HomeMy WebLinkAbout4-29-37~tt~1 ~f ~P~MB~tMtt
1st February 99
PHIS INDENTURE MADE Thla ...................... day ot ............................................. A. D., 18......,
behreen the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, oe Grantor and
...........................................J.obn ..~.., .. Me.~.o ~>^ ................................................................ .
P.O. Box 780922
............................................~ebast.ian,...FL ~.~.2978.........................................................
of the County at ....Indian..Ri.ver ,,,, ^nl State of ...Florida
as Grantee, WITNESSETH,
That the Grantor for and in consideration of the sum of $ 1 ,.OOO : OO , , , to it ' brand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ,~1; 8, , , , heirs, legal representatives and assigns
the following property situatedQQin Sebastian, Indian River County, Florida, to-wit:
All of Lot(s~ ~, ,&, , 3 81ock, 2 9 , , , , ,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 Umes 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 Fust part has posed 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 fast above written.
Attest: .. ~.G~'lr.~..~~/~6C.-~C~I+C:4r:......
City Clerk
Signed, Scaled uncl Delivered
In th rese~ofs
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
((llitq ~ceal)
I HEREBY CERTIFY, That on this ........~.$.~...........dny of ........~'.~t?~;uary ....................'.........., 19.9,9
before are personally appenred ........................................................... and .......................................
respectively Mayor and Clty Clerk of the City of Sebastian, n municipal corporation under the Inws of the 9tnte of FlorWa to me known
to be the ludh•idunls and officers described In and who executed the forego{ng copveyunce to
.............................................. J ohn.. L. ~ .. Me r.c e r ............................................................... .
, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, and severally acknowledged the executlmr thereof to be their tree act and Bred
as such officers thereunto duly authorized; end that the Official seal of said corporation Is duly of ' hereto, and the said conveyance
is the act and deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the
last nfurrsaid. .~-
LINDA M. t1ALLEY
MY COMMISSION N CC 740478
EXPIRES:June ig,2002
ea,asa mm rmm:y wwk tmas:wikots
CITY OF SEIIABTIAN, FLORIDA
/~
II y ~j~u1!1 ............................ .
Mayor
of Florida, the day and dear
My
I.61 Florkla at I.ar . .......................
1
J
•
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City of Sebastian
1225 MAIN STREET ~ SEBASTIAN, FLORIDA 32958
TELEPHONE (561) 589-5330 ~ FAX (561) 589-5570
February 8, 1999
John L. Mercer
P.O. Box 780922
Sebastian, FL 32978
Dear Mr. Mercer:
Enclosed is Cemetery Deed No.1674 for Lots 37 & 38, Block 29, 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 ol~ice 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 for
more information regazding 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 for your
convenience.
Sincere ,
Kathryn M: O'Ha-:oran, CMC/AAE
City Clerk
KOH:hng
Enclosures
• •
THE SEBAST.ZAN CEMETERY'
CITY' OF SEBASTIAN, FLORIDA
Y
OF THB SUM OF:
Dollars ($ ,~
FROM:
on this --f--- day of v 39
following described Ceme ery Lot (s
conditions as stated herein:
for the purchase of the
upon the terms and
Description of Property: ' ~.
Cemetery Lot ( T ~ B1ock %~~ Unit
~~~1~--
Purchase Pr e: ~ ~
Dollars ($ ~•,~
Terms and Condition of sale:
This contract sha11 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 City of Sebastian agrees to se 1 the above
the above named purchaser (s) on t and
above instrument. /a
or S•
Toned property to
Lions stated in zhe
Witness
r
1 ~
Js.% ,fpT
Name j ~ /~"': f~~ f~~'"': ,~,,~'> p' ~
,~°
Unit /
~,
Block
Lot ~ ~~
Date of Mark-out
•{ r .r
~,,l~ ~,r ,. n
Date of Burial / ~ ~`~~g'~ Time
T.._. .
Name of Funeral Wome
`,:, - ~`
f
Authorized by - ~ -..
_ _ _.
~ (~ ~ ,~~- r ~ ~cef
0 wN ~. ~ • ~x ~p9aa
S~ 4s~-t Q>n
Paid by CEMETERY Receipt No ................. Dated .............................. NO.
List Price $ .l ,.OOO.: OO Maximum No. Burial Spaces ................ .
Net Paid ,1, 000.00
$ Monument permitted ....................... ~ ~ ~~~
~,
~,~„ i~r-
,-*
(Data above this line for City Record only)
FLORIDA DEPARTMENT OF
HEALT
A. (TYPE)
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
Q L, 3I
Q. ,g ~y
U`~
1. Name of First Middle Last Date Month Day Year
Deceased of
Kathleen B Mercer Death April 2 2001
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Sebastian Inst. 1022 Genesee Avenue
3. Name of Medical Address Phone Number
certifier Richard Penly, M. D. 8005 83rd Avenue
Medical Examiner Physician Sebastian, FL 561-581-9977
4. Name of Funeral Home/Di-eat'Df5r1~5'd'I Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 1623 N. Central Avenue
Strunk Funeral Home Sebastian, FL 1228 561-589-1000
5. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. ~ J osette was contacted on 4 / 2 / O 1
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Penly will complete and sign the medical
certification of cause of death within 72 hours.
c. ~ was contacted on He/she verified that
Medical Examiner, will complete and sign the
medic c ifi ion of a f death within 72 hours.
6. Funeral Director/ i ature F.E. No./Reg. No. Date Signed
~+' s. '"' 1862 4 / 2 / 01
e. BURIAL - TP.ANSlT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-01-0173
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.
~No extension of time for filing the death certificate has been requested.
ftegistrar~r+ Date Date Certifi ate
Subregistrar Signature .e . , ~,~ (1~ ~ ~ Issued: ~ `Z.I Q ( Due: t~~? J ~ /
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number: Date
Medical Examiner, ,gave authorization by telephone to
Funeral DirectorlDirect Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. Awaiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemetery
BURIAL STORAGE Date of Disposition -~ (, ~~r /
^CREMATION OTHER (Specify)
Signature of Sexton
or Person-in-Charge -
~6 b--p~
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.
Distribution: White: Cemetery or Crematory
DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer
(Stock Number: 5740-000-0326-2) Pink: Local Registrar