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Home My WebLink About4-24-07Tifu of #rhastian T r m r t r r jj i r b NO. 01.828 THIS INDENTURE MADE Tills ....... 9th ......... day of ... , .JANUARY ............ . ..... . ........ A. D., fiX 2002 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and BETTY DOTY 671 S.W. FORSTER AVE. ............................................. ..SEBAST.IAN,.. FLQRIDA..3.29 58 ............. ............................... of the County of ......I.NDIAN RIVER ........... and State of ....FLORIDA as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ .. , . 7 QQ.•,O O ............. 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 , .. , ..... heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) ...7... , Block,. 24.... , 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 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: ....... L,! (.:. ..'. l .�- :_"_'� ............ /1 City Clerk /ned, led and 7ered ence of: ....... ........... CITY OF SEBASTIAN, FLORIDA By . ?` ✓Q, il�1!'). !! )! . W.V..►. A.0 ................ Mayor STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this .....9th ..............day of ........ January ........ .......................:x..2002 before me personally appeared ..... Wa 1 t e r W . Ba me 3 and Sally A . Mai O 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 ......................... .........................Betty. DOq................................................................... ......................... ............................... and severally acknowledged the execution thereof to be their 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. WITNESS my signature and official seal at Sebastian, In the County of Indian River and State of Florida, the day and year last aforesaid. HJOCANNESANDBERG �7YLls�,Ilort ... ..... � ................. MY COMMISSION !E CC 7258+12 Notuic, State of Florida at Lrge. EXPIRES: Apra 30, 20D2 My expires t 4f��li o Bonded Thru Notary Public I nderwritars Name Unit Block C Lot I Date of Mark -out Date of Burial / " Time Name of Funeral Home -S2!9 00 Authorized by DOTY, BETTY DEED #01828 671 S.W. FORSTER AVE. SEBASTIAN, FLORIDA 32958 LOT 7, BLOCK 24, UNIT 4 0A, Paid by CEMETERY Receipt .0 3.4 . No... .....Dated .. 1 /.9 /.?,Q Q? List Price $ . 700 . QQ .... .............. . .. Maximum No. Burial Spaces . . Net Paid$ ,790.0� • . ............. ....... Monument permitted ...................... . I-- (Data above this line for City Record only) 7 i -�rca DOTY, BETTY NO. 01828 LOT 7, BLOCK 24, UNIT Z a a, a _m Wti _ OZ �N cc 0 6 r Q IM4 �Rn 61 N ZW -M02 . W o. �L Q > cc a N co a C 0 w� Q~ CC a °o ve i ,i O ru O Iti Ul O ti a O Iti r� O d Garage Sates 00150134`1920 7 001501 341910 r� 001501 362100 Community Center Rent O Yacht Club Rent 8s Gz sic ru 001501 343800 O N ° a�� O 001501 369400 (0 m Weekend Service Q Yacht Club Security Deposit 680800 220682 II a a II� w 680800 220683 Riverview Park Security Deposit N VID �Ilea IIN �IIN = 8 rr White - Dept. of Origin • Yellow - Finance • Pink • Applicant LL O u_ NVIGUVnU 0 64 J i w N Q Z a a, a _m Wti _ OZ �N cc 0 6 r Q IM4 �Rn 61 N ZW -M02 . W o. �L Q > cc a N co a C 0 w� Q~ CC a °o ve i ,i O ru O Iti Ul O ti a O Iti r� O d Garage Sates 00150134`1920 7 001501 341910 r� 001501 362100 Community Center Rent O Yacht Club Rent 8s Gz sic ru 001501 343800 O OC� Cemetery Lots a�� O 001501 369400 Interment Fee 001501 369400 Weekend Service 680800 220681 Yacht Club Security Deposit 680800 220682 II a a II� w 680800 220683 Riverview Park Security Deposit VID �Ilea IIN �IIN = Initlals White - Dept. of Origin • Yellow - Finance • Pink • Applicant LL O u_ NVIGUVnU CITY OF SEBASTIAN 0349 CITY CLERK'S OFFICE RECEIPT Name s� ❑ Cash Date i ' �" 0 P�Check 9 2 Amow tPaW 001001 208001 Sales Tax 001501 322900 Garage Sates 00150134`1920 Copies/Bid Specs. 001501 341910 LDC /Code of Ordinances 001501 362100 Community Center Rent 001501 362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501 343800 Cemetery Lots 601010 343800 Cemetery Lots Lot/Niche _ , Block _ _, Unit 4— 001501 369400 Interment Fee 001501 369400 Weekend Service 680800 220681 Yacht Club Security Deposit 680800 220682 Community Center Security Deposit 680800 220683 Riverview Park Security Deposit Total Paid Initlals White - Dept. of Origin • Yellow - Finance • Pink • Applicant ff A DEPARTMENT OF EALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 4 i u� 1. Name of First Middle Last Date Month Day Year Deceased of Eugene Lewis Doty, Jr. Death Jan. 10 2002 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Vero Beach Inst. VNA Hospice House 3. Name of Medical Address Phone Number Certifier Noor Merchant, M.D. 13060 U.S. #1 1561-589-0879 Medical Examiner MPhysician Sebastian, FL 4. Name of Funeral Home /Direet-BispC l Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. Strunk Funeral Home Sebastian, FL 1228 561- 589 -1000 5. Check a. ❑ The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. �] Jeannie was contacted on 1/10/02 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Merchant will complete and sign the medical certification of cause of death withim 72 hours. C. was contacted on . He /she verified that Medical Examiner, will complete and sign the edicAl c9ofication o)/ca f death within 72 hours. 6. Funeral Director/ 'nature F.E. No. /Reg. No. Date Signed 1 R A I 1/in /n 7 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -02 -0021 FA five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. F No extension of time for filing the death certificate has been requested. Regi mffll sr� Date Date Certificate Subregistrar Signature APA , Issued: 1/10/02 Due: 1/15/02 C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA Approval Number: 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 Method of Disposition: Place of Disposition Sebastian Cemetery BURIAL FI STORAGE Date of Disposition �- ®CREMATION OTHER (Specify) Signature of Sexton �; or Person -in- Charge I 2 l / c 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 County Health Department in the county where disposition occurred. Distribution: White: Cemetery or Crematory DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740 - 000 - 0326 -2) Pink: Local Registrar January 10, 2002 Betty Doty 671 S.W. Forster Avenue Sebastian, Florida 32958 Dear Mrs. Doty: Enclosed is City of Sebastian Cemetery Deed No. 01828 for Cemetery Lot 7, Block 24, Unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office. Since o, City Clerk SAM.js enclosures The Sebastian Cemete* City of Sebastian, Florida Receipt is admowledged in the sum of: Dollars ($ 7DO O 0 ) From: TTY X� T X Phone: STf- 133 7 on this day of 20 I)A for the purchase of the following described Cemetery Lot(s)/Niche(s) upon the terms and conditions as stated herein: Description of Property. Cemetery Lot(s)/Mche(s) 7 Block 24 . Unit 4 ' _ D Dollars .(� 7D e 6 ) Purchase Price: � ��, �a ;� ; 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: Purchaser sib ature Purchaser signature The City of Sebastian agrees to sell the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. xty of Sebastian .Witness 601010 343600 Cemetery Lots Lot/Niche 7 Block %dr Unit 001501 369400 Interment Fee CITY OF SEBASTIAN CI'TX.,CLERK'S;OFFICE tJ . RECEIPT`. kY Name D Cash Date f� Check # AmounthWs ; 001001 208001 Sales Tax - 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501362100 Community Center Rent 001501362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501343800 Cemetery Lots 601010 343600 Cemetery Lots Lot/Niche 7 Block %dr Unit 001501 369400 Interment Fee