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Home My WebLink About4-25-32fli#g of J Prhas ittn NO. 15th November 96 THIS INDENTURE MADE This ...................... day of ............................................. A. D.. 19......, between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and William B. and/or Gloria C. Carter ....... I ...........................1.507 • -Clearb-rook * Stre'et............................................................. Sebastian, Florida 32958 ..................................................................................................................................... of the County of ..Indian , River ...................... an] State of............4.�5�................................ as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ 1 0 0 . to it in hand p ... J ......:.............. paid, the receipt whereof is herewith ac- knowledged, o- knowledged, does by this instrument grant, ban aa, sell, release, convey and confirm unto the Grantee ,their heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) 31,& 3 2 Block, 2 5... . , 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 iuch 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 seal to be hereto affixed, the day and year first above written. Attest: .j�n... � City Clerk Signed, Sealed and Delivered in the Presence of: �z:.. .................... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By Cp f, L�.Q..O .� ..e .. 4-4-5.A�.. . Mayor (Qu deal) I HEREBY CERTIFY, That on this ........... 1.5th...... day of.........No.Vember ............................. 1996, 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 individuals and officers described in and who executed the foregoing conveyance to William. B... ..and/ ........r ...................................... ............................................ ....... . and severally acknowledged the execution thereof to be thole free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corporation. Name 1a iii a - Unit Block AS Lot_ 7. Date of Mark -out ila.te of Burial %a -~, Time 4 Name of Funeral Home Authorized by °5 OF State o da, Department of Health, Vital Statistics. �L�1-r APPLIL'ATION FOR BURIAL — TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF William B. Carter DEATH Dec. 24 1998 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Brevard Melbourne Inst -Holmes Regional Medical Center 3. Name of Medical Medical Examiner Address Phone Number Certifier 150( Shashin Desai, M.D. Physician 2290 W. Eau Gallie Blvd., Melbourne, FI 407-255- 4. Name of Funeral Home/ Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Direct Disposer 1623 N. Central Avenue Strunk Funeral Home Sebastian, FI 1228 561-589-1000 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box Misty was contacted on12/28/98 within 72 b 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 Dr. Desai 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 Sebastian CemeteryIn state cemete Removal Final Disposition: crema y - /county: Indian River from state Donation 7• Funeral Director/ Sig ur F.E. No./Reg. No. Date Signed 1862 12/26/98 B BURIAL — TRANSIT PERMIT Permit No. 1228-98-0558 Permission is hereby granted to dispose of this body. - E] 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. Date Date Ce; if c Subregistrar Signature Issued: i Z y 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. Is] Methods of Disposition: 9BURIAL ❑ CREMATION CEMETERY OR CREMATORY Place of Disposition "� �T�� l o ❑ STORAGE Date of Disposition j ecp"M ❑ OTHER (Specify) Signature of Sexton ) or Person -in -Charge) This permit must be endorsed by the Secton or person -in -charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the County where disposition occurred. DH 326. 10196 (Replaces HRS Form 326 which may be used) ...— (Stock Number: 5740-000-0326-2) J