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Home My WebLink About4-30-02 .- w.tty ot t'tbu.attun ..' 4lrmrtrry mrr~. NO. r '1 ,:, "j 0 .. u (O THIS INDENTURE MADE TIaJa 23rd day of March 99 A. D.. 19....... between the City of Sebllstlan, a munlclpal corporation existing undcr the laws of the State of Florida, as Grantor and Mrian 3Bn M:!1tm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12766 . '1'2 8th' . Street. . . . . . . . . . . . . . . . . . . . . . .................. .... .................. ..~~s.e~.a~4~..fl: .~?~~~..................... of the County of ........... ..lnc;l;i,l;tJl. RiYe~.............. ani State of ........ Florida.................................... as Grantee, WITNESSETH, That the Grantor for and in consideration of the sum of $ .... ?Q9..QQ.............. to It in hand paid, the receipt whereof Is herewith ac- knowledged, does by this instrument grant, bargaID, sell, release, convey and confirm unto the Grantee l;1~,J;' . . . .. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, florida, to-wit: All of Lot(s) ~... .. ,Block, .~9.. . .. ,UNIT ... ~ . . . .. . ... ,of Sebastian municipal cemetery as per Plat Number 1 thereof recorded In Plat Book 2, at page 6S 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 hereatler 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 faiiure 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 lUst part has caused this Instrument to be executed in its name and on Its behalf by Its Mayor and "....." 'Urn, CI... md '" 00''''''. ..1 '0"'............ U. do,'" '-7~~,(..... MaTor ') (Qlitu J&enl) STATE OF FL A COUNTY OF INDIAN RIVER 23rd I HEIlEDY CERTIFY, That on this ....................... .day of March 99 19... .. before me personally appeared .~~~~..~. ~ . !!,~~;qg~;-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and I<at~. '~'" . Q ~ ~;u.~J;"!w. ... . . .. . resp,'ctively Mayor and City Clerk of the City of Sebastian, B municlplIl corporlltlon under the laws of thc State of Florida to me known to be the IndividuAls And offlee.. described In and who executed the fOfl'golng COtlveYllnce to Marian Shawn Melton ....................................................................................................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. and severally acknowledg..d the execution thereof to be their free act and deed .s slleh officers thereullto duly authorlscd I and that the Official seul of said corporation Is duly affix iNreto. and the said conveyance Is the lIct ..nd deed of Bald corporation. WITNESS my signature and official seal at Sebastian, In the last aforesaid. \\ K Name Ge.Y'\ .ev~ N.' I Groom Unit 4 Block ~o Lot ~ Date of Burial J.j /(0 1 'let I ;J I ,~ f q~ I I Date of Mark-out Time II: 00 /1 /fl. Name of Funer'~1 Home. ) { .(~, i.- .,,,1. '",,(' ,-,' ",,::t~_.,:>//;,~^d~'"Z}t:,? Authorj?:~d_by. ' Q.r. ------_._-----,.._-_._-~~--_.-.._- Paid by CEMETERY Receipt No. . . . . . . . . . . . . . . . . Dated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1./ .. 30 - 02.. List Price $ . . . . . . . . . . . . . . . . . . NO. Maximum No. Burial Spaces. . . . . . . . . . . . . . . . _ Net Paid $ .................. Monument permitted. . . . . . . . . . . . . . . . . . . . . . . /'1878 (Data above this line 101' City Record only) . . THE SEBASTIAN CEMETERY CITY OF SEBASTIAN~ FLORIDA Dollars ($ ~. f!/J--J the Description of Property:' () Cemet:ery Lo~ (S~che ~ Purchase Pr~ce: J to '" . Terms and Condition of sale: Block 3L Unit: .. J Dollars (~tJ- ~J This contract shal.l 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 Ci ty of Sebastian agrees to se :z the the above named purchaser (s) on th te above instrument. Witness March 23, 1999 Merian Shawn Melton 12766 128th Street Roseland, FL 32958 Dear Ms. Melton: . . City of Sebastian 1225 Main Street 0 Sebastian, Florida 32958 Telephone (561) 589-5330 Q Fax (561) 589-5570 E-Mail: cityseb@iu.net Enclosed is Cemetery Deed No. 1678 for Lot 2, Block 30, 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 or you may call or call the Department of Revenue at (904) 488-9487 f~r more information regarding the completion of this form. We are enclosing two copies of each the receipt and ask that you sign and return to us the copies marked with an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided f~r your convenience. Sincerely, ~m. t)'l/tUI~A- Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:lmg Enclosures I~ State o~da, Deparbnent of Health, Vital Statistics . APPL510N FOR BURIAL - TRANSIT PERMIT Ld.- .(? 30 1/1 A. 1. Name of Deceased (Type or Print) First Last Month Day Year Middle DATE OF Broom DEATH Feb. Name of (If neither, give street address) Hosp. or Inst. 623 3rd Street S.W. Address 15 1999 2. Place of Death County I ndian River 3. Name of Medical Certifier Frederick P. Hobin, 4. Name of Funeral Home/ DiJe.t 9iel!38lilillio. Geneva City, Town or Location Vero Beach Medical Examiner Phone Number M.D., M.E. Physician 2500 S. 35th Street, Ft. Pierce, FI 561-464-7378 Mdres&,. Fla. Lic. No.1 Reg. No. Phone Number (Area Code) 16B N. Central Avenue Sebastian, FI 1228 561-589-1000 Strunk 5. Check Appro- priate Box Funeral Home a The medical certification has been completed and signed. A completed certificate of death accompanies this application. b 0 was contacted on 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 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 Cemetery Final Disposition: 7. Funeral Director/ Oi~"t It'il" IIr I ndian River F.E. No.1 Reg. No. 1862 Removal from state Donation Date Signed 2/16/99 B. BURIAL - TRANSIT PERMIT Permit No. 1228-99-0089 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. . ~e!lil!t1 al .!II Subregistrar Signature ~~~~d:~g~~~~t:t~ Iq~ C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA , Medical Examiner Date Signature or 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 d!3ath is required for all cremations. D. CEMETERY OR CREMATORY Methods of Disposition: B BURIAL o CREMATION o STORAGE o OTHER (Specify) Place of Disposition Date of Disposition J(.~-r~ G~ ~ ':f.d.x.uCU1'\. I <\ I \ q q q Signature of Sexton ) or Person-in-Charge) ~"w:'-..)., ('10......1- This permit must be endorsed by the Seeton 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 (Replace. HRS Form 326 which may be used) (Stock Number: 5740-000-0326-2)