HomeMy WebLinkAbout4-30-09
mity of &rbu.atiuu
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1861
NO.
THIS INDENTURE MADE TIIk
4TH
.. ,..........
day of
........ ..SEr'r.~M.~ER.................... A. D.,XilC ~9.D2
between the City of Sebastian, a municipal corporation existing undcr the laws of the State of Florida, os Grantor and
CLAUDIA F. MUNGO
..................................... iT3'()" BRE'EZY' 'WAY~" iz '.:. 6' ...........'
, . ... ... .. . .......................... SEBASTIAN.,. . .F.l ORI.DA.. 32.958,. ....
of the County of ....):NP.J..t;\N..RJ.v~R................... an-1 State of ....FLORIDA......................................
as Grantee, WITNESSETH I
That the Grantor for and in consideration of the sum of $ ) R 9... 9. Q . . . . . . . . . . . . . . . . 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 .... . . . .. heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
All of Lot(s) ...?.. ,Block,... ~.Q.. ,UNIT. . fJ. ..... .... ,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 rust 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.
A Uest :
C) fl' -
~~........l1?....................... .
/ Cit;' 6~~k
CITY OF SEBASTIAN, FLORIDA
By .W.4.\v.~~............,
Mayor
.. .. . .... . ..~~4!m4?......,..
~.,i!.~...,6~..,...
(dHttl ~eaJ)
ST ATE OF FLOlllDA
COLTNTY OF INDIAN RIVER
I HEHEDY CERTIFY, That on this
4th
,day of ...... P~.P.t~!I1'!J.~X............................., ~..4002
before me personally appeared... ~?~.~~~. Y!.... .~.?,:r;!1e.~......"..,....,.,.,........ and. .S.9.ll.y. A.... .:t1.9.:i..Q... ,.......,..
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 Ilnd who executed the foregoing conveyance to
........................................ ........... ~l.~.':l.~~?:. .~... ..~1f.I?-g~."...............................................,....
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . . , . . . . . . . . .. and severally acknowledged the execution thereof to be their free act and deed
as such officers thereunto duly authorized; and that the Official scnl of said corporation is duly affixed thereto, and the said conveyancc
is thc act nnd deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the
last aforesaid.
H. JOANNE SANDBERG
MY COMMISSION # DD 089532
EXPIRES: April 30, 2006
Bonded Thru Notary Public Underwrite,s
County of Indiall River and State of Florida, the day and year
;')~. I //
r?Y:.. ./..~~..r;:;y~kq.,.,.,..".,.,.,.
Nota PubUc, State of Florida at Larger-y
My c mmlsslon expires I
/
Name 4 J /J::.',r'; (3 M t/ )f c) /-) 5 K... .
I
Unit
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Block
3D
Lot
q.
Date of Burial
9/3/0'V
9/"Ilc) 1-0 .
Time / D .' b 0 4. .
Date of Mark-out
Name of Funeral Home
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Authorized bY' //-;</ ~;1'/OL
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Unit,
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Block
Lot
Date of Mark-out
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Date of Burial
/1,'01> A.
Authorized by
CLAUDIA F. MUNGO
Paid by CEMETERY Receipt No. . . 9.~ ~.4.. .... .. Dated 9/4/02
List Price $ ..?~9.~ 9.9....... Maxunum'~~ ~. .~~........... ...... ...
. . ur paces.............'....
NO.
Net Paid $
700.00
..................
Monument permitted. . . . . . . . . . . . . . . . . . . . . . .
j1861
LOT 9, BLOCK 30, UNIT 4
(Data above this line for City Record only)
CnYOf
SE~AS:r!AN
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HOME Of PELICAN IS.LAND
September 5,2002
Claudia F. Mungo
1130 Breezy Way, #2-6
Sebastian, Florida 32958
Dear Mrs. Mungo::
Enclosed is City of Sebastian Deed number 1861 for Cemetery lot 9, Block 30, Unit 4. Also
enclosed is a copy of your receipt.
If you have any questions, please contact our office.
{2.l1J-' -
SAM:js
enclosure
The Sebastian Cemetery
City of Sebastian, Florida
Receipt is acknowledged in the sum of:
~)/~cifL--I~ Dollars ($ 7thJ, ,hj
(!iu~ r; n~/
//36/ ~::x/ #,p-t
e;/~1U.' /~' 3cl;JSg--
on this "I tit day of ~~?, 20 cJ ,;2 for the purcluise of the following
desoibed Cemetery Lot(s)/Nich (s) upon the terms and conditions as stated herein:
)
From:
Description of Property:
Cemetery Lot(s),lNiche(s) '1 Block
Purchase Price: ~iy4#!~ & ?7~d~d/
,
3tJ Unit -7
Dollars ($ 7#,M
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:
Purchaser signature
Purchaser signature
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.
.--"'
(;City of Sebastian
Witness
. ,
@ DELUXE R$F .
CITY OF SEBASTIAN 0983
"11 0-l"1:l CITY CLERK'S OFRCE
0 :oOl> RECEIPT
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CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
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State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
U7
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j~q
FLORIDA DEPARTMENT OF
A.
(TYPE)
1. Name of First Middle Last Date Month Day Year
Deceased Alfred J. Mungo, Sr. of Sept. 1 2002
Death
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
I ndian River Roseland Inst. Sebastian River Medical Center
3. Name of Medical Address 8005 83rd Avenue Phone Number
Ce rtifie r Michael VenaZio,~;D.
nMedical Examiner Physician Sebastian, FL 772-388-2110
4. Name of Funeral Home/lilo...", ulsposal' Address Fla. Lie. No.lReg. No. Phone No. (Area Code)
Establishment 1623 N. Central Avenue
Strunk Funeral Home Sebastian, FL 1228 772-589-1000
5. Check
Appropriate
Box
a.D
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
b. t!J
Liz .was contacted on 9/3/02
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Venazio will complete and sign the medical
certification of cause of death within 72 hours.
c. 0
was contacted on
He/she verified that
, Medical Examiner, will complete and sign the
B.
e of death within 72 hours.
F.E. No.lReg. No.
1862
Date Signed
9/1/02
6. Funeral Director/
liirel;l ulsposer
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-02-0367
o 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 will not be able to complete the medical certification of cause-of-death section of the death certificate within
72 hours.
ONO extension of time for filing the death certificate has been requested.
~glstrar or ·
Subregistrar Signature
Date
Issued:
9/1/02
Date Certificate
Due: 9/6/02
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.
Method of Disposition:
~BURIAL
DCREMATION
Signature of Sexton
or Person-in-Charge
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
D.
o STORAGE
Date of Disposition
9/ i/o~
DOTHER (Specify)
} ;f><jJ '1. ;t:L>C)..
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.
DH 326. B/97 (Obsoletes all previous editions)
(Stock Number: 5740-000-0326-2)
Distribution: White: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar