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Home My WebLink About4-24-35Tito of #rhafifian 14853 p r m r t [� r Ij ID r r b NO. THIS INDENTURE MADE Mds ... Z5TH............ day of ...... JULY . ............................... A. D.,Xll..2.QQ2 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ... ............................... KI ZABETII.. VAN.. Z I.L E..................................... ............................... . 1122 ROYAL PALM DRIVE, BAREFOOT BAY, FLORIDA 32976 ............................................. ............................................ ............. I.............................. of the County of ...... INDIAN..RIVER ................. an�i State of ......FL.QRIDA ........... ............................... as Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ ,1.,,12 5.. 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) . 3 5... , 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: .....�. .. .................. . . . City Clerk Signed, Sealed and Delivered In the Presence of. .. -.... . .......... ....... . ....... . ........ STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By .,r��. � . !`! .............. Mayor (civ Seal) I HEREBY CERTIFY, That on this .....2.5.TH ............ day of ... JULY .......................................... XW .2QO2 before me personally appeared ,.WALTER W. BARNES and SALLY A. MAID ............................... 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 ........ ............................... EL I,ZABET.K . MAN. Z IU................................................................ ....................... ............................... 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. umn,q ii <Oi '��' 2� G H. JOANNE SANDBERG ra Y .; MY COMMISSION # DD 089532 Nota ublie, State of Flor da at Larg. e. EXPIRES: April 30, 2008 My c fission expires s Pfi,lti. Bonded Thru Notary PL#* Underwriters Name f:-- Unit i Block Lot Date of Mark-out Date of Burial Time Name of Funeral Home Authorized by - - -------- -- Paid by CEMETERY Receipt No. ......... Dated ... ELIZABETH VAN Zj---- List Price $ ..... Afaximurnqo_ LE Net Paid$ 1. 125,00 ..... Burial Spaces. NO. Monument permitted ....................... -1853 (Data above this line for City Record W. LOT 35, block 24 V) , UNIT 4 0 M O O ru r V r O Dl -a O r ru O u-r O ru O Ul ru O r MO v-�� om n 0 1 D � In = N a� <� aZ < Z;K ;CM- z TO -O M &;r 0n NT =O r UlNiZ 1 0 40 �N ND I a Z � � I � I I G eU N g I� 0 a m m 0 0 v N �v 0 0 CITY OF SEBASTIAN 0891 CITY CLERK'S OFFICE RECEIPT Name ❑ Cash Date Check # AmountPak 001001 208001 001501 322900 001501 341920 001501 341910 001501 362100 001501 362100 001501 362150 001501 343800 601010 343800 001501 369400 001501 369400 680800 220681 680800 220682 680800 220683 Sales Tax Garage Sales Copies/Bid Specs. LDC /Code of Ordinances Community Center Rent Yacht Club Rent Non Taxable Rent Cemetery Lots Cemetery Lots Lot/Niche _, Block, Unit Interment Fee Weekend Service Yacht Club Security Deposit Community Center Security Deposit Riverview Park Security Deposit Total Paid /c z (/ Initials N white - Dept. of Origin a Yellow - Finance • Pink . Applicant N , V Pi 2 } 0 J r H ..� 17 O � �y O ,9 t t � M J ILA M "$ N 4 V I- F Loll vir AD � r N }AM Q a 4 � o S� U FLORIDA DEPARTMENT OF HEALT A (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT f �y 1. Name of First Middle Last Date Month Day Year Deceased of Roger G. VanZile Death July 24 2002 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland Inst. Sebastian River Medical Center 3. Name of Medical Address Phone Number Certifier Muhammad Fairoog, M.D. 777 37th Street MMedical Examiner Physician Vero Beach FL 772- 567 -2277 4. Name of Funeral Home /13ire6t- Dacp4eml Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) 1623 N. Central Avenue Establishment Sebastian, FL 1228 772 - 589 -1000 Strunk Funeral Home 5. Check a. U The medical certifcation has been completed and signed. A completed certificate Or deatn accompanies tnis Appropriate application. Box b. 6 Carolyn was contacted on 7/24/02 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Farooq 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 rtificatio of use of death within 72 hours. 6. Funeral Director/ ignat A F.E. No. /Reg. No. Date Signed 1862 7/24/02 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -02 -0324 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. No extension of time for filin a th certificate has been requested. RegrrF� Date Date Certificate Subregistrar Signatu r /„ Issued: 7/24/02 Due: 7/29/02 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 FISTORAGE Date of Disposition�� /� CREMATION F10THER (Specify) Signature of Sexton 1 or Person -in- Charge J} 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. DH 326, 8/97 (Obsoletes all previous editions) (Stock Number: 5740-000 -0326 -2) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar i C Iz> . The Sebastilan Cemetery City ®f Sebastian, Florida Receipt is acImowledged in the sum of: Dollars ($ / gas , as ) From: d;> 27-�,EZ -11 LW .Z /Z- z5 2 /(-'o Yf% A41?7-Ale on this day of 20� for the purchase of the following described Cemetery Lots) eo upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)/Niche(s) Block v?-711 Unit Purchase Price: 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: Purchaser signature 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. gly of Sebastian Witness July 30, 2002 Elizabeth Van Zile 1122 Royal Palm Drive Barefoot Bay, Florida 32976 Dear Mrs. Van Zile: Enclosed is City of Sebastian Deed number 1853 for cemetery lot 35, block 24, unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office. Si y, oil Sally A.' 6, C City Clerk SAM: j s enclosure LottNiche , Block _a-O Unit 001501369400 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 CITY OF SEBASTIAN 089; 7 �==M No O _ .o "r m ' T7D LM m� W t ; $ •w � r ,iii -� p A "n ru N -2 001001 208001 Sales Tax -4 mm O ` 001501 341920 O 001501341910 ;S ru 001501 362100 Community Center Rent i ru .r Yacht Club Rent 001501 362150 Ln 001501 34,';800 Cemetery Lots Ul ��p( Ln Cemetery Lots W LLr w T.a v w \ 1� ov N lr{ CM ED c N 00 t C V— co co LottNiche , Block _a-O Unit 001501369400 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 CITY OF SEBASTIAN 089; 7 CITY CLERK'S OFFICE RECEIPT SName Aff- 0 Cash Date .Z' AmountPaid 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDCICode of Ordinances 001501 362100 Community Center Rent 001501 362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501 34,';800 Cemetery Lots ��p( 601010 343800 Cemetery Lots LottNiche , Block _a-O Unit 001501369400 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