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Home My WebLink About4-27-13%11 tlul 111 1'9ruualtult , 1621 Or m r t rr u 19r NO. THIS INDENTURE MADE 761a .....Zth ............. day of ............ ..�y........................... A. D., 199....., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Lydia CCoyne ......... ..............................5 lea ii3rir"F' N2y5et 8.............................. ............................... ...................................................................................................... ............................... of the County of .Indian. River .......................... an State of ........ Florida .............. ............................... as Grantee, WITNESSETHo That the Grantor for and in consideration of the sum of $ ...... . 500.. ......... .... to it i' 0� in hand paid, the receipt whereof is herewith ac- .... knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee .NF.... heirs, legal representatives and assigns the following property situated In Sebastian, Indian River County, Florida, to -wit: AB of Lot(sO ..... , Bbd*, 2%..... , UNIT !F ........... , 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 carne 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 or Seb oakat, Florida, bomm- fore, stow and hereafter allopted or provided for the government and operation of said cemetery. The conditions, restrictloas and requirements oosrlslrad in this Instrument shall be covenants ranning 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 rubs, 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 flebastian, Florda. 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. CITY OF SEBASTIAN, FLORIDA Attest? ....... .. ....................................... By "•:•r!f J.................. City Clerk Mayor SI ed, S sled and Delivered 1 the sure o ..? .................... ( GIit Seat) ) ... t STATE OF FLORIDA COUNTY OF INDIAN RIVER lath May qq I HEREBY CERTIFY, That on this ........................day of .................................................... IS...., before are personally appeared . , , , Rllth SU11iVan . and Kathryn M. 0 Halloran .. ....... .... .. .... ... .. 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 ...... ........... .................... Lytii a.. gRyne.......................................... ............................... . ......................... ............................... and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorised; and that the Official seal of said corporation Is duly of thereto, and the said conveyance Is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the unty o v e� State f Florida, the day and year last aforesaid. /1 /1 LINDA M. SALLE MV COMMISSION / CC 4 :. r.... ................. EXPIRES: June 18, 19H eota;r�y P� bli e, Stste o orlds at Large. Bonded lie" Nolte' Pubse IhndnwAMa it Ion ea r r\ U r1; ,j /'r y Cos 1 1� -- Unit Block Lot Date of Mark -out _/ n Date of Burial Z`f / Time Name of Funeral;'Homp ' ,✓T!C /V Authorized by I 1 J i se b, Z/- 27- r3 Paid by CEMETERY Receipt No ................. Dated ......... . List Price $ . qo 00..... NO. .... Maximum No. Burial Spaces ................. Net Paid $ . 5DO »iW......... Monument permitted ....................... ' , 1 6 21 (Data above this line for City Record only) M n RTIV¢lfp OF rn State of Florida, Department of Health, Vital Statistics 4 / 3 APPLI(QDN FOR BURIAL — TRANSIT PERMIT d '6 7 A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Lawrence Coyne DEATH Jan. 4 1998 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River. Roseland Inst. Sebastian River Medical Center 3. Name of Medical Medical Examiner Address Phone Number Certifier Seth Baker, M.D. Physician 8005 83rd Avenue, Sebastian, FI 561 - 388 -4606 4. Name of Funeral Home/ Address Fla. Lic. No. /Reg. 761-589-1000 one Number (Area Code) Direct Disposer 1623 N. Central Ave. Strunk Funeral Home Sebastian, FI 1228 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b Evelyn was contacted on 1 /5/98 within 72 hours after death. He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Baker will complete and sign the medical certification of cause of death. c ❑ was contacted on . He /she verified that Medical Examiner, will complete and sign the medical certification. 6. Place of Sebastian Cemetery I st to cemetery/ Removal Final Disposition: cre ry - name o ty: Indian Riv r from state Donation 7. Funeral Director/ re F.E. No. /Reg. No. Date Signed Bic 1862 B. BURIAL — TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-98-0009 ❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director /Direct Disposer Report" will be filed with the Local Registrar of the County in which death occurred. ❑ No extension of time for iling the death certificate requested. -� Date Date Cert is t Subregistrar Signature Issued: t 14 Due: I y C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA Signature Medical Examiner Date or 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. A waiting period of 48 hours after death is required for all cremations. D. CEMETERY OR CREMATORY Methods of Disposition: Place of Disposition t�. t� � , 14 BURIAL ❑ STORAGE Date of Disposition / 3 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in- Charge) This permit must be endorsed by the Secton 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. DH 326. 10/96 (Replaces FIRS Form 326 which may be used) (Stock Number: 5740- 000 - 0326 -2) T THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA �EIP IS HEREBY ACKNOWLEDGED OF THE SUM OF: ." 71 -/� j Gam' i ��fJFI on this ' day of following described Ceme conditions as stated herein: Dollars ($ yG'G' 19 q'J for the purchase of the upon the terms and Description of Property: Cemetery Lot( 1 a Block Unit Purchase Price: Dollars ($ ) Terms and Condition of sale: This contract shall bed 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 ell the above mentioned property to the above named purcha er(s) o the ter and conditions stated in the above instrument. /� f Witness