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Home My WebLink About4-26-17Titg of #rUaatian NO. THIS INDENTURE MADE Tk1s ......26th.......... day of .............March......................... A. D., 18..97., between the City of Sebastlan, a municipal corporation existing under the laws of the State of Florids, as Grantor and Guillermina Martinez .......................................... .349 - BensChap..Street.......................................................... Sebastian, Florida 32958 ..................................................................................................................................... of the County of ...Indian. River lorida and State of ................................................... as Grantee, WITNESSETHa That the Grantor for and in consideration of the sum of $ ......599.0 ......... 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 her ..... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) .17. .. . , Block, .?6 .... , UNIT 4 ........... , 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 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 runnipg 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 first above written. Attest .!....!...4�.. / .. City Clerk Signed, Sealed and Delivered In tit resence oft / 7 ............................... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By •I'V.LV.) •Ae.!r...:............ Mayor (TitgSeal) I HEREBY CERTIFY That on this 26th March 9 ........................day of ................................ .................., 18.... ., before me personally appeared .. Walter W. Barnes and 1 8 hrp 1, 0tHalran . ....lo ............. 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 1 u. ' 11.Qrii4m .Martinez......................................................... ................................................... 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 rreto, and the said conveyance Is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the Couryky of last aforesaid. I Florida, thi day and year LINDA M. GALLEY ! ............... ., W COMMISSION / CC 376724 ots Public, tate o FI Ida at Large. +r� r EXPIRES: June 18, 1998 My co ralssion expires , ,q ^ eabea � NcWy Pdec tk*Wgen Lina M. Gall State of Florida, Departo of Health and Rehabilitative Services, Vit*tistics APPLICATION FOR BURIAL — TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF LUIS MANUEL MARTINEZ DEATH MARCH 24, 1997 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 561-589-8992 GEORGE A. MITCHELL, D.O. TlPhysician 13855 U.S. HIGHWAY #1, SEBASTIAN FLORIDA 32958 4. Name of Funeral Home/ Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Q(1*X (1X�IXftX 36 E. BREVARD DRIVE DAVIS FUNERAL HOME MELBOURNE, FLORIDA 32935 276 407 254-1532 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b )t� GEORGA A. MITCHELL, D.O. was contacted on 03/25/97 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 GEORGE A. MITCHELL,D.O. 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 Instate cemetery/ SEBASTIAN CEMETERY Removal Final Disposition: crematory - name /c INDIAN RIVER from state Donation 7. Funeral Director/1 Signature F.E. No./Reg. No. Date Signed �Gr>XAf(27t��.A . N , f(,? FE0002886 MARCH 25. 1997 B. BURIAL — TRANSIT PERMIT 276-08-97MAR Permission is hereby granted to dispose of this body. Permit No. ❑ 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. )CNXNo extension of time fppjiling the de t certi c requested. X�4�i►�X Date Date C is to Subregistrar Signature Issued: MAR. 25, 1997 Due: �� 1997 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 SEBASTIAN CEMETERY Methods of Disposition: Place of Disposition SEBASTIAN, FLORIDA BURIAL ❑ STORAGE Date of Disposition Or-, CZ ,71" l q 7 ❑ 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 � a I ter� , Ir ,* A ,� r, v � Date of Mark -out Date of Burial ?,/,2 IZ7 Time Name of Funeral Home D Y u U A14 4 j Paid by CEMETERY Receipt No ... 934 3/26/97 List Price $ ...500.00 ........... Dated .............................. Lot 17 . ........... Maximum No. Burial Spaces Block 26 500 *00 ................ I -Jr -ii t 4 Net Paid $ ........ .......... Monument permitted J. NO. 1010 r: • THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA HEREBY ACKNOWLEDGED OF THE SUM OF: . AP FROM: (ibr/ . Dollars ( ) on this 0((� T day , 19for the purchase of the following described CemePinx: Lot(s)/Niche( ) upon the terms and conditions as stated her Description of Property: Cemetery Lot—,f Block Unit Purchase Pric Dollars 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) on he tem, and above instrument. 4�7tLness &Zel 1 an ioned property to tions stated in the