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HomeMy WebLinkAbout4-24-33THU of orhastian (Irmpt]ery BP,eb NO. '1851 THIS INDENTURE MADE This .....?2ND.......... day of ........ JULY .............................. A. D.,XA..20.Q2 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ......................... I .............. THEODOOR.. VAN.. GEL DER .............................................................. 6045 RIVER RUN DRIVE SEBASTIAN, FLORIDA 32958 ..................... ............................... of the County of . INDIAN ..RIVER ...................... and State of ... YLORIDA........................................ as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ . 9.5 0 . 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 .. , ..... , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) ... 13. , Block, ..ZA .. , , 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. K Attest:..'. Y6:k ...................... Ci Signed, Sealed and Delivered In thg Presence of: < ^ Lmat Gtr STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By 12"• •••' v•• ........... Mayor (lllttg �*ral) I HEREBY CERTIFY, That on this ........ •22ND• • • • • • • ,day of .......... JULY ,..2.Q02 before me personally appeared ....Walter W. Barnes . ........ and ... Sa1ly,.A... Maio ............. ................... 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 ................................................ .THEODOOR . ,VAN, ,GEL DER..................... ............................... . ......................... ............................... 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 yea- last aforesaid. (10�-ta-' •... ' .. it �Gf: H. JOANNE SANDBERG ublic, State of Florida at Lame. MY COMMISSION I DD 089532 fir/ EXPIRES: April 30, 2006 My fission expires: Bonded Thru Notary Pubic Uwerwriers Name Unit Block Lot _ _ - Date of Mark -out % 'it" Date of Burial_ fJ ® 0 Time_ Name of Funeral Horne iw Authorized by r VAN GELDER, THEODOOR Paid by CEMETERY Receipt No.... Q f M .. , . , , Dated ... List Price $ , ,9 5 0 : 00 Maximum No. Burial Spaces ................. Net Paid $ ..?59.-00 ..... .... Monument permitted ....................... (Data above this line for City Record only) 1851 LOT 33, BLOCK 24, UNIT 4 FLORIDA DEPARTMENT OF HEALTH A. (TYPE) State of Florida, Department of Health, Vital Statistics (� APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of Neeltje van Gelder Death Oct. 6 2002 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian Inst. 6045 N. River Run Drive 3. Name of Medical Address Phone Number Certifier William McGarry, M.D. 1460 36th Street Medical Examiner Physician Vero Beach, FL 772- 562 -7777 4. Name of Funeral Home /Q0e&tqspMV Address 1623 N. Central Ave. Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment Strunk Funeral Home Sebastian, FL 1228 772 - 589 -1000 o. L necK a. LJ I ne medical cemncatlon nas oeen completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Megan was contacted on 10/7/02 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. McGarry will complete and sign the medical certification of cause of death within 72 hours. C. was contacted on He /she verified that Medical Examiner, will complete and sign the edi al ce ' Xn of cause of death within 72 hours. 6. Funeral Director/ 0001" gn ure F.E. No. /Reg. No. Date Signed �r 1862 10/7/02 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -02 -0417 A 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. nNo extension of time for filing the death certificate has been requested. Wegis 77r -'d Date Date Certificate Subregistrar Signature t,.k Issued: 10/6/02 Due: 10/11/02 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 ethod of Disposition: Place of Disposition Sebastian Cemetery BURIAL STORAGE Date of Disposition CREMATION nOTHER (Specify) Signature of Sexton or Person -in- Charge } 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, 8197 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number 5740-000-0326 -2) Pink: Local Registrar O = W V S LL N0r m�m N NpX0 0�O. yy v I V N d A L U')J l"1 cn N a S y.6 on O l� 0 fl N �^ O d 0 Q r W 0 z a F dN dm W CO) 21 0 OH =Z�m� C D N J N _j O2LL N Q Un:m V �-)� Z LN = W --ocL U. V w Yz > �Q 7 .y m m 7 y U O C N U 7 C In N ... N Z l0 mm TO�1 "O'� J LL fn V% per. N C O 7 N N t C C C `�'i E c E E U E Y= E E ° t d E 3 0_ z 0 v `= 3 Y c°� �C N m ('7 P�J M (7 Cco7 li a O ru Ln O ru O Ln O ti a $ O r r— U3 O on m E a >" Ln a ru ru 0 4 (4 A S_ � •O C O 6 F d d T • C � O O C w3 A July 24, 2002 Theodoor Van Gelder 6045 River Run Drive Sebastian, Florida 32958 Dear Mr. Van Gelder: Enclosed is City of Sebastian Deed number 1851 for cemetery lot 33, block 24, unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office. Since i aio, City Clerk SAM:js enclosure 0 O a w 0 . 8 --k a a 0 f 0 w W 03 r r- ru V Ln 0 ti 0 O t 1 b m�Z IT z�> C G) z m or- N�v m A M mi M u \Ib D i w +� N � O A V CITY OF SEBASTIAN CITY CLERK'S OFFICE 0877 RECEIPT Name Van 6 e td iii ❑ Cash Date 7 1 U heck # ttC.(l V Amounthid 001001208001 1� 001501322900 Garage Sales b m�Z IT z�> C G) z m or- N�v m A M mi M u \Ib D i w +� N � O A V CITY OF SEBASTIAN CITY CLERK'S OFFICE 0877 RECEIPT Name Van 6 e td iii ❑ Cash Date 7 1 U heck # ttC.(l V Amounthid 001001208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501 362100 Community Center Rent 001501362100 Yacht Club Rent 001501362150 Non Taxable Rent 001501 343800 Cemetery Lots 601010 343800 Cemetery Lots Lot/Niche Block cpr- , Unit 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 Is White - Dept. of Origin • Yellow - Finance a Pink . Applicant The Sebastian Cemetery City of Sebastian, Florida Receipt is acknowledged in the sum of: Dollars ($ 5 S3 D4 From: -M Qd ) ©r Vo-,'6e(der 6 045 O Ver ku n Dr Se- bas-f -iaki, Ph0 h e` (7 7a, 5E9 - 2009 on this day of J—tk LV , 200_ 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)/Niche(s) 33 Mod,, Unit Purchase Price: Dollars ($ /7 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. X, or we, agree to purchase the above described property on the terms and conditions stated in the foregoing instrument: Purchaser sign ure 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. L30W& ty of Sebastian fitness