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Home My WebLink About4-28-37~.. f~- 16~~~ 5 UlP11tP#P~1~ ~PP~ NO. 5 .. day of ....~118t ................................ A. D, 1 98 .., THIS INDENTURE MADE Tlds .................... hetw•een rlK City of Seboatlan, • municipal eorporst[oa ~e:latlag under the laws of the State of Florida, as Gnotor and .. AQna.~,d .L... ~xt~., . G1Qxi,a..~i... ~aZtQa..Fallla.].Y.. Revocable .Marzt$1.. D.eductiQn .Txust..and ........ . ..... . Revocable Discretionarq Needs Trust ................................... 57G • Croton• •Ay~y.. Sebastian( . ~..3a9.58 ..................................... ..... . nr the County of ..??man.River ...........................na state nf .........k'1Q>:id~.....:.................... ...... a Grantee. WITNESSET'H~ That the Grantor far acrd b corrmderation of the sum oft .... 1 y ~ ~~ • • • • • • • • • • ~ it in head paid, the noeipt whereof is her with so- knowledged, does by thL instrument grant. bugaia, sell, release, convey and confirm unto the Grantee ttlPlr• • ~~ 1~a1 tepresgttativw I d aaeigrrs the following property situated in Sebastian, Indian River County, Fbrida, tovvit: Au of Lot(a) 36&37• ~ Bbd • 28 • • • • ,UNIT , , 4 , • • . • .... , of Sebastian munidpal smeary as per PLt Number i thereof recur .~ is Pht Book 2, at page 65 of the public records Ia the of6oe of the Cork of the Circuit Court of St Lurie County of Fbrida; acid bnd now lying ipd being in Indira River County, Florida. To Have and to Hold the snare forever; provided that acid property shall be used nobly and exclusively for the interment of the human dead' be used, kept and nuintained at all times in accordance with the robs and nguhdbns, ordhrarras and rewludons of the City of Sebastlan. Florid fore, now and hereafter adapted or provided for the government and operation of said cxmetery. The oonditiona, restrlctiona and requirements ; m this instrument shall be covemats running with the brad. In the averd of the tallure of the owner of any property sitwted wkhin raid cemeU sern sari comply with such Tuba, reguhtiona, nsolutlons and ordiaartees and the cotrditions of the debd of conveyance thereof then the titb of n in and to acid property shall terminate and the acme shall revert to the City of Sebastian, Fbrida. IN WITNESS WHEREOF, The acid party of the rise part hat eased thin instrument to be executed b its name and on its behalf by its b attested by its City Clerk and its corporate seal to be hereto aftlxed, the day and yea fast above written. Attest: ....... City Clerk . gnrd, S and Deli red o the ace ofy-~ ~~ STATE OF FI.oRIDA rnrTNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA Mgor Z (~it~ p43PaI) I HEREBY CERTIFY, That on thin ........5ell............day of .. • • •~lLtg,1.IBt ................................... trrd shag i~ hemto- ~lntained ry to ob• d- owmr tYor and „ l88• •. ~ Y Are known be~forctivelpeMsyor and City Clerk of the City of Sebastiaa,t~ m~ 1torel m cwvtysncetto ~ ~w`~LL~~~ . 9tateootHFlolida to . • • . • .. • • to be Use Ind~v~duula and officers descnbal to and who caeca go g Donald L ,. Barton, , Glgria .fit . B~t.4~ .Family.. Rexo~ahls . Ma>;ikaJ..Ileduction . ~t~ .and ....... ReVOCable D19CretlODaL'y Needs Trust , , and severally acknowledged the execution thereof to be their free a ................................................. h as such otfIcers thereunto duly ruthorised; sari that the Official senl of said corpont~is duly laed thereto, and the said is the net and deed of said eorpontioo. WITNESS my algnatnn and otttctal sal at last aforesaid. T ~+~ra~ '~'( ral l o~- State of Florida. the and deal 6nveyance and year a HEALrI' State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL -TRANSIT PERMIT A. L. ,~ 7 8 1. Name of First Middle Last Date Month Day rear Deceased of Donald Louis Barton Death Feb. 5 2002 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Seba ion Inst. 7tl 3. Name of Medical Address Phone Number Certifier Noor Merchant, M . D . 13060 U . S . # 1 Medical Examiner Physician Sebastian, FL 32958 561-589-0879 4. Name of Funeral Home/DiiceF~Biepeaed Address Fla. Lic. No./Reg. No. Phone No. (Area Code) Establishment 1623 N . Central Ave. Strunk Funeral Home Sebastian, FL 1228 561-589-1000 5. Check Appropriate Box 6. Funeral Director/ B. BURIAL -TRANSIT PERMIT Date Signed 2/5/02 Permission is hereby granted to dispose of this body. Permit No. 1228-02-0056 ~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 Certificate Subregistrar Signature Issued: 2 /5 /02 Due: 2 / 10 /02 c Approval Number: Date Medical Examiner, ,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. Awaiting period of 48 hours after death is required for all cremations. D Method of Disposition: ~V BURIAL CREMATION Signature of Sexton or Person-in-Charge a. ~ The medical certification has been completed and signed. A completed certificate of death accompanies tnis application. b. ~] Tiffany was contacted on 2 / 5 / 0 _ 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. c. STORAGE OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition ~/ ~ / ~ .v 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 returnea within 10 days to the local County Health. Department in the county where disposition occurred. was contacted on medico rtificati of ` se of death within 72 hours. ign re F.E. No./Reg. No. . _~/_/ .~ ~ _ 1862 AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA . He/she verified that Medical Examiner, will complete and sign the 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 CITY OF SEBASTIAN ~~~ ':~ f'< CITY CLERK'S OFFICE- t,,,?' 1 '•~ .RECEIPT Name' `~. 1. ~ ;~ - ^' Cash i Date:. q Check # - i AmourdPaki 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 CopieslBid Specs. 001501341910 LDC/Code of Ordinances ~ I 001501 362100 Community Center Rent ~ 001501 362100 Yacht Club Rent 001501 362150 Non Taxable Reni '~ 001501343800 Cemetery Lots ~ 601010 343800 Cemetery Lots Lot/Niche ,Block ~` ~ ,Unit ' ~%~ 001501 369400 Interment Fee - 001501 369400 Weekend Service i 680800 220681 Yacht Club Security Deposit 680800 220682 Community Center Security Deposit 680800 220683 RiJerview Park Security Deposit Total. Paid Initials White- Dept. of Origin • Yellow - Finaecr • Pink -Applicant o g a it ~ , o ~~~ N N T ~ T N ~ ~ ~~ ~ }~ Q J b4 D i .a m ~ ~ _ ~ rv Q ~ ~ ru a O ru O Iii a ~ ay :' a a ~- N W ~ ~~ ~ 1 p ~ Z ~'" ,~ I ~ '~ ' c =' ~LLN ~vk~~ v o WQ m~`m° _' m '^ ZW mo= !J m ~ V W n. Ya > ~ ~ ti r. Z> ~ a~~ a ~ a ~ ~~~¢ ti N = ~~~~ ~p ti III V II~ a III W ~~~~ z W ° ~riq q ~-~w 0 a°o ~ ve we~o~v,~~o .u3dvs o Nnoevno Se.¢~ ~.4. ~rtic ti4-m a~ ~. g ov~C.~, _. o~~ cy+.~ ~~ , __ __ ~'p __ __ s~ ~_ ~~ti~ _. _ _ _ rs'9S% J _~~~ 9 ~~ __ __ .. J THE SEBAST.AN CEMETERY CITY OF SEBASTIAN, FLORIDA RECEIPT IS gEREBY_ACgNOWLEDG^ -THE SUM OF: on th ' ~' day o~ __ follow ng described Ce conditions as stated h~ Description of Property: Cemetery Lot e~ Purchase P 'ce: Dollars ($ r ~ J ./ • 29 ~ t (s for n the the purchase terms an Block ~~Unit Dollars ($, Te an`d Co ition of sale: the This contra ~~~~ s aI a `binding upon both parties, the seller an~~~ the purchaser, when approved by the owner of the property above desl~ribed. 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 the above named purchaser(s) on above instrument. the and pro~ezj~y to stated in the