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Home My WebLink About4-26-01Paid by CEMETERY Receipt No.... *....... Dated ..January Li 1997NO. List Price $ .................. 150 Maximum No. Burial Spaces ............. ,3 Lot 1, B10C�C 26 ..00 Net Paid $ ......... Monument permitted ......Unit ................. 4 (Data above this line for City Record only) (/ �f THU of Orbttsfian C�Pritrtrrit IDrr NO. THIS INDENTURE MADE Tile ........ 24th........ day of . January .................................. A. D, 19 97, , ,, between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Ruth B. Wagner .and/or Phyllis Beatty .......................................... P.O. Box 1044 ........................................Roseland, ..FL .. 32958................................................................. . of the County of ........IndianRiver ...... . . . ... . . .. . . . sal State of ..Florida as Grantee, WITNESSETH[ That the Grantor for and in consideration of the sum of $ 1500.00 to it I q,hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ;'elr heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: Allof Lot(s)1 } � t ?, , Bktck, . 2;6 .... , 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 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 iuch 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 fust 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 I Attest:�.��t..I.... By (ySR�±.GL.A.:.f...!`_.... ..... ......... ...... �Ity Clerk l Mayor Signed, Scaled and Delivered In the recence oti 4 1L9C2 ... ................. ((Qitg *111) STATE OF FLORID COUNTY OF INDIAN RIVER I IIEREBY CERTIFY, That on this ... 24th..............day of .January........................................1e.97. before me personally appeared Louise R. Cartwright endKathryn ..... 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 hudividuula and officers described In and who executed the foregoing conveyance to Ruth B. Wagner and/or Phyllis_Beatty ....................................... ........................................................ 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' [hereto, and the said conveyance is the act and deed of said corporation. WITNESS any signature and official seal at Sebastian, In the County o I dl Iver Stat of Floy�da, Y�e day and year last aforesaid. l f � � l LINDA M. ULLEY MY COMMISSION / CC 376724 ' .. ..... ...: . DIPIRES: June 16. 1996 Not c, Sta o lorlda at IArg 9ontled 7hru Wry PuM WMA" My co lesion ex r Linda M. Ga lev State of Florida, Departm of Health and Rehabilitative Services, Vital istics CA APPLIFOR BURIAL — TRANSIT PERMIT A. (Type or Print) 41 / 1. Name of First Middle Last DATE Month Day Year Deceased Ruth Betty Wagner DEATH 01/06/97 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 13840 U.S. Highwa #1 Ralph Geiger, M.D. Physician Sebastian Florida 32958 (561)388-0770 4. Name of Funeral Home/ Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Direct Disposer 1623 North Central Avenue Strunk Funeral Homes P.A. Sebastian F1 32958 1228 (407)562-2325 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b Kathv was contacted on 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 Ralph GeigerFM.D. 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 j_Wematory/2PKKC0unty:, tate cemRemoval Final Disposition: Indian River from state Donation 7. Funeral Director/ ignat F.E. No./Reg. No. Date Signed Me I It b 2 n, In& /07 B. BURIAL — TRANSIT PERMIT Permit No. 1228-97-0014 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 filing the death certificate requested. Qegist� Date Date Certific to / Subregistrar Signature —� A.Q 1 M Issued: f-14 9 7 Due: �� ` 9 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:0 F w -c TEr2 Y Place of Disposition ��AAST�c-r ® BURIAL ❑ STORAGE Date of Disposition ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in -Charge) Ce, ,4 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) Date of Mark -out Ire Date of Burial e.%dt At Time Name of Funeral Home_ Authorized-by- f Name E✓.s�!7� Unit Block Lot Date of Mark -out Ire Date of Burial e.%dt At Time Name of Funeral Home_ Authorized-by- • • THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA OF THE ,SUM OF: FROM: :"s f. on this day o 19 :Z for the purchase of the following described Cem ry Lot( 7�N-rci�sj—upon the terms and conditions as stated h ein: Description of Property: Cemetery Lo Purchase Pr Terms and Condition of sale: Uni t rs 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 ment the above named purchaser(s) one tPmms and condli above instrument. /) ( I-, U/ Witness property to stated in the THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA CEI P S HER Y ACKN LED ED OF,HE .SUM OF: � ollars ) FROM: 5�:: �2j on this day o 19 for the purchase of the following described Cem ry Lot( pon the terms and conditions as stated hd ein: Description of Property: Cemetery Lot Purchase Pri Terms and Condition of sale: unit rs 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 menti the above named purchaser(s) one terms and condlit above instrument. � ) 1 ,-1 1 Witness property to stated in the SS � yO�For PELICPN City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 January 31, 1997 Ruth B. Wagner & Phyllis Beatty P.O. Box 1044 Roseland, Florida 32958 Dear Ms. Wagner & Mrs. Beatty: Enclosed is Cemetery Deed No. 1567 for Lots 1, 2, and 3, Block 26, 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. 0. Box 1028, Vero Beach, Florida 32960. We are enclosing two copies of Receipt No. 923 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, %A �n- Jew. Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:lmg Enclosures