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FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
(1fYR
y ���� ��
HOME OF VELILAN ISUND
For information contact:
Kip Kelso - Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589-2545
City Clerk's Of�ce
City Hall, 1225 Main Street
Sebastian, FL 32958
Office (772) 388-8295 or 388-8214
Fax: (772) 589-5570
FUNERAL HOME: Strunk Funeral Home
ADDRESS: t��� Nnrth (`Pntral Av n., Sebastian, FL
PHONE #: 772-589-1000 �� '
(Check One)
��OPEN BURIAL LOT Lot 27 Block 38 Unit 1, Addition
OPEN CREMAINS LOT Lot Block Unit
OPEN COLUMBARIUM NICHE Niche Block Unit
N S E W
BURIAL DATE AND SERVICE TIME: A�ril 22, 2008 - 2 P.iVI.
FOR DECEASED: Elden E. Cuddie �
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
N.�`/1�,� �.�' ..� ���2 -��r �� _��
Signature Date
I certify that I have determined the ownership of the above described site, that all site fees and
administrative fees have been paid and authorize opening of same.
NAME AND SI NATURE OF LICENSED FUNER DIR CT .
J�.��-i �� .�/�.
Name ignature Date �
Cemetery Sexton �ertification:
I certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and that all fees have been paid:
• � Yz��oB
Ceme ry Se on Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
Name �"�D �/f L v'..�•� �� "�%�CC � � %`7 � �
0
I unit
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Date of Mark-out � �r � �� �
Date of Burial �/` '"%�'�d � Time ► - �
Name of Funeral Home � � � �✓ �
,
Authorized by �`� i„� � �, � "�'��` � +, ;�c`�� �� �..ti� dF� �'"�"
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B1ock 38 Zots 27 and 28 Unit Z Addition
Deed # 434
E1den E. and Elva E. Cuddie
5 Land Circle, Sebastian
Paid by �eneial�c�eipt No. . . . . . . .. . . .. Dated. . .. . . Jan, , 16, . 1981. .
List Price **200.00** 2
$ • • • • • • • • . . . . . . . . . . Muximum No. Burial spaces . . . . . . . . . . . .
Discount $ .................. Total area in square foet ................
Net Paid $.....*.*.Z.Q�..OL?.*.* Monument permitted .... F1dt .
�� � u�, 7��� (Data above this line for City Record only)
Deed # 434
Elden E, and Elva E, Cudc '
5 Land Circle, Sebastian
BZock 38, Zots 27 and 28,
Uni t Z Addi tion
Obituaries � Death Notices � Newspaper Obituaries � Online Obituaries � Newspaper D... Page 1 of 1
ELDEN E. CUDDIE
Elden E. Cuddie, 92, died April 17, 2008, at Palm Bay Community Hospital in Palm Bay.
He was born in Gladwin, Mich., and lived in Sebastian for 36 years, coming from Midland,
Mich. Before retirement, he owned and operated Cuddie Hardware Store in Midland and
worked for pow Corning in Midland as an electrician for 10 years. He was charter member
of Calvary Baptist Church in Sebastian. Survivors include his wife of 70 years, Elva E.
Cuddie of Sebastian; sons, Kenneth Cuddie of Clearmont and David Cuddie of Sebastian;
daughters, Eleanor Wood of Sebastian and Janet Snyder of Stevenson, Wash.; sister,
Marion House of Clare, Mich.; nine grandchildren; 17 great-grandchildren; and three
great-great-grandchildren. SERVICES: Visitation will be from noon to 2 p.m. April 22 at
the Strunk Funeral Home in Sebastian, with a service at 2 p.m. in the funeral home
chapel with the Rev. Clifton Cooley and the Rev. David Cannon officiating. Burial will
follow in Sebastian Cemetery.
Published in the TC Palm on 4/19/2008.
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http://www.legacy.com/tcpalm/Obituaries.asp?Page=LifeStoryPrint&PersonID=10790... 4/21 /2008
FLOR�IDA� D`EPARTMENT OF
HEALT
A.
1. Name of Fi�st Middle Last Date Month Day
Deceased of
Elden E. Cuddie Death April 17
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
�revard Palm Say inst. Palm Bay Community Hospital
3. Name of Medical Address Phone Number
certifer David Norris, AA.D. 1421 Nialabar Road, #210
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
Year
2008
Medical Examiner Physician Palm Bay, FL 32907 321-43�-8140
4. Name of Funeral Home6DiwoFDis�eee}� Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 1623 �I.Central Ave.
Strunk Funeral Home � Cremat r Sebastian, FL 32958 1228 772-589-1000
5. Check a. � The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. � Marlsol was contacted on 4/18/08
He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death,
and that Dr. Norris will complete and sign the mediql
certification of cause of death within 72 hours.
6. Funeral Diredor/
B.
�
was contacted on He/she verified that
, Medical Examiner, will complete and sign the
of death within 72 hours.
F.E. No./Reg. No.
`�/%/� 44048
BURIAL - TRANSIT PERMIT
Date Signed
4/18/08
Permission is hereby granted to dispose of this body. Permit No. 1228-08-0194
A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
n contacted by the funeral director and will not be able to complete the medical ceRification of cause-of-death section of the death certificate within
72 hours.
�No extension of time for filing the death certificate has been requested.
�� Date Date Certficate
Subregistrar Signature �ir�,! Issued: � I 17I08 Due: 4/22 /08
�• AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number: Date
Medical Examiner, , gave authorization by telephone to
Funeral DiredoNDired 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.
�� CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemetery
� �
BURIAL �STORAGE Date of Disposition /� �g
�CREMATION
Signature of Sexton
or Person-in-Charge
�OTHER (Specify)
� _ 11 �.s�% �
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 retumed
within 10 days to the local County Health Department in.the county where disposition occurred.
DisVibution: White: Cemetery or Crematory
OH 326, 8/97 (Obsoletes all previous editions) Yelbw: Funerel Director or Direct Disposer
(Stodc Number. 5740-000-0326-2) Pink: Lacal RegisVar �� `� �