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Home My WebLink About4-30-37 aBly of ~tbu.6ttun ~tmtttry m ttb ,16 ',I " ~ NO. THIS INDENTURE MADE TIIIa ......16 th. . , . , day of .......... E e hr:ua r.y.. .. . .. .. .. .. .. . .. ... A. D., 19. 9.9.., belween Ihe City of Sebastian, a municipal corporation existing undcr the laws of the State of Florida, os Grantor and ".,.".,.,..,....,. ................ ~9.I),$,t~n~g. .M.... .S.P/3.t:.~.I?................. P.O. Box 877 , , . . .. , . , , . . .. .. . .. .... . .. .. .. ...... Ro s e.land., . . FL. . .3 2 9 5.7. .. .. . . .. .. . .. . . . . of the County of .. ..+.If,4;i,~.t:l.. g;i.y.~.:r;.................... ani Stote of ..... ;E'.';I, <;>.:J;".:t q!3: ..................................... as Grantee, WITNESSETH I That the Grantor for and in consideration of the sum of $ ?~ 9.9.Q: .q9.............. to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargam, sell, release, convey and confum unto the Grantee .l:1.~~. . .. heirs, legal representatives and assigns the followingllroperty, situated inj)ebastian.,I)1dian River <;ount.l(, FloRda, to-wit: 21 , 22 , z 3 , 24, 2.5 , 2 () , 27 , .)4', 35 , 3 b , 3 / , 3 tl , All of Lot(s)39.,.4{l., Block, .. ,3Q. .. ,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 Riyer 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 conditlons, 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 prDperty shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the fust 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 fust above written. CITY OF SEBASTIAN, FLORIDA Au.,R(~mD~~........... . II . . City Clerk B1~Jr,~................... MaTor Signl'd, Sca d IIl1ll Dclivered In the sen e of: _ I .. .HZ~HHHHHHH. ",."" ,::., ,4,C(~~~~~~<:~::....... ....... (<1titl,l ~t'lll) TATE OI~ FLOIllDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this ..........~f!):;h,......day of ..........F~l:>.:I::.l,l.a~y.................".........., 19.9.9, Ruth Sullivan Kathryn M. Q'Halloran before lIle personally appeared ,....,........,..........,..,...,....",.,"",..."...,.,. and ...,................................... respl'clively Mayor and City Clerk of the City of Sebastian, a municlpul corporation under the laws of the State of Florida to me known to be the Indl\'idulll. ulld officers described In Ilnd who execulcd the fo[('golng CORveYllnce to "..,...". ..... ....... ................<;:.(H1~,t.~P~E:!,. M.... .~.P.~):;E:!.l?.... ......... ......"...,. .......... .... ..... ..... ....... ..... , , . , . . . . . , , . . . . . . . . . , . . . . . . . . , . . . . , . . . . . . . . . . . . . . . . . . . .. and severuily acknowledged the exec eof to be their free act and deed as sllch officers lhereunto duly Ilulhorizcd; and that the Official sClll of said corporation Is d y affi cd thereto, and the said conveyance is thc IIct IInd deed of said corporation. WITNESS last aforesaid. LINDA M. GALLEY MY COMMISSION It CC 740478 EXPIRES: June 18, 2002 Bonded 111m Notary Public Und8!wrilers ......................... r \~.' Name (" ......... / "J rJ>N SIAAle ,6- Spit rES Jj '3D _?;; 7 Date of Mark-out 10 ,6a-/9;A I / - /0,43 IrA / / Unit Block Lot Time I 0 : eO It- /14; , Date of Burial .,.".~--'. "../ ,,;.,(' (., Name of Funeral Home ~, ,./ . ~ ," -_...,._-....'>n;;,'...,.~:";.f.'._......- '\ u" . .' ,.. .,...,.,l,~,:.....,.,...f! . :. ""._' ^;~...>.,',;f. -:-,..:;4"./".,";.' .,:,~.!.~.",,~. "'::':~,",.':.',: Authorizedby.;'.'._,1.::/ ., <<~. . ~~, ~.\ =' f rl\ r'\ . I ./ ) v'y'\ ; .' :5, [lB.~] State of Florida, Departme~ Health and Rehabilitative Services, Vital S.. tics APPLlCATI~OR BURIAL - TRANSIT PERMIT 37 '- -"J ",-~..."_.Cl- ':'" crt...-..", ,.,r::!r..~ './' I -- .' I ..... ....-. f6 3t) LI Lj I A. 1. Name of Deceased (Type or Print) First Constance Middle Last Spates DATE OF DEATH Month Day Year 10/21/92 City, Town or Location 2. Place of Death County Indian River 3. Name of Medical Certifier Pedro Espat, M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral 5. Check Appro- priate Box Vera Beach ..-J Medical Examiner Xl Physician Address Name of (If neither, give street address) Hosp. or Inst. 1080 31st Avenue Address 13855 U.S. Highway #1 Sebastian, Florida 32958 (407)589-8992 Fla. Uc. No.1 Reg. No. Phone Number (Area Code) Phone Number 916 17th Street Homes, P.A, Vera Beach, Fl 32960 130 (407)562-2325 a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b IXJ PF'g was contacted on 10/21/92 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 Pedro Espat, M.D. 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/ Oft ~Gt D;~~voe," Indian River FE No.lReg. No. 2088 Removal from state Donation Date Signed 10 21 92 ~ B. BURIAL - TRANSIT PERMIT Permit No. 0130-92-0473 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. ne\...l:ol. <11 UI ~ c... "" ~ ~lL.." - .....~ Subregistrar Signature - -.. T ", .... 'l'" Date . u 1_. I ... _ Date Ce,!i!ic,~. I........ Issued:~Due: ~ C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL -AT-SEA Signature or Medical Examiner, , Medical Examiner Date , 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. D. CEMETERY OR CREMATORY Methods of Disposition: . BURIAL o CREMATION o STORAGE o OTHER (Specify) /iJ f,~~YZ- Place of Disposition Date of Disposition 5E/3jJ"!:/J~ Ce#'J€J;Lj. lo/~ ~ /9~' , , Signature of Sexton ) or Person-in-Charge) 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 HRS County Public Health Unit in the County where disposition occurred. HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-2) J.