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Home My WebLink About4-27-11Name A-11— 4e Unit Block Lot /l Date of Mark -out 30 // / 7/y Time - Date of Burial �� OD Name of Funeral Home Authorized by CERTIFICATE OF CREMATION Name of Deceased: Loretta D. Bingham Date of Death: 08/22/2014 This Certifies That The Deceased Named Above Was Cremated At Space Coast Crematory, Melbourne FL Date of Cremation: 08/29/2014 Time of Cremation: 0706 Cremation Number: 15278 C -Reference Number: 21539 Cer ified Crematory Clorator Space Coast Crematory Is Owned & Operated By Arnmen jami(y Cremation and funera(Care Patin Bay - Melbourne - R,ockfedge -T tusvi((e PO BoX 1346, Melbourne FL 32902 STATE OF FLORIDA - BURIAL/TRANSIT PERMIT - REPLICA NAME OF DECEASED: Loretta D. Bingham PLACE OF DEATH - COUNTY Brevard NAME AND ADDRESS OF ESTABLISHMENT Ammon Family Cremation And Funeral Care 1001 South Hickory Street Melbourne FL 32901 LICENSED DIRECTOR D. Joys Eiker PLACE OF CREMATION Space Coast Crematory Melbourne, Florida CREMATION APPROVAL ISSUED BY Medical Examiner District #18 DATE OF DEATH: 08/22/2014 CITY, TOWN OR LOCATION FACILITY OR STREET ADDRESS, IF NOT A FACILITY Palm Bay William Childs Hospice House ESTABLISHMENT LICENSE NUMBER: F041850 PHONE NUMBER: (321) 724-2222 FH ASSIGNED PERMIT NUMBER: F041850 21539 67914 NAME OF CEMETERY OR PLACE OF FINAL DISPOSITION; DATE OF DISPOSITION: DIRECTOR'S LICENSE NUMBER: F044563 DATE OF CREMATION: 08/29/2014 ME CREMATION APPROVAL NUMBER: C14-08-280 SIGNATURE OF SEXTON/OFFICIAL: THE ORIGINAL PERMIT WAS ISSUED BY THE STATE OF FLORIDA; MEADE GRIGG, STATE REGISTRAR. SHOULD A CEMETERY, CHURCH OR OTHER AUTHORITY NEED A COPY OF THE ORIGINAL STATE ISSUED PERMIT, CONTACT AMMEN FAMILY CREMATION AND FUNERAL CARE. Iwo 01841 THIS INDENTURE MADE Thla ...... 7 tb........... day of ....JAN.0ARY ............................. A. D., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and JAMES F. AND LORETTA BINGHAM ....................................................................................................................................... 1233 W. BOUGANVILLA CIRCLE ...................................... BAREF.00T • .BAY,...FLORIDA. .3.2.9 7 6 ............................................... . of the County of ...... INDIAN..RIVER ................. anal State of ...... FL,ORIDA .. ,................................. es Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ .9 Pg. t Q Q ................ to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee . • • . • .... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) • .11... , Block, • 2 7.... , 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. (NOTE: THIS DEED NUMBER 01841 WAS AUTHORIZED TO REPLACE DEED PURCHASED IN JANUARY, 1998 BUT NEVER SENT TO PURCHASER, FOR CREMAINS OF JAMES F. BINGHAM)— DATED APRIL 4, 2002 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 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 first 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 first above written. � 71 ........... Attest: ........... .... ......... City Clerk Signed, Sealed and Delivered in the Presence of: ... . ..... I.......... W ............................ STA'L'E OF FLORIDA CITY OF SEBASTIAN, FLORIDA By �..W.f "............ Mayor ((Qi#g Seal) COUNTY OF INDIAN RIVER (Original Date) I HEREBY CERTIFY, That on this .....7.th..............day of .......... January ............................. 199.8., (New Deed Issued) 19th April2002 before me personally appeared ..... WaI t.ex..til ... Bar.11 a ......................... and ...... Sally. A....Ma.IA.......... respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the individuals and officers described In and who executed the foregoing conveyance to ....................................James,. F..t..BingerP..sad..LQr.e.U4..D;Lnghaln................................... and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corporation. WITNESS my Elgnature-and official aeal at Belmi;Ian.. in the- £ouaty-a%Indian River and State of Florida, the day and year last aforesaid. H. JOANNE SANDBERl3 ...... ................ r MY COMMISSION M CC 725842 Notary ublic, State of Florlda at Large. ` k EXPIRES: Aptil 30, 2002 My eo isslon expires: '/J`" Bonded Thru Notary Publk Underwriters CITY OF SEBASTIAN 4928 ' CITY CLERK'S OFFICE 4 9 2 8 RECEIPT Name 4m m e n f /_/-arn i 1 Y 4 ❑ j i Y1"Cash / Date I - ( 1- 14 X Check # (c� � q �3 No. 001001208001 001501322900 001501 341920 001501 341910 001501 341930 601010 343800 001501 343805 Amount Paid Sales Tax Garage Sales Copies id Specs. LDC/Code of Ordinances Election Qualifying Fees Cemetery Lots LoUNLche -LC Block 2-7 , Unit 4 Cemetery Fees 51 y 4W Total Paid( Initials White - Dept. of Origin • Yellow - Finance • Pink • Applicant FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY :11 1, SEBASTIAN drWARV HONE OF PELICAN ISLAND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 FUNERAL HOME: Ammen Family Cremation and Funeral Care ADDRESS: 1001 S. Hickory Street Melbourne, FL 32901 PHONE #. (321) 724-2222 (Check One) OPEN BURIAL LOT Yes OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME FOR DECEASED: Lot Block Unit Lot 11 Block 27 Unit 4 Niche Block Unit 0-a N ��r E W Tt� N4 LorettaD. Bingham Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of owner ) James M. Bingham Name Sig ature Date 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 DRECTOR: Michael W Ammen 8/29/2014 Name _ignatur Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: ' � 1 Cemeteysext6n Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. Name A Unit j Block Lot Date of Mark -out Date of Burial Time Name of Funeral Home S Authorized by BINGHAM, JAMES F. AND LORETTA DEED 4601841 1233 W. BOUGANVILLA CIRCLE BAREFOOT BAY, FLORIDA 32976 LOT 11, BLOCK 27, UNIT 4 JAMES BINGHAM INTERRED IN LOT 11A - JANUARY, 1998 (CREMAINS) ORIGINAL DEED NEVER ISSUED - THIS DEED WAS ISSUED ON APRIL 4, 2002 TO LORETTA BINGHAM Paid by CEMETERY Receipt No ................. Dated ...January ,7, 19 9 8 List Price $ . 9 �, ; 0 ....... Maximum No. Burial Spaces ................. Net Paid $ ..9 QQ.•, Q.Q....... Monument permitted ....................... (DATED APRIL 4, 2002) (Data above this line for City Record only) BINGHAM, JAMES F. AND LORETTA NO. 01841 LOT 11, BLOCK 27, UNIT 4 z April 22, 2002 Loretta Bingham 1233 W. Bouganvilla Circle Barefoot Bay, Florida 32976 Dear Mrs. Bingham:: Enclosed is City of Sebastian Cemetery Deed No. 01841 for Cemetery Lot 11, Block 27, Unit 4. If you have any questions, please contact our office. Sin , taH�. Maio MC City Clerk SAM J s enclosures