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Home My WebLink About4-22-16Tito of OrhastiMri 01601 G G NO. THIS INDENTURE MADE TWa ......22nd......... day of .......June ......... ... A. Dy AX 2.901 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ......... ............................... EDWARD J . REGAIN 6155 S. MIRROR LAKE DR. , NOS i05...... ......................................... MAST.IAN, ... FL ORI,DA..3. 2958 -. 8405 ...... ..................................... of the County of ....... IND.IAN RIVER .................. and State of .......... FLQ R. 11) A................................. as Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ . ; 5 ; 0 0 . , , , , , , , , , , , to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confum unto the Grantee ....... , , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) . 16... , Block, ...? 2 .. , 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. STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA Amj' � ................. Mayor (QIitg Sent) I HEREBY CERTIFY, That on this ...... 22i?d ........... day or ...........June ,x 2001 before me personally appeared ...... Walt.er..W.. Barnes .............. and ..$A! ly.. io respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the Individuals and officers described in and who executed the foregoing conveyance to ........... ............................... Edward. . J.... Re. g, an.................................................................. ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year last aforesaid. Y MY H. CO JOANNE ANDBER 5942 EXPIRES: April V, 2002 9 K; :t10 Bonded Thru Notary Pumc- uniKrwrt ere �.. . . .................. Nota ublic, State of Florida at Large. My isslon expires: Attest: ............. .....'.. ............. City Clerk Si ned, S led and Delive d i the Bence of . .... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA Amj' � ................. Mayor (QIitg Sent) I HEREBY CERTIFY, That on this ...... 22i?d ........... day or ...........June ,x 2001 before me personally appeared ...... Walt.er..W.. Barnes .............. and ..$A! ly.. io 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 ........... ............................... Edward. . J.... Re. g, an.................................................................. ........................................................ 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. Y MY H. CO JOANNE ANDBER 5942 EXPIRES: April V, 2002 9 K; :t10 Bonded Thru Notary Pumc- uniKrwrt ere �.. . . .................. Nota ublic, State of Florida at Large. My isslon expires: r Name Unit Block Lot F' S 4. rr Date of Mark -out x. r Time Date of Burial Name of Funeral Home Authorized by REGAN, EDWARD J. 6155 S. MIRROR LAKE DR., NO. 105 SEBASTIAN, FLORIDA 32958 -8405 LOT 16, BLOCK 22, UNIT 4 Paid by CEMETERY Receipt No ... Q 84-, .. _ . . .Dated ... List Price $ Maximum No. Burial Spaces .. Net Paid $ ... 7�` � . � � ............... • Monument permitted ...................... . (Data above this line for City Record only) DEED ;'01801 EDWARD J. REGAN LOT 16, BLOCK 22, UNIT 4 NO. 1t5,kj -,L- FLORIDA DEPARTMENT OF HEALT �. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 7 zz 1. Name of First Middle Last Date Month Day Year Deceased Edward J. Regan Death March 5 2004 ?. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or St. Johns St. Augustine Inst. Fla ler Hospital, Inc. I. Name of Medical Address Phone Number Certifier Ernest Carames, M.D. 16 St. Johns Medical Park Drive Medical Examiner Physician St. Augustine, FL 904- 794 -5411 I. Name of Funeral Home/Dirael Pisp@&* Address Fla. Lic. NoJReg. No. Phone No. (Area Code) Establishment 1623 N. Central Avenue Strunk Funeral Home Sebastian, FL 32958 1228 772 - 589 -1000 Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Sherri was contacted on 3/8/04 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Carames will complete and sign the medical certification of cause of death wit 'n 72 hours. C. J was contacted on He /she verified that Medical Examiner, will complete and sign the medi rtifi ause of death within 72 hours. Funeral Director/ ur F. E. No. /Reg. No. Date Signed ra DisDiepeear;• zlkA-,� 1862 31 S / 04 BURIAL - TRANSIT PERMIT �Permission is hereby granted to dispose of this body. Permit No. 1228 -04 -0097 i 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 filing the death certificate has been requested. Wagw rte." Date Date Certificate Subregistrar Signature "— M Issued: 3/5/04 Due: 3/10/04 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 wafting period of 48 hours after death is required for all cremations. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery BURIAL STORAGE Date of Disposition 3 // O O y CREMATION OTHER (Specify) Signature of Sexton or Person -in- Charge tis 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 thin 10 days to the local County Health Department in the county where disposition occurred. Distribution: White: Cemetery or Crematory 1 326, 8/87 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer ock Number: 5744000.0326.2) Pink: Local Registrar CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Name ❑ Cash Date �a -O �Checkf No. V O AmountPald 001001208001 W j rnj Ln Garage Sales O i 001501 341920 I ■ [%- LDC/Code of Ordinances SET 001501362100 !^O ru Yacht Club Rent JEr 001501362150 ,4- :i 140 Cemetery Lots rC 601010 343800 ')1 ru � � v r J E V O 4 D C �y O C l.� rn tm Ic O 0 .. CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Name ❑ Cash Date �a -O �Checkf No. V O AmountPald 001001208001 Sales Tax 001501322900 Garage Sales 001501 341920 CopieslBid Specs. 001501341910 LDC/Code of Ordinances 001501362100 Community Center Rent 001501062100 Yacht Club Rent 001501362150 Non Taxable Rent 001501343800 Cemetery Lots 601010 343800 Cemetery Lots LoUNiche Ile , Block 0�2 , Unit 001501369400 Interment Fee 001501369400 Weekend Service 680800 220681 Yacht Club Security Deposit 680800 220682 Community Center Security Deposit 680800 220683 Riverview Park Security Deposit Total Paid 7, ' d Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant aff OF �K�TN HOME OF PELICAN ISLAND June 28, 2001 Edward J. Regan 6155 S. Mirror Lake Dr., No. 105 Sebastian, Florida 32958 -8405 Dear Mr. Regan: Enclosed is City of Sebastian Cemetery Deed No. 01801 for Cemetery Lot 16, Block 22, Unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office. Sin y, y A. M ', CMC City Clerk A The Sebastian Cemetery City of Sebastian, ]Florida Receipt is acknowledged in the sum of: Dollars ($ 75D 'e4' G ) on this day of (s) up on 20 D / for the purchase of the following described Cemetery Lot ch s) e the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)%Niche(s) Block Unit Purchase Price: 4de v' Dollars VX 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 signatur 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 ity of Sebastian Witness