HomeMy WebLinkAbout4-26-07Paid by CEMETERY Receipt No...9 Dated ... Jane ,23, 1997
List Price $ ..................Maximum No. Burial Spaces .............. , , Lot 7
0
500.00 Block 26
Net Paid $ .................. Monument permitted ......................Unit 4
(Data above this line for City Record only)
Titg of i6phastittn
Trutrtery Berb NO.
NO.
•15,1
(jfj
'1566`
THIS INDENTURE MADE Ills .....23rd........... day of .January ................................. A. D., 1897...,
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
Judith McDonald
......... .......................................... 13255..U...S....1.. #19 ......................................................... .
Sebastian, FL 32958
.....................................................................................................................................
of the County of ... Indian River , , , , , , , , anti State of Florida
.....................................................
as Grantee, WITNESSETHr
That the Grantor for and in consideration of the sum of $ .50 ... 0..... 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 Granteeshe heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to -wit:
All of Lot(s) , . L. , Block, , 26 , , , , UNIT ,4, , , , , , , , , , , .. f 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 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 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 fust above written.
CITY OF SEBASTIAN, FLORIDA
Attest..el, ...�'. .j By
City Clerk Mayor (!//
Signed, Sealed and Delivered
In the Presence of:
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
I HEREBY CERTIFY, That on this .....2.31'.4 .............day of .January:........................................ I6.9.7.,
brfure nee personally appeared . Louise R. Cartwright................. and...Kathryn M. O'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 he the individuals and officers described In and who executed the foregoing conveyance to
Judith McDonald
.......................................................................................................................................
..................................................... 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 affix hereto, and the said conveyance
is the act and deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the Co my of Iver Sta of FI ride, the day and year
Iasi aforesaid. �--� \ /n/ /
LINDA M. GALLEY
MY COMMISSION ! CC 575724
— D(PIflES: Iwo 18,1886 Not ry u ic, St e Florida at Lar e
8onialThruNoblyPuMUndenalYn My ommission a ar
Linda M. Galley
Name 11 0''.7 4 -
Unit
Block
Lot
Date of Mark -out
j
Date of Burial t Time A,
Name of Funeral Home'
Authorized bv—,_
«� usl -�iR 'I�la�c
on
lyd 7. �'�rk�,li�'��
Paid by CEMETERY Receipt No...922 .......... Dated ... 1997
List Price $ ................. ............. NO.
500. .00 Maximum No. Burial Spaces ... * ............ Lot 7
Net Paid $ .................. 'Block 26
Monument permitted ......................Unit
.....................Unit 4
(Data above this line for City Record only)
THE SEBASTIAN CEMETERY
CITY OF SEBASTTAN, FLORIDA
'PT IS EREB AC NO LEDGED OF THE SUM OF:
i
�= Dollars ( /)
/ 'Ifn A
FROM:
on this day o , 19'1 / for the purchase of the
following described Cem ry Lot (fS '*'4 ehe upon the terms and
conditions as stated h in:
Description of Property:
Cemetery Lot Unit
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 a ove
the above named purchaser(s) on he msrand
above instrument. � � %
of S
Witness
oned property to
ions stated in the
an j
C�
J
``� Y O�
Z
F OF PELICAN �5
City of Sebastian
1225 MAIN STREET o SEBASTIAN, FLORIDA 32958
TELEPHONE (407) 589-5330 11 FAX (407) 589-5570
January 31, 1997
Judith McDonald
13225 U.S. 1, #19
Sebastian, Florida 32958
Dear Mrs. McDonald:
Enclosed is Cemetery Deed No. 1566 for Lot 7, 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. O. Box
1028, Vero Beach, Florida 32960.
We are enclosing two copies of Receipt No. 922 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. O'Halloran, CMC/AAE
City Clerk
KOH:Img
Enclosures
B. BURIAL - TRANSIT PERMIT Permit No. 1228-97-0007
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.
Registrar ->?r �-�S Date /3197 Date CertiSubregistrar Signature �-- ni /.� �- �t.r.� 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 ba s+- i nn—Deme-ter-y-
12 BURIAL ❑ STORAGE Date of Disposition January 7 , 1 997
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton )
or Person -in -Charge) 42-1-
This
2 =
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)
7,
- State of Florida,
Depart of Health and Rehabilitative Services, Vita *istics
APPLII N N FOR BURIAL - TRANSIT PERMIT i7
A. (Type or Print)
1. Name of First
Middle Last DATE Month Day Year
Deceased Joel
C. McDonald DEATH 01/03/97
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
87 Royal Pal m Blvd.
John Suen M.D.
Physician Vero Beach Florida 32960 (561)770-4888
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
un,l„ 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 John Suen, M.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.
Removal
6. Place of Sebastian Cemetery In state cemetery4/,`u`nty:
Final Disposition:
cr tory - Indian River from state Donation
7. Funeral Director/
ature F.E. No./Reg. No. Date Signed
Direct Disposer
- -taw I I G Z n17nA7q7
B. BURIAL - TRANSIT PERMIT Permit No. 1228-97-0007
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.
Registrar ->?r �-�S Date /3197 Date CertiSubregistrar Signature �-- ni /.� �- �t.r.� 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 ba s+- i nn—Deme-ter-y-
12 BURIAL ❑ STORAGE Date of Disposition January 7 , 1 997
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton )
or Person -in -Charge) 42-1-
This
2 =
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)