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TH1S INDENTURE MADE TW� .....6.t.Yl............ dxy or ..........J.anuar.y ....................... w, n., DY2,�.QQ
behceen lLe Gty of Sebnstian, e munictpel corporatfan e:ieting undcr the lewe of the Stete of Floride, ne Grantor and
................................................ Phi.lzp..E...Gix.ou..a.nd/.o.r.. �J.len..Ci.x.ou..........................
8006 141st Street
. .. . . . ......... ... ........................... . . Sebas L i�ar�•,• • .F.L.. 3 29•58.... , ... . . . . . . . ... . . .. . . ........ ... ....... . ... .. ...
of the County of .�?1.C1.7.$A.Ra.V�.X' ....................... an:l 5tate ol Flor,ida.................................
ae Grantee, WITNE89ETHi
That the Grantor for and in considerat3on of the sum of S 1 J �� �•�� ... , to it in hand paid, the receipt whereof Is herewith ao-
knowledged, does by this instrument grant, bargain, sell, celease, convey and confirm unto the Giantee t�? e i T, heirs, legal rep:esentatives and assigns
the following properiy situated in Sebastlan, Indian Rivec Coanty, Florlda, to-wit
All of Lot(g)13 & 14 glock, . 3 �. ... , UNIT 4. ...... ...., of Sebastian muniapal cemetecy as per Plat Numbec 1 thereof cecorded in Plat
Book 2, at page 65 of the public recocds in the ofFice of the Cleik 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 focevei; provided that said property shall be used solely and exclusively foc the interment o( the human dead and shall
be used, kept and maintained at all times in accordance with the rules and regulations, ocdinances and cesolutions of the City of Sebastian, Florida, heceto-
fore, now and hereafter adopted or ptovided for tha government end operation of said cemetery. Tha conditlone, restrictions and roquirements contalned
In thla inetrument ehall be covenante tunning with the lend. In the event of the tallure of the owner of any property eitueted wlthin eald cemetery to oh-
serve and comply with such rules, regulatlons, resolutions and ordlnances and the conditions of the deed of conveyance thereof then the tltle of such owner
in and to said pcoperty shall terminate and the same shall revect to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said pazty of the Cust pazt has caused this instrument to be executed in its name and on its behalf by its Mayor and
atteated by Its City Clerk and its corporate seal to be heceto affixed, the day and yea[ fust above written.
Attests —� ��«�`:•5'1.+......
Clty Cterk
CITY OF SE13A6T/IAN'�, FLOftIDA
p� (/,Y��1f w^^' . . . . . . . . . . . �. : . . . . . . . . . .
Ma�or
Signed, Scelecl und Dclivered
In t6e P se o(e •
.. .. ..... ....f� .G./ (� . . ... . .. ...... ((dirg �e�l)
.... .�.. .....` ...................
STA'CE OF FI.ORIDA
COUNTY OF INDIAN RIVER
I Hk1iEDY CERTIFY, That oa tnu ...... 6th........... aaY �t .......... January ............................. lYi.�Q�
betore me perconally eppearcd Chuek Neuberger .... .. ................. Q„aKathryn M. 0 Halloran
........................... ..............�..................
respcetively Mxyor and City Clerk of the Clty of Sebextien, u muNcipul corporntlon under the luwa ot the 3tate of FlorWa to me 1[nown
to be the Individuuls und offieere desedbed In und who exeeutcd tlie toregoing euwveyunee to
..........................................P.hiJ.i.p...E.....C.izau. sndl.or..�l.lan..Cizau...............................
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, and severally acknowledged the executimi thereot to be their trce act end dee�
as such ofticers thereuntu duly authoriced; snd that the Ofticful scul o[ sald puratiun fe duly attixed thrreto, end the safd cunveyance
la thc xct und deed of aeld corpor�tlon.
WITNES9 my signnture nnd otticlsl xsl at Sebestlan, In the Count of I e an 3tate ot Fto�ids, the day end �es:
�xst utureedd. ��
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,° »•„ LINDAM.OALLE1f
���MY COMMfS510N 1 CC �IM7B
EJ(PIRES: June 18, 2002
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Date of Burial �//� /% ' Time � � � L ��
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PHILIP E. CIROU
Mr. Philip E. Cirou, 90, died June 7, 2012 at his residence in Sebastian.
Born July 7, 1921, he was a lifelong Floridian and lived in Sebastian for 28 years
coming from Fort Lauderdale, Florida.
He served in the US Coast Guard during the World War II on a sub-chaser in the
North Atlantic and crossed the Arctic Circle, "Northern Domain of the Polar Bear"
finrice.
He was a member of St. Sebastian Catholic Church, a Life Member of American
Legion Post #189 Sebastian, FL and one of the founders of the Holy Name
Society of St. Sebastian Catholic Church.
Survivors include his wife of 37 years, Ellen Cirou of Sebastian, son, Mark Cirou,
daughters, Michele Cirou, Catherine Libman, brothers, Tommy Cirou, Corky
Cirou, Frank Cirou.
.- -�
F�,own}nrr�rd�rnF: ;' State of Florida, Department of Health, Bureau of Vitai Statistics
����T BURIAL TRANSIT PERMIT
DATE PRINTED: June 8, 2012 TRACKING NUMBER: 2012077830
�. DECEDENT INFORMATION
Name of Deceased Date of Death
PHILIP E CIROU June 7, 2012
Place of Death - County City, Town or Location Name of facility, or street address if not a facility
INDIAN RIVER SEBASTIAN 8006141ST STREET, SEBASTIAN, FLORIDA 32958
Name and Address of Funeral HomelDirect Disposa! Establishment Fla. Lic. No./Reg. No. Phone Number
STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000
1623 N CENTRAL AVE
SEBASTIAN, FLORIDA, 32958
Funeral Director/Direct Disposer Fla. Lic. NoJReg. No.
TIMOTHY W. MARVIN F022789
2, BURIAL - TRANSIT PERMIT
The Florida Department of Health, Bureau of Vitai Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes.
Permit Number: 2o12-FO4197o-5o1s
• aG / �� • Date Issued: June 8, 2ot2
4 J�
Meade Grigg, State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: SEBASTIAN CEMETERY
Method of Disposition: BURiAL Date of Disposition: / /
Signature sexton r person-in-charge or by the funeral director/direct disposer when there is no sexton)
DH 326E, 1/11
64V-1.011, Florida Administrative Code
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING !N SEBASTIAN MUNICIPAL CEMETERY
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For information contact:
Kip lEelso - Cemefery Sexton
Sebasfian Munlclpal Cemetery
(772) 589-2545
City Clerk's Office
City Hall, 1225 Main Street
Sebasfran, FL 32958
o�ce (r�2) ss8-8245 or 3ss-8294
Fax: (772) 589-5570
STRUNK FUNERAL HOME b CREMA30RY
FUNERAL HOME: ���3 No;en�ra' "�•-
ADDRESS: SEBASTiAN, FL 32958
PHONE #:
( h One�
OPEN BURIAL LOT
OPEN CREMAINS LOT
OPEN COLUMBARCUM N1GHE
,�,SJB� DATE AND SERVICE TIME
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FOR DECEASED: �" 1 �
Name
�ot ��-�--
Lot
Niche
v��cl. ,
Block �/ Unit
Block Unit
Block Unit
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NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide pro � r documentation of ownership}
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Name Signature Date
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 SIG TURE O� LICENSED FUr NFRAL DIR�TOR: �
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Name Signature Date
Cemetery Sexton Certificatian:
I certify that I have checked the ownership information by viewing the owner's deed and confirming
with C�erk's office and that all fees have been paid:
� i
Cem �ery ext n Da e
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.