REBY ACKNOWLEDGED OF TEE SUM OF: /6 FROM: on this day of following described Cemete stated herein: Description of Property: Cemetery Lot( s) d Purchase Price Terms and Condition of sale: 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 conditions stated in the above instrument. Witness THE SEBASTIAN CEETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA 4,1994 A-34, /..acesin QCS y Lot(s) ite,,k 44e &.(5/ Dollars 'lam 19yf for the purchase of the upon the terms and conditions as Block (5Z Unit Dollars (s ?ee• March 25, 1993 John P. Rose Olivi 450 Memorial Avenue Sebastian, Florida 32958 Dear Mr. Mrs. Olivi: Enclosed is Cemetery Deed No. 1395 for Lots 29 and 30, 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. Very truly yours, Kathryn M. O'Halloran City Clerk KMO:iml enclosures City of Sebastian POST OFFICE BOX 780127 o SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589 -5330 0 FAX (407) 589 -5570 7. t