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Home My WebLink About4-26-30aName S u � � � 1-g b. /,1:�''L.—"7-1��[�� *4 04,,04 S 1 i2 MRSO Unit Block �b Lot Date of Mark -out Date of Burial - - "1/1.13 4 Cy v Name of. Funeral Home Authorized by Time FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBASTIAN HOME OF FEUCAH WNW For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 FUNERAL HOME: >*7I'LLI'X It ADDRESS: Q I% 1-7f'- S -1 -2e -t' V eV -0 r3e&L k i'L PHONE #: e (Check One) OPEN BURIAL LOT Lot 300— Block 2-6 Unit Z— OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S EW BURIAL DATE AND SERVICE TIME: -7 rx- - (I o '. I-0 pi rt_d,� FOR DECEASED: J ASG h ue d u -e, Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) I"ITV 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 SIGNATURE OF LICENSED FUNERAL DIRECTOR: Name Signature Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming withClerk's office and hat all fees have been paid: AS ib Ce ter4 Sexton D to This form to be provided to Clerk's Office by Sexton for permanent record upon completion. FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY .11 SEsnsngN HOME OF PENCAN ISfANp For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 FUNERAL HOME: > 1 r (ki'\ IL ADDRESS: 16 1-71k S+reetl UW0 13C(A-CV\ 4�L .32 960 PHONE #: 5 &Z - Z 3 2-5 (Check One) OPEN BURIAL LOT 2 Lot 300-- Block 2- & Unit Ll OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E_W_ BURIAL DATE AND SERVICE TIME: - Z F - 10_ 3 . LG PM �1 DSC- i n FOR DECEASED: S u SLA -I'1 U- a uc- Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) ame 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 SIGNATURE OF LICENSED FUNERAL DIRECTOR: Name Signature Date Cemetery Sexton Certification: 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: Cemetery Sexton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. Cqj of Orhastian �Gi lig i NO. I';15 6 2, THIS INDENTURE MADE Thla .......16th........ day of ............June .......................... A. D, 19.97.., between the City of Sebastian, a municipal corporation existing under the laws 'of the State of Florida, as Grantor and Muriel G. Leduc and/or Susan Leduc .......................................... 1.521..5-th--AVenue................................................................... Vero Beach, FL 32960 ..................................................................................................................................... of the County of Indian, River ...................... ., sail state of .....Florida ...................................... ....... as Grantee, WITNESSETHe 112 5.00 . to it in hand id, the receipt whereof is herewith That the Grantor for and in consideration of the sum of $ ......................... (a ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ,their heirs, legal representatives and assigns the following propertI&IIpated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s,21.3. DA BIo k, 26 .... , UNIT . A .......... , 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 Clark of the Circuit Court of St. Lucia 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 inch 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 said to be hereto affixed, the day and year first above written. CITY OF SEBASTIAN, FLORIDA Attest:.., G� �r�e��? its, . r....... By ........... City Clerk Mayor Signed, Se nd Delivered In thA0FPLOUIDA f: .......(!L..: ............................. (010 Sea!) STA COUNTY OF INDIAN RIVER 16thJune I HEREBY CERTIFY, That an N4 ........................day of ..................,................................, 19 9.., before me personally appeared .Walter W. Barnes and Kathryn, M.,,O' Halloran .................................... ................n respectively Mayor and City Clerk of the City of Sebastian, a munlellal 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 a duc.. andJ. A lr ..SJJ.IaXL . L e duc...................................... and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorised; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance Is the net and deed of wild corporation. WITNESS any signature and official seal at Sebastian, in the Co my of Indian Ri and State of Flor da, the day and year last aforesaid. nets► iN. AN LEY , MY COYNAION / lx .. .. .. ... .... .......................... F>wm-.Nna 1g. In Not Public, St a of Florida at ge. gaidsdTian, "I ryyaEleliisntalMe My ommlaslo pirewr Linda M. Galley