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Home My WebLink About2-12-14Paid by CEMETERY Receipt No. .43.4 ......:Dated ..March 21 t 19RC� . W.) a List Price S .. h00_00 ........ Maximum No. PuiW Spaces ... � ............ Net Paid $ . CiOQ f00• • • ... • . Monument permitted .. cf_1&t ............. t 8 0 Unit 2 Edwina Van Antwerp Block 12 FU Fox 893 Lots 13 14 15 16 (Data above this line for City Record only) c 95 , > > > Sebastian ,_17L :�2. � Ctv of Opbss#ian WPutrtrr e NO. 10,.,(.x THIS INDENTURE MADE TW .... Zl t............ day of ..... March ........... .... . ... . .... . between the City of Sebastian, a municipal corporation existing under the laws of the State of Florkla, &a Greait,, ........... . .............Edwina. Van, Antwt..... and /or. . John. dart. AncwPrp ............... , ............... . ...... , . ....................... E0..Brax..893............. Sebastian,. XL ... �2g5.H. ...................... I ..... . , .. . of the County of ... I(? C4aP. .]��Ver ......................... and State of .. Florida ............ , ... • ... • .................... . as Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ .. 69p_ � .. .... ......... to it in hand paid, the receipt whereof is Itcrewttl. u:o- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee , , ?t ... heirs, lest represent.,tives r,n; as: ^re,;:: the following property situated in Sebastian, Indian River County, Florida, to -wit: l •, 14 , All of Lot(s)15,..16 , Block, ,12..... , UNIT , 2 . , , , , , , , , , , of Sebastian municipal cemetery as per Plat Nvn ^t:er I there -of r,: c r.'•ew Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Flo.ida; said ": rct uuw )y i,q srr,::: in Indian River County, Florida To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for t::e interment o: the I,cmai ji- at. Ti . be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, fore, now and hereafter adopted or provided for the government and operation of said cemetery. The condition, restric'_tons ;ind regdyeiu c':t;: w in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated srithir, said verr o, e,; st serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof thin the tine of s:ac!t' 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 first part has caused this instrument to be executed in its narne.. au d up. its behalf by its h':iy:�` attested by its City Clerk and its corporate seal to be hereto affixed, the day and year first above written. At.................. ... Q City Clerk Signed, Sealed and Delivered In the Presence of . r..444-0 ...................... w..L ?... - ................... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEDAIST'IAN, Fl.O:JV -A By.................. I HEREBY CERTIFY, That on this ...........day of .....(`Mart~% . , ...................... ......... , ..., :its.:;` -3 before me personally appeared . L... Gene. Harris ...... ............................... and ,.a............. respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the haws of the State, of Flovidn to mz known to be the individuals and officers described In and who executed the foregoing coaveyance to .............. . ............... WWi.na. Var3. Antwerp.. aad /. ar..Jobla .Vw. Antwerp...... ............. . ...................... ............................... and severally acknowledged the executlun thereof to tie theie free st,i r t e' sal u such officers thereunto duly authorised] acid that the Official seal of said corporation is duty affixed thertte, me tea': F'!-'d r:�c.;•:: a:o e Is the act 4nd decd of said corporation. WITNESS my signature and official seal at Sebutian, In the County of Indian Ricer and State cf I+'loni0a, i!. a clip a +A tar last aforemid. Notary Pufillc, Seri to of 't t:+i My commission explser a tm i P: l y i #','Ht.c it 'ii if!: ,a.. is t. F• .:. iIC. - I On T Name /'C' e)e 1 V Fil d I ,iL Z' Unit Date of Mark -out ^ 2 C Date of Burial Time boo q 1 I Name of Funeral Home . A/u N D , Authorized by'—++t '��p�^�"'� o` a 0 C g �5 o� z c =o=g$g g a g z b H 1 i o w � Q N tL 0 W F W S Q2 I F V) O 3 2 FLORRIE VAN ANTWERP Florrie Van Antwerp, 97, of Wabasso, FL, passed away February 19, 2013 at Indian River Medical Center, Vero Beach, FL. She was born March 6, 1915 in Aucilla, FL. Florrie was a resident of Wabasso for the past 85 years having come from Aucilla, FL. She attended the Grace Methodist Church of Wabasso and owned a Citrus Business. She is survived by her sons, John L. Van Antwerp, Wabasso, FL, Frederick Van Antwerp, Wabasso, FL, daughter, Carolyn Anderson, Jacksonville, FL, sister, Clyde Kennedy, Vero Beach, FL, 6 grandchildren, 9 great grandchildren, and 2 great -great grandchildren. Feb.21.2013 11:47 AM SEAWINDS FUNERAL HOME 7725891939 PAGE. 1/ 1 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY flmY i; MOMS OF PELICAN MAW For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Olerk's Office City Half, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 FUNERAL HOME: - C' A L,0 1 ADS F7um @ n ADDRESS: _ ? 3 S PHONE* 7? S-E3 y- 19 33 (Che One) OPEN BURIAL LOT Lot ,., 4:�— Block �1� Unit, _ OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: Dorf D4 (d ;212- �T ,¢ � • c,c,,p`,,� — FOR DECEASED: fir. / O lr r If.�4 v1 .4v/ 4 G ✓r- NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of owners p) 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 SIGNATURE OF LICENSED FUNERAL DIRECTOR: &)You/ - rs-*a4vi -2L7 jj/.�; Name Signature p –te .Cemetery Sexton Certification: �rwYy�_��____�_��______ I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and th all fees have been paid: Date Ce a Sexton This foram to be provided to Clerk's Office by Sexton for permanent record upon completion. FLtyR1DADfI°A[i i0foF., ,.' State of Florida, Department of Health, Bureau of Vital Statistics BURIAL TRANSIT PERMIT HEALT DATE PRINTED: February 21, 2013 TRACKING NUMBER: 2013027215 1. DECEDENT INFORMATION Name of Deceased Date of Death FLORRIE VAN ANTWERP February 19, 2013 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH INDIAN RIVER MEDICAL CENTER Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lie. No. /Reg. No. Phone Number SEAWINDS FUNERAL HOME & CREMATORY F041682 F041682 (772) 589 -1933 735 SOUTH FLEMING STREET SEBASTIAN, FLORIDA, 32958 Funeral Director /Direct Disposer Fla. Lie. No. /Reg. No. ANTHONY GABBARD F044749 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2013- FO41682 -5039 (11LO'C4 � ` Date Issued: February 20, 2013 � 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: A 5 /2.� -- EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10/12 64V- 1.011, Florida Administrative Code