Loading...
HomeMy WebLinkAbout4-25-05It, Paid by CEMETERY Receipt No.. 8� ....... Dated ......... 8 � 6 / 96 L O t 500.00 Bloc List Price $ .................. Maximum No. Burial Spaces ................ Unit 4 500.00 Net Paid $ .................. Monument permitted ....................... (Data slave this line for City Record only) Ti#Lj of 0rbtts#ian Trute#Prij B.eieb NO. .1',j44 NO. THIS INDENTURE MADE T61a .......... 7th _._. day of ............. August .................... .. A. D., 19..9.6., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ........................................ Bar.barft. . Rxc.c.i.................................................................. 113 Duban Street ....................... I................ Sebastia.n.,-Tlor•i•da.•329.58............................................ of the County of .Indian River Florida ......... ......................... anal State of ....................................................... as Grantee, WITNESSETHm 500.00 That the Grantor for and in consideration of the sum of $ .... ............. to it y'm hand paid, the receipt whereof Is herewith ac- knowledged, o-knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee h2 r ... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) , 5..... , Block, . 2 5.... , 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 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 defied 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. {� CITY OF SEBASTIAN, FLORIDA Attes� / / / .�....... By . . Mayo .. .. ........... Cit Clerk Mayor Signed, Sealed and Delivered In the esence oh 4 ............ (Clitq eel) iilwm 6F FLORIDA COUNTY OF INDIAN RIVER I IIEREBY CERTIFY, That on this ............... 7 th.... day of ............... Augus t ......................... I9. 96 brfore me personally appeared,..Louise R. Cartwright Kathr n M. 0 Hallora n ............... ............................ 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 conveynnee to .............................................. Barba.ra..Ri.cci..................................... I.......................... ............. „ •• „ ......••••••.••........... and severally acknowledged the execution thereof4o be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly aIfixl hereto, and the said conveyance is the act and deed of said corporation. % WITNESS my signature and official seal at Sebastian, In the Coun of ndi nd 'State,'of F oR , the day and year Iasi aforesaid. / 1-40 '"'�ANDA M. GALLEYW COWA1113M 0 cc 37572, 1 :...... ..... . ................. ................... Nota Public, State f lorlds at Lar et](Pm: ,ms is, 199E rY g BMW My co ulaslon expirEa Linda M. GOley • THE SEBAS77AN CEME•TERY CITY OF SEBASTIAN, FLORIDA PT IS HE EBY ACKNOWLEDGED OF THE SUM OF: Dollars FROM: on this ./ day •of �/' "/,%� �' 19 G '(.=f for the purchase_ of the following described Cemeter, Lot.(a-r1 upon the terms and conditions as stated herein: Description of Property: Cemetery Lot -Block ��J Unit Purchase Pri ce..`f�� G-� / 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 ment the above named purchaserfs on the terms and co� above instrument. �,, l j City of S -Witness property to stated in the 04� °� • E0, ELICAN City of Sebastian 1225 MAIN STREET 13 SEBASTIAN, FLORIDA 32958 TELEPHONE () 589-5330 o FAX (dam) 589-5570 August 8, 1996 Barbara Ricci 113 Duban Street Sebastian, Florida 32958 Dear Mrs. Ricci: Enclosed is Cemetery Deed No. 1544 for Lot 5, Block 25, 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. 0. Box 1028, Vero Beach, Florida 32960. We are enclosing two copies of Receipt No. 899 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. SincereI Z, . 0"At- Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:Img Enclosures r Name Unit Block Lot Date of Mark -out Date of Burial Time -9 Name of Funeral Home Authorized by Paid by CEMETERY Receipt No. ........... Dated ......... 8 / 6 /'96 Lot 5 List Price $ . 500..00 Maximum No. Burial S Block 25 NO. 500.00 paces ................. Unit 4 Net Paid $ .. . ............ Monument permitted 1 -.5 (Data above this line for City Record only) Direct Disposer 1623 North Central Avenue 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies /6- - State of Florida, Depart of Health and Rehabilitative Services, Vitatistics x J priate APPLICA FOR BURIAL — TRANSIT PERMIT A. (Type or Print) Box b )p n...-; 1. Name of First Middle Last DATE Month Day Year Deceased Stanley Joseph OF Christensen DEATH 07/30/96 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Brevard Melbourne Inst. Mariner Health Of Melbourne 3. Name of Medical Medical Examiner Address Phone Number Certifier 720 E. Haven Avenue Cemeter In state emet ry John i D.O. X Physician Melbourne, Florida 32901 (407)724-4545 4. Name of Funeral Home/ 7. Funeral Director/ Address ,Sign re I Fla. Lic. No./Reg. No.1 Phone Number (Area Code) Direct Disposer 1623 North Central Avenue 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b )p n...-; was contacted on 07,431 119A 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 Potomski , 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 Seaast i an Cemeter In state emet ry Removal Final Disposition: 3mcrematoX- e/county: Indian River from state Donation 7. Funeral Director/ ,r ,Sign re F.E. No./Reg. No. Date Signed a/ PATI I a ` Z. W/11 1 /96 - - B BURIAL — TRANSIT PERMIT Permit No. 1228-96-0352 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. J Date Date Certificate Subregistrar Signature ` -e ' � Issued: 3Q 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--� BURIAL ❑ STORAGE Date of Disposition t 49 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton) ` or Person-ir-Charge This permit must be endorsed by the Sexton or person -in -charge (or oy 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.