The URL can be used to link to this page

Home My WebLink About4-25-14Paid by CEMETERY Receipt No....940 ...... Dated. January 27, 1997 • Lot 14 List Price $ .................. Maximum No. Burial Spaces ................ Block 25 Net Paid $ ...9011.0 ....... Monument permitted .....................Unit 4 (Data above this line for City Record only) Titg of Orhantittn NO. TrutrtrrIj 33rrb NO. THIS INDENTURE MADE nU .27th .............. day of ,January .................................. A. D., 1997..., between like City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Joan Williams ........................................9890 - Holly • Street.................................................................. Micco, FL 32976 ..................................................................................................................................... of the County of Indian. River .. . . ... . .... . ..... . an -I State of . Florida as Grantee, WITNESSETHk That the Grantor for and in consideration of the sum of $ . 9 .00 , , , 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 ,She , , , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit; All of Lot(s) . ,i4. . , Block, .25..... , 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 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 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 fust above written. CITY OF SEBASTIAN, FLORIDA Attest: ...)77.40:'LGrC'/r:!k4A.l.►..... By4U4441..'e City Clerk Mayor Signed, Sealed and Delivered In the Presence of. ................ (9itu deal) STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this ...27tb...............day ofJantlary ................. 19.97, before me personally appeared ,Louise R. Cartwright and Kathryn M. O;Halloran ................... .................... 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 iudividwds and officers described In and who executed the foregoing conveyance to Joan Williams ....................................................................................................................................... ............................. I.......................... and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official scut of said corporation Is duly affixed thereto, and the said conveyance is the act and (Iced of said corporation. WITNESS my signature and official seal at Sebastian, In the Corr�dy of n Iverr"��d&7a ofFlorida, the day and yes- last aforesaid. I'' n /1 LINDA M. GALLEY MY COMMISSgt% 31672'1 ..... . , . EXPIRES: Jmu 18,1898 Nota Public, Sta a Florida at Lar 9mkdW 16m gaNy Pub 1A1d1nsMgt My c roralsslon ex ea s Linda M. Galley . 0 9 W THE SEBASTIAN CEMETERY CITY OF SEBASTIAN, FLORIDA OF THE SUM OF: G FROM: on thisC_.Z / ✓ day of , 19 following described CemeFinx: y Lot conditions as stated he Doll ars (401, Z/) for the purchase of the upon the terms and Description of Property: Cemetery Lot Bloc 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 the above named purchaser(s) on above instrument. the ab9ire ment' ned property to d condions stated in the • T7F OF —.c.4 SSS' City of Sebastian 1225 MAIN STREET 0 SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 0 FAX (407) 589-5570 January 31, 1997 Joan Williams 9890 Holly Street Micco, Florida 32976 Dear Mrs. Williams: Enclosed is Cemetery Deed No. 1568 for Lot 14, 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. 924 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. Sincerely, Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:Img Enclosures Name Unit Block Lot Date of Mark -out ll Date of Burial— 21 Time Nnmp M Fiinpr;al Hnmp Paid by CEMETERY Receipt No... 924 ......... Dated. 1997 27 ......... List Price $ .................. Maximum No. Burial Spaces ... Lot 14 ............. Block 25 Net Paid $ ...900. of) ....... Monument permitted ..................... Uni t 4 (Data above this line for City Record only) NO. 6�dG� Tom. LcI-ib vckd t), an 4 ��h�erwlo(�e -- ---------Dud1565 lel I�l,�rka5,l In 4'-� "'L State of Florida, Departm f Health and Rehabilitative Services, Vital tics 5� APPLICATFOR BURIAL — TRANSIT PERMIT /� /� A. (Type or Print) z ( " / 1. Name of First Middle Last DATE Month Day Year Deceased E. Penelope Cavanaugh DEATH 01/17/97 2. Place of Death City, Town or Location Name of (if neither, give street address) County Hosp. or Brevard Little Hoo lXvgod Inst. 9890 Holly Street 3. Name of Medical Medical Examiner Address Phone Number Certifier 7744 Bay Street Noor Merchant M.D. Physician Sebastian Florida 32958t'561)589-0879 4. Name of Funeral Home/ AddressFla. Lic. No./Reg. No. Phone Number (Area Code) Direct Disposer A n. c% ► .-s i_em ^161�..7 •....... 5. Check Appro- priate Box a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies this application. b [j She i- was contacted on 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 Nnar Marchant, M_[]_ 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 Cemeteryn state cemetery/ Removal Final Disposition: tory - nEne nty: Indian River from state Donation 7. Funeral Director/t-eispvs>?r" ' ature F.E. No./Reg. No. Date Signed %;ee1 `b 6 7_ m /17747 B. BURIAL - TRANSIT PERMIT Permit No. 1228-97-0037 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. �. - Date7 /9 ., Date Certi is e1 Z/5 Subregistrar Signature Issued: Due: 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 3&c44n_t,�. El' &422 g'72 0 BURIAL ❑ STORAGE Date of Disposition / ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in -Charge) L,3 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)