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Home My WebLink About4-31-41w wuy Ul ~tUUHltUll eemttery meeb. 1620 NO. THIS INDENTURE MADE 'I1aII ...' 3rd . , , . . . day of ,...... .~r~~.. .. .. .. .. .. .. .. .. .. .. .. . .. ... A. D., 19.?~.., between the City of Sebastian. a munlclpal corporation existing under the laws of tbe State of Florida, 08 Grantor and .. ...,.....,.......................... ..I,9.:i,~. '~'" .I?~.i,nt;e;(."............,...,... 13225 US 1, Lot 30 .....",......,............................. Sebastian,. ,FL. 32958..,.,........... ..............',....,........,'........,.. of the County of.. ~!).~.~~. R~ X~;l: .. .. . .. . .. .. . .. . .. .. .... ani State of ......... f.J,o;(iQI;l.. , .. .. .. .. .. , .. .. , .. .. .. . .. . .. .. . .. a. Grantee, WITNESSETH, Tha t the Grantor for and in consideration of the sum of $ ..? ?q : 9.Q , . . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargam, sell, release, convey and conllrm unto the Grantee h~F..... heirs, legal representatives and assigns the followl!lg.property situated in Sebastian, Indian River County, Florida, to-wit: 1'1lche All of USfm . 4 ~Wli!~ 1; 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 exclusively for the interment of the human dead and shall be uled, kept and maintained .t all time. in accordance with the rules and reiulatlons, ordinance. 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 conditions, restrictions 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, 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 llrst 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 corporate seal to be hereto affIXed, the day and year first above written. CITY OF SEBASTIAN, FLORIDA Atte.~{,,-~.}Y)...CYla(JLM~ (j City Clerk By W.~,W.~................. Mayor Gi::'.:~\:~ . :E::~;;ZJ;;'.............. STATE OF FLORIDA COl'NTY OF INDIAN RIVER I HEIlEDY CERTIFY, That on thll .. )~~.......,........ .day of (QIitll ~l'1l1) March 98 19. .. ., b,'f'Jre me personally appeared . ,~~~~.~~. .~'.. ~~~'?.,....,......................,... and~.t;~~.~~.,9.'.~~;1,<?~~n...,..... respI'ctively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the l8\\'s of tbe State of Florida to me known to be the Individuuls lInd officers described In and who executed the for,'golng CURvcYllnce to . . . . . . . . . . . .. . . . .. .. . .. . ... ... ... . .... . . .... .. . . . ,LQis. A. . .Painter... . . . . . . . . . , . . . ... . . . . . . . , . .. , . . .. . , . . , . '" .. . .. . . ... .. . . . . .. . . , . . . . . . . , . . , , . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and .everally acknowledgeti tbe execution thereof to be their free act and deed as such officers thercunto duly .ulhorlled I and that the Officl.1 seal of said corporation I. du\ af xed thereto, and the said conveyance Is tbc oct and deed of said corporation. UNDA M. GALLEY MY COMMISSION' CO 37 EXPIRES: June 18, 1 Bonded Thrv IloIIry PullIIc of Florida, the day and year WITNESS my signature and official JeIlI at Sebas~lan, In th last aforesaid, , Unit ~/lL~f/ "I .3/ It. /}I/A/me (CR-e/11 Name Block t-ot ti,e;' ~ tt ,tJ/ WE-S r Date of Mark-out ,2.. A- /'1 a / / Date of Burial d/S;/ f8 Time ;2..: 00 ;?,~ Name of Funeral Hom~/. 'i ,/ '-,/:;/! .-' ; . ~-,~> :I ' Authorized b~ .. "'~"",,~-,,--, ~ -- :~'-"~><-",'~.)"'- ,;,)~":.'<(,,~~,,""P';~; 5 >fJ. ~ I J' rlr ((!fer; /-tI/5 /3~J~ 1/5 / lvi] Seb. rL 3.?foo " A{ch~ 73/ j _ 4/ 3/tU L1r7l/ttWL~) fJe'# / ic7tJ !I~ I rJ-5 -tJ ~ '- - .-' ~ "'] r: ;v"" .". '....,~ .,'\' Paid by CEMETERY Receipt No. . . . . . . . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . List Price $ . . . ~~?:.~? . . . . . . Maximum No. Burial Spaces. . . . . . . . . . . . . . . . . 650.00 Net Paid $ .................. Monument permitted. . . . . . . . . . . . . . . . . . . . . . . NO. 1620 (Data above this line tor City Record only) . . q1D THE SEBASTIAN CEMETERY CITY OF SEBASTIAN~ FLORIDA Dollars ($0?...~M ) FROM: for the purchase of the upon the terms and Description of Property: Cemetery Purchase Pri ~- Unit Dollars ~'~ '!rm~~'r5~~tio~ 1}safe: 0/(; ~~ ~~/ltff~1C ~ c ntract shall be 'binding upon bot purchaser, when approved by the owner 0 , i15~ arties, the seller and the he 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 the above named purchaser (s) above instrument. iy\ \ ~, CZi\JCAJJ~l(J.~h Witness "- " . . PLEASE PRINT DECEASED NMIE: L H -( it. s. AR~ V) (J3 69 IUIIT! DATE OF BffiTIl: !MONTH! '0"" )7 !YUill ------------------------------------------------------------------------------------------------ FOR OFFICE USE ONLY .wAC" t// COLtJ1\tmERIUM: Iwt:nl NICH I NUlVIBER: ~ ~ . ,'1y 0 '" "- \ F.l ,.".. "':fI . ~ ~ - ,<:r +(7~1] S \,~ O/' PELIC~ . City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589-5330 0 FAX (561) 589-5570 May 8, 1998 Lois A. Painter 13225 U.S. 1, Lot 30 Sebastian, FL 32958 Dear Mrs. Painter: Enclosed is Cemetery Deed No.1620 for Niche 41 West, Block 31, Unit 4. Also enclosed is a form - Return for Transfers of Interest in 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, P.O. Box 1028, Vero Beach, Florida 32960. We are enclosing two copies of Receipt No. 970 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. Sincerely, ~m. Oil~A- Kathr)n M. O'Halloran, CMC/AAE Ci~ Clerk KOH:lmg Enclosures ~1' \..; State Of~12a.J' Department of Health, Vital Stati~tics APPLlC~ FOR BURIAL - TRANSIT PERMIT . /!/ /f / ,.(j 3/ J() 117' DATE Month Day Year OF DEATH January 21, 1998 Name of Deceased 't: (Type or Print) First RalP~ '. <I: Middle Herbert last Painter Place of Death City. Tor... n or Location Name of (If neither, give street address} County ..... . l-tlsp. or Indian Rl~ ms 13225 ' 0.S.#1, Lot 30 Name of Medical) Medical Examiner Address Certifier ' . , 2500 S. 35th Street Frederick Robin, "n Physician Ft. pierce P'L 34981 Name of Funeral Home/ Address Fla, lie. No.1 Reg. No. Direct Disposer. 1937 Old Dixie I '103 KB0000285 _Indian River Creaa~iCl18I Tnc. Vero Sea h II.UU~~ Check \ a The medical certificaticn has been comp:eted af'd signed. A completed certificate of death accompanies Appro- ;. this application. priata .' Box Phone Number c III I- 1 I was contacted on within 72 hours after death. He/she verified t/1at this death was from natural causes, that there was 110 accident nor other external cause of death, and that will complete and sign the medical certification of cause of death. ~rick Rnhi ft, M. n. t{ijcWrick HobIn. M.D. medical certification, was contacted on 1-21-98. Yelshe verified that . Medical Examiner, will complete and sign the b 0 1 :' \ Place of Final Disposition: Funeral Director / Direct Disposer FE No./Reg. No. KA0000235 Removal from state Donation Date Signed , ~. .. BURIAL - TRANSIT PERMIT 1 Permit No.195-98-021 Permission is hereby granted to disp~e of this body, '] A five day extension of ~lme lor fili~9 the death certificate (exclusive of w~ends) has been requested and granted as undue hardship would result from filing within the normal time limit.lf the certificate cannot be ti:ed withIn this extended time limit, a "Funeral Director/Direct Disposer Report" will be fjled wit the Local Registrar of the County in which death occurred. ,i No extension of time for filing t d~"th certificate rested Registrar or ,} ~.J:~ Date 1/22 me Date Certificate Subregistrar Signature ,. /L. Issued: , ~ Due: .j '.AUTHOR~ATION for CREMATION, DISSEC'nON or BURIAL-AT-SEA 't ME# 98-19-060 Signature ., or ~ Medical Examiner. Fr~dr H~bin, M.n. . gave authorizatior by telephone to Paul Goodridge . ~ FLineral Dlrec:or/Direct Di~fCSer. Date, 1/22/98 The Medica! Examiner's approva! must be obtained before jispcsal by 2.nyof the above -rethocs. A w::liting period of 48 hours after death is required for all cremations. , "1edica: Examiner Date FOR FUNERAL DIRECTOR/DIRECT OlSPOSER USE ONLY Date Burial-Transit Permit (pinl( copy) was filed with Loca! Registrar: Date Temporary Certificate was filed with local Registrar: Date complete Certificate was f:led with Lecal Registrar: Follow-Up Efforts & Activities (Note parties & dates :o'ltacted\: Name and place cf dispOSition: 'S&('-)('"J':, \l c....>"' C!.eME Tc:R.~ 0fJ Fwnera: D'rector/Direct Disposer Report filed: Yes _ No Date F~d' :l~49'eJ FUNERAL DIRECTOR/DIRECT DtSPOSER COpy ), 326. 10/96 (Replaces HRS Form 326 ..h,ch may be vsed) Stock Numller: S140-COC.0326-2) J.