The URL can be used to link to this page

Home My WebLink About4-26-16Titg of #pbttll#ian Tr ice► i t s 4 g U p p b NO. 97 THIS INDENTURE MADE Title .....1...3.t......... I... day of ............June .......................... A. D., 1e......, between llm City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Mrs. Norma Jean Sullivan .......................................... 4.3.4..Ro'lling.. Hill'' Driv.e........................... ........................... Sebatsian, FL 32958 ..................................................................................................................................... of the County of.........znd;LAR.iixve.r............... and State of Florida to Grantee, WITNESSETH, That the Grantor for and in consideration of the sum of $ .... 1,0.00.. 0 . to it in hand paid, the receipt whereof is herewith a0 knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee . ,her, , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lots) 1 A&A § Block, .. 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 shun be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at an 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. /J City Clerk CITY OF SEBASTIAN, F��LORIDA JA Mayor Signed, Sealed and Delivered Int Presence ofr / ac. .�r...........I................ STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this .............. 13th ... day of .....June........................................ io.97, before me personally appeared Walter W. Barnes Kathr n M. O'Halloran ........................................... 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 ............................................Mrs...Ng ria...lean..5U,II�VALA................................................ .............................••........................ 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 signature and official seal at Sebastian, In the Cou�ity of n�*da of Florida, the day and year R last aforesaid. _ l /Y1 LINDA M. HAIIEY \ MY CCMMISM I CC J7 4 DlP1RE9: Jisw 1s, tsM sa m TAm NOMY Pete Li :..... . ...................... Florida a Be. QState of Florida, Depart t of Health and Rehabilitative Services, Vitatistics A. (Type or Print) APPLICN FOR BURIAL — TRANSIT PERMIT L 1. Name of First Middle Last DATE Month Day Year Deceased Paul Lee Sul l i vanD OF TH 05/05/97 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. Highway #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 ER Heather was contacted on_p5,� 7- 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 Geiger. M.D. will complete and sign the medical certification of cause of death. C ❑ medical certification. was contacted on . He/she verified that Medical Examiner, will complete and sign the 6. Place of Sebastian Cemel-igrk In state cem e / Removal Final Disposition: cremator /county: Indian River from state Donation 7. Funeral Director/ Signa aF.E. No./Reg. No. Date Signed Direct Disposer il(diQ 1 a L T. 05/05/97 B. BURIAL — TRANSIT PERMIT Permit No. 1228-97-0216 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. - DateDateS s 4 7 Due: CerStifi Q/9 7 Subregistrar Signature Issued: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA Signature or , Medical Examiner Date 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 rad-7%-'–-�— 00 BURIAL ❑ STORAGE Date of Disposition R 151-7 i ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in -Charge ) 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 1.t iLq Unit 14 Block Lot -",j L , 7 Date of Mark -out 1' Date of Burial 2e 7 Time -- Name of Fundral Hp"rn' Authorized by