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HomeMy WebLinkAbout4-27-33( ULI Of Orhastiall *rmrtL r US rb• NO. 0 '1GO7 THIS INDENTURE MADE This ..... ��th........1. day of .......... AllgllSt........................ A. D., 19 ...., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and John Grover ................ ..................................... 3'3 ................................................... "Co'rl'CoYd "DYi'v�' Sebastian, Florida 32958 ..................................................................................................................................... of the County of ...... inai.an„River.................. ani State of ..F.tor=d.a......................................... as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ 5 00.00 . . ...... . . . . . . . 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 hl g.... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: Allof Lot(s) 33 ... , Block, 2 .... , UNIT . 4, ......... , of Sebastian municipal cemetery as per Plat Number I 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 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 uld 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. Attest ..... ..!.'...... . .... City Clerk Signed, Sealed and Delivered In the sense of: ................. .......... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By aoFo V) Mayor I HEREBY CERTIFY, That on this ...2Ztb..............day of ..... Aug -us t.................................... 109.7.1 before me personally appeared ,,.., W.alter . . . W. Barnes ..... and ........................................... 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 John Grover ....................................................................................................................................... ........................................................ 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 amid corporation. 11 WITNESS my signature and official seal at Sebastian, In the last aforesaid. __ LINDA M. BALLET W COMMIS110 8 CC 37 EXPRO:.hns 18. 19911 Bonded TMu Mealy Puh1e IlndsnalMs my of n9i. otary Pu li My commissio Linda M. Galley State 1pf Florida, the day and year aIt Larges( 033 F=_7 State of Florida, Depar t of Health and Rehabilitative Services, Vitotistics APPLICN FOR BURIAL — TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Robert Matthew Grover DEATH July 31, 1997 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland Inst. Setastian River Medical Center 3. Name of Medical Medical Examiner Address Phone Number Certifier Talib Hussain, M.D. X Physician 7770 Bay Street, Sebastian, Fl 561-589-7177 4. Name of Funeral Home/ Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Direct Disposer 1623 North Central Ave. Strunk Funeral Home Sebastian, Florida 1228 561-589-1000 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b ❑ Phyllis was contacted on 8/1/97 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. Hussain 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 Cemeter In state cemery Removal Final Disposition: ema tor n county: Indian River from state Donation 7. Funeral Director/ Signat a F.E. No./Reg. No. Date Signed Direct Disposer 1862 7/31/97 B. BURIAL — TRANSIT PERMIT Permit No. 1228-97-0334 Permission is hereby granted to dispose of this body. ❑ 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 fili he death certificate requested. Date Date Certifi at Subregistrar Signature Issued: Due: 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 JR BURIAL ❑ STORAGE Date of Disposition 6& ' 7 . ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton) or Person -in -Charge) /�� 75 ,IC1�gal 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 HRS County Public Health Unit in the County where disposition occurred. HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-2) Name Unit Block 1el , (25 /L G V %z-- i je— Lot Date of Mark -out ) Date of Burial©— r Time_ �'� 0 00 Name of Funera Home _- n Authori'md by S 14k vt 1110- w .N z.aot/i ,(-ky-c 2e_c_<C F/I� // 9 q 7 Paid by CEMETERY Receipt No.. 9 5 3 .. .... „ , Dated ....... 8 W M, , , , , , , , , , L O t 33 No 500.00 Block 27 List Price $ .................. Maximum No. Burial Spaces ............... Ub i t 4 500.00 Net Paid $ .................. Monument permitted ....................... ` 1 a . (Data above this line for City Record only) 0 0 q -n5 THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA PT IS EREBY ACK OWLED O� THE SUM OF: Dollars ($ ) FROM: on this day of following described Cemeter Lot conditions as stated herein: 0 19.1 // for the purchase of the .) upon the terms and Description of Property: Cemetery Lo lock 4�z Unit Purchase Pri Dollars l � ) Terms and Condition of sale: This contract shall be 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 sell the above the above named purchaser (s) one ms and above instrument. city 5'tZnesis an ned property to ons stated in the • City of Sebastian 1225 MAIN STREET C1 SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589-5330 o FAX (561) 589-5570 September 2, 1997 John Grover 343 Concord Drive Sebastian, FL 32958 Dear Mr. Grover: Enclosed is Cemetery Deed No. 1597 for Lot 33, Block 27, Unit 4. Also enclosed is a form - Return for Transfers of Interest in Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded. If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, P. O. Box 1028, Vero Beach, Florida 32960. We are enclosing two copies of Receipt No. 953 and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided for your convenience. Sincerely, Kathryn M. 'Halloran, CMC/AAE City Clerk KOH:hng Enclosures