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HomeMy WebLinkAbout4-31-56wUnit Block J 1 Lot Date of Mark -out Date of Burial % ` Time 419Av I' Name of Funeral Home Authorized by FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR �URIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBosTtAN Nowa PIZe D For information contact: Kip Kelso • Cemetery Sexton Sebastian Municipal Cemetery (772) 589.2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388.8214 Fax: (772) 589.5570 FUNERAL HOME: ADDRESS: PHONE #: 11 (Check One) )PEN BURIAL LOT Lot Block Unit _ OPEN CREMAINS LOT Lot Block Unit ..._,OPEN COLUMBARIUM NICHE Niche? W. Block—=Unit W BURIAL DATE AND SERVICE TIME: / 6 0 0 FOR DECEASED: rvame NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Name W1 Signature Dale I certify that I have determined the ownership of the above described site that all site fees and administrative fees have been paid and authorize opening of same NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR. ,or Name Signature Date -------------------------------•--•--- Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office Ind that all fees have been paid Cem ry Soklon Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. .A CITY OF SEBASTIAN FINANCE DEPARTMENT RECEIPT 9969 arfim van lto ❑Cash Date 1-11-16 [a Check # 110 ❑ Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit - 001501362100 Taxable Rent - 001501362150 Non -Taxable Rent - 450010 369900 Airport Badge 001501 329500 Alarm Permits 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 369900 Miscellaneous Revenue 001501 359000 Other Fines/Forfeitures 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 343805 002LEM Fae 5h -nn Total Paid 50.00 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant oma SEBASTIAN HOME OF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENT FORM I, Stuart Norton, Grantee of City of Sebastian Cemetery Certificate #1724 by way of Jeanette Selig's will, do hereby transfer my interest in the following: Unit 4, Block 31, Niche 56W of the Sebastian Municipal Cemetery to: Lorraine Rossmiller 7653 Niantic Avenue, Unit T3 Micco, FL 32976 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow interments in their interment sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation." I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of Sebastian. uart Nortn State of v { q {i vl { d County of t' �� Before me on this K� day of �i5, personally appeared Stuart Norton, known to me or who produced �LI1 e -e U&PFig2.. as identification, who acknowledged tome that he/she/they executed the same for the uses and pur ose erein set forth. Wotarpublic Signatuni Printed Name: My Commission x ' l I 14 Sa erwich Notary Stamp: COmmonw a vginia Notary Public Commission No. 148337 My Commission Expires 116016 The City of Sebastian hereby consents to the transfer of burial rights: By:/Z/�i^— ATTEST: Joe�City M nager Sally A. May, MMC - City Clerk App ed as to Form and Legal Sufficiency: o ert A. Ginsburg, CityAttorney ma SEBASTIAN HOME OF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENT FORM I, Mark Norton, beneficiary of one forth (1/4) interest in the City of Sebastian Cemetery Certificate #1724 through Jeanette Selig's Last Will and Testament, dated February 9, 1996, do hereby transfer my interest in the following: Unit 4, Block 31, Niche 56W of the Sebastian Municipal Cemetery to: Lorraine Rossmiller 7653 Niantic Avenue, Unit T3 Micco, FL 32976 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow interments in their interment sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation." I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of Sebastian. (ss.) Mark Norton State ofI County of i,m- j jt� Witness Before me, on this � day of Y nk1 D)S, personally appeared Mark Norton, known to me or who produced0-Vi2m,&Arij6M1s fc&rneas identification, who acknowledged to me that he/she/they executed the same for the uses and purposes herein set forth. -NoPublic Signature Printed Name: I lip"• My Commission Ex ' Notary Stamp: RY' PUBLIC y cc REG is 7594455 = — _ ; MY COMMISSION = EXPIRFs C' The City of Sebastian hereby consents to the transfer of burial right: By: e ATTEST: Joe Griffi , City Vanager Sally A. Appr ed as to Form and Legal Sufficiency: Robert A. Ginsburg, CitfAttorney City .m, SEBASTIAN HOME OF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENT FORM I, Michael Norton, beneficiary of one forth (1/4) interest in the City of Sebastian Cemetery Certificate #1724 through Jeanette Selig's Last Will and Testament, dated February 9, 1996, do hereby transfer my interest in the following: Unit 4, Block 31, Niche 56W of the Sebastian Municipal Cemetery to: Lorraine Rossmiller 7653 Niantic Avenue, Unit T3 Micco, FL 32976 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow interments in their interment sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation." I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of Sebastian. A"t."d / %, Inc (ss.) Michael Norton State of MC, County of IZftIw Before me, on this Aayy of MI:1 '�IFersonally appeared Michael Norton, known to me or who produced identification, who acknowledged tome that he/she/they executed the same for the uses and purposes herein set forth. (-'Va,A+ln�en� Notary Public Signature POETY&W NOTARY RAW WAKE COWN.. NC 1101YOMOMMERM&210111 The City of Sebastian hereby consents to By. 2 Joe Gri In; City Manager Apprr add as to Form and Legal Sufficiency: Robert A. Ginsburg, City A torney Printed Name: 4 tJC� WC� My Commission Expires: Notary Stamp: ATTEST: '" 1 " I Sally A. Maio MMC - City Clerk cay« SEBASTL'W HOME OF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY TRANSFER OF INTEREST IN BURIAL RIGHTS CONSENT FORM I, David Norton, beneficiary of one forth (1/4) interest in the City of Sebastian Cemetery Certificate #1724 through Jeanette Selig's Last Will and Testament, dated February 9, 1996, do hereby transfer my interest in the following: Unit 4, Block 31, Niche 56W of the Sebastian Municipal Cemetery to: Lorraine Rossmiller 7653 Niantic Avenue, Unit T3 Micco, FL 32976 in accordance with Section 34-13 of the Code of Ordinances of the City of Sebastian which states: "Sec. 34-13. Sale of interment sites. No interment site owner shall allow interments in their interment sites for a remuneration, nor shall any transfer of interest therein be valid except by written consent of the city. No interment sites shall be bought or sold for speculation." I hereby certify that I have received no remuneration for this transfer. I request the consent of the City of Sebastian. 1 6;�( (ss.) David Norton State of (U�naSa hose County of ec4Asl\. ,e its Before me, on this "day of -Pecc v , 3D Is, personally appeared David Norton, known to me or who produced "DW tueo U, tfr�& ( as identification, who acknowledged to me that he/she/they executed the same fUthheses and purposes herein set fo�6,,irMAA. s Notary Public Sign re Z Printed Name: My Commission Expires: '3,,1k� �jg , r�n:3l c Notary Stamp: The City of Sebastian hereby consents to the transfer of burial rights: n _ ��wj \ / / By: /!�G ^-- ATTEST: v fp�l , Joe Griffin, City/ Tanager Sally A. Maio MMC - City Clerk Approved astoForm and Legal Sufficiency: Robert A. Ginsburg, City Aftorney K1•t4 L1 Y4 Xrjr 4a Kxs4 acts. Irme#Pr1ij Drrb NO. 12th April 2000 THIS INDENTURE MADE 71de ...................... day of ............................................. A. D., If....... between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ....................... ;.......................... J.eane.t.te..S.elig............................................................ 557 SW Acacia Avenue ............................................. .... Sebas-tiani.. FL...3295.g................................................... of the County of .. Indian..River ..................... ani State of ...... Flllr.i.da..................................... as Grantee, WITNESSETHe That the Grantor for and in consideration of the sum of $ L t 300: OO . . ...... . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee .1?errr ... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: Niches All of 5 5 & 5 6 Bloom 31 W UNIT 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. 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 used, kept and maintained at all times in accordance 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 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 first part has caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clark and its corporate seal to be hereto affixed, the day and year first above written. CITY OF SEBASTIAN, FLORIDA Attes�aa4tl.)71 .../ LLfCX..... B7 ..VY.tA-Gj` !-. ayoW....................Clerk M Signed, Sea f9 u d Delivered In the oft c - ......... ............ (Ctg Seal) STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this ....... 12th .......... day of ................ April........................... IR2000 before me personally appeared ...... , Walter . . .. W. Barnes .................. and Kathryn.M.,,,O,!HA119rap.. ................ respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the Individuals and officers described In and who executed the foregoing conveyance to Jeanette Selig ....................................................................................................................................... ........................................................ and severally acknowledged the execution thereof to heir free act and deed as such officers thereunto duly authorised; and that the Official seal of -said corporation Is duly x thereto, an the said conveyance is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the County io ian,. tvei/and Sta a of Florid , the day and year last aforesaid. LINDA M. GAMEY r MY COMMISSION II CC 740478 EXPIRES: June 18, 2002 ary ublic a of Florida at L ge. '' esmMd7lruNotary PubleUndenaerrr My co a pires;