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l-yPritP#P~~ ~pP~ No. ' 1630
THIS INDENTURE MADE Tlds ........?~........... day of .....May ................................... A. D, 1898...,
bet~ceen ilia City of Sebastian, a municipal corporation exiettng under the laws of the State of Florida, os Grantor and
Y'y AIIR Va ar10
729 Carnation Dr
............................................. Sebast~.a 32 58 ...........................................................
ny.. F'I; . 9.
of the County of Indian River .. anJ stole of ...... F.~-S~X~d& .......................... .
ss Grantee, WITNESSETHr
That the Grantor for and in consideration of the sum of $ ,1 J OOO.:OO . ........... . . to it in hand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargain, sell, release, convey and con£rrm unto the Grantee i7er , , , , heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit:
AB of Lot(s)?L&??, ,Block,?8 , , , , , ,UNIT 4. , , , , , , , , , , , of Sebastian munidpal cemetery as per Plat Number 1 thereof rewrded in Plat
Book 2, at page 65 of the public records in the ofAce 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 ba used solely and exclusively for the interment of the human dead and shall
be used, kept and maintained at all tImea in accordance with tho rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, herato-
foro, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, reatrlctiona and require;nenta contained
in this instrument shall be covenants running with the land. In the event o~ tho 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 dried 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, Tha said party of the first part has caused this instrument to ba 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.
Attestt .~~~..V ............................... ...........
City Clerk
SJ ncd, S led and Delivered
(r tl~e scnce ot:
.(f,v
sTn'rr OF Fr.ollron
CUUNTY OF INDIAN RIVER
CITY OF SEI3ABTIAN, FLORIDA
IIy .~y~~~'....ry""G.~~ ...................
Mayor
((~Iit~r ~-ett1)
I IIE1tEIIY CERTIFY, That on thb ..~r2i ...................day of ...........May..................................., 1~8..,
briars me personally appeared , , ,Ruth St1111Van and Kathryn M. 0' Halloran .
reapc•etively Mayor anal City Clerk of tht City of Sebastian, a municipal corl~orntiun under the laws of the State at Florlde to me known
to be the Inah•iduuls and officcra descrilx•d In and who executed the forrgoiug cuwveyunce to l
Mary Ann Vallario
.......................................................................................................................................
...................................................... and severally acknowledged the executimr thereof to be their tree act and tired
us such officers thereunto duly nuthnrizcd; and that the Official seal of said corporation la duly affixed thereto, and the said conveyance
is the net and deed of said corporation. ;• ~ ~~•
WITNESS my signature and otOciel seal at Sebastian, In the Cou ty of
last atorrsaiti.
~,~ ,•.~s LINDA M. GALLEY
~+R ~;: PAY COMMISSION / CC y/572~ . ~`
DtPllifS:.lune te, false ~~-
r f esadea Ilse rlotin t ~""'I"" My rnm
State of Florida, the day end year
~~
pc, S o da nt Large.
exp[ren
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Name~~0~'''~ Y4 t { '~t~t' ,cJ"
,,
Unit
Block
Lot
Date of Mark-out ~ ~,~ '~
Date of Burial ~l ~ ~ ! 9 Time ~'`
Name of Funeral Home ~°~ ~''~~`~r`'' ~`J ~
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Authorized by ~. " ~
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FLORIDA DEPARTMENT OF Ste~f Florida, Department of Health, Vital St,,,~;~tics
HEALT ~ APPLICATION FOR BURIAL - TRANSIT PERMIT
A. (TYPE)
,% ~ i, ~ a
~' a? 8'
1. Name of First Middle Last Date Month Day Year
Deceased of
Mary Annr_ Vallario Death May 1 1999
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Sebastian Inst. 729 Carnation Drive
3. Name of Medical Address Phone Number
Certifier N. Noor Merchant, M. D. 7744 Bay Street
Medical Examiner Physician Sebastian, FI 561-589-0879
4. Name of Funeral Home/Direct-9ispo5'al A r s Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment ~$~~ N . Central Avenue
Strunk Funeral Home Sebastian, FI 1228 561-589-1000
5. Check
Appropriate
Box
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
b. ~ Lori was contacted on 5 / 3 / 99
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Merchant will complete and sign the medical
certification of cause of death within 72 hours.
a
c.
was contacted on
He/she verified that
Medical Examiner, will complete and sign the
medical ficatio of a of death within 72 hours.
6. Funeral Director/ na a F.E. No./Reg. No. Date Signed
p;rest-B;,roser• 1862 5 / 1 199
B.
BURIAL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No.1228-99-0233
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.
,~, Date Date Certifcate
Subregistrar Signature `'ku ~ ~ Ti~.~ M ~ Issued: ~ 9 g Due: 9
-rte __
c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number: Date
Medical Examiner, ,gave authorization by telephone to
Funeral DirectodDirect 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
~1 BURIAL STORAGE Date of Disposition ~ H
CREMATION OTHER (Specify)
Signah~re 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 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