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Home My WebLink About4-21-15i AM Tttu of #PI1aSfiiltt It Ut rtrrlj W'i i NO. (}1Y60 THIS INDENTURE MADE nb .....Z1St........... day of ...... September ....................... A. 13,,Xlk.Z9 0 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Frank E. or Dorothy. I., ..Osborn ............................ . .7.09..Silverhorn..C.t.: .................................... Barefoot..Bax.,...T Orlda..32. 976................... ............................... of the County of ....... Indi.an..Rime = ................. and State of ........ Florida.... ............................... as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ .l a. 8.0 Q t 0 0 ............. 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) 15.&16 , Block, . 2 L ... , 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, and Delivered In the resepce of: .)g ......•.� s ..................... ... 1Q0 ......... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By Ily- Ate.......... Mayor (Cite deal) I HEREBY CERTIFY, That on this ....... 21St .......... day of ..... ► S. ep tml?. er ............................... iv before me personally appeared ..Waltar...W.,..$ erne .S ............................. and .Kathryn..M,...Q'.H 11Q.raA. 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 .... .............. ..I .................. Frank.. �...Qx..l1.QXot. X.. ►.. QSb4. XA............. ............................... ......................... ............................... 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 d year last aforesaid. H. JOANNE SMIDBERG ./ 6 ' ` N ,� MY COMMISSION # CC 725842 Notary ubBe, State of Flor4&r .� EXPIRES: April 30, 2002 My co ' fission expires: Bonded Thru Notary Pubk Underwriters Name Unit Block Lot Date of Mark -out zal —I_,o Date of Burial d Time �C-) Name of Funeral Home 01V X t� Authorized by x OSBORN, FRANK E. OR DOROTHY I. 709 SILVERHORN CT. BAREFOOT BAY, FLORIDA 32976 7 -al- a000 DEED #1760 LOTS 15 & 16 BLOCK 21 UNIT 4 Frank E. or Dorothy I. Osborn Paid by CEMETERY Receipt No ............. 9 �21 �2QQQ �A�EFGbT/�3, ....Dated . . 1 800.00 NO. List Price $ , , p, , , , , , , , Maximum No. Burial Spaces ................. lots 15& 16 Net Paid $ .I..$QQ ;QQ ...... Monument permitted ....................... Block 21, Y't ti , vj (Data above this line for City Reeord only) ff EP ARTMENT OF ALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT uy 1. Name of First Middle Last Date Month Day Year Deceased of Dorothy Osborn Death 5 -19 -01 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian Vero Beach Inst. 2715 53rd Avenue 3. Name of Medical Address Phone Number Certifier Farhat Khawaja, M.D. 7754 Bay Street, Ste 7 F—Imedical Examiner Physician Sebastian FL 32938 (561) 589 -3000 4. Name of Funeral Home /Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 916 17th Street 1(561) Strunk Funeral Home Vero Beach FL 32960 0130 562 -2325 5. Check a. F-1 The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. ® Peg was contacted on 5 -21 -01 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Khawaja will complete and sign the medical certification of cause of death within 72 hours. C. was contacted on He /she verged that , Medical Examiner, will complete and sign the medical certificaWn of cause of death within 72 hours. 6. Funeral Director/ Sig e/ F.E. No. /Reg. No. Date Signed Direct Disposer 4428 5-c-;{-0 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 0130- 01-0252 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. KANo extension of time r filing the death certificate h tbee r Registrar or Date Date Certificate Subregistrar Signature Issued: 0 Due: 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 7 WBURIAL STORAGE Date of Disposition CREMATION OTHER (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, 8/97 (Obsoletes all previous eddions) Yellow: Funeral Director or Direct Disposer (Stock Number. 5740. 000. 0326 -2) Pink: Local Registrar Ab 0 � P ?fF OF PEI ICPN 5� City of Sebastian 1225 MAIN STREET o SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589 -5330 0 FAX (561) 589 -5570 September 25, 2000 Frank E. Or Dorothy I. Osborn 709 Silverhorn Ct. Barefoot bay, Florida 32976 Dear Mr. & Mrs. Osborn: Enclosed is Cemetery Deed number 1760 for Lots 15 & 16, Block 21, Unit 4. Also enclosed is a form - Return for Transfers of Interest in Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded. If you wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, 2000 16th Avenue, Vero Beach, Florida 32960. Sincerel , / �F�V &Jcv`" Kathryn M. O'Halloran, MMC City Clerk KOH/js Enclosure(s) 4 0 0 CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT �r` ' Initl I White - Dept. of Origin • Yellow - Total Paid • Pink - Applicant O V —%7 O UjIn r ru I sr m ui M3 W O r ru V ru ru Un W-1 ru 03 -J �� 001501369400 Name f ,:te ❑ Cash Date � -,"2,1 / " ,Check # 72 Community Center Security Deposit :.: No. # Riverview Park Security Deposit AmountPald 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances '' a :001501362100 Community Center Rent V 001501 062100 Yacht Club Rent I 001501362150 Non Taxable Rent =: 001501 343800 Cemetery Lots 0 601010 343800 Cemetery Lots V ~ m �r` ' Initl I White - Dept. of Origin • Yellow - Total Paid • Pink - Applicant O V —%7 O UjIn r ru I sr m ui M3 W O r ru V ru ru Un W-1 ru 03 -J Lot/Niche ^ l! , Block ��' I Unit y/ 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 �r` ' Initl I White - Dept. of Origin • Yellow - Total Paid • Pink - Applicant O V —%7 O UjIn r ru I sr m ui M3 W O r ru V ru ru Un W-1 ru 03 -J °tea a �o m rV C ��.y to Rs `0 '' a m V n A N t 00 N Nn 0 y V ~ m 01 O a m to Rs `0 '' a m V n A N t 00 Abe Sebastian CemetA� City of Sebastian, Florida Receipt is acknowledged in the sum o£: Dollars ($ /, sc 9f on this day o 20 D/� for the purchase of the following described Cemetery Lot(s)/Ni e(s) upon the terms and conditions as stated herein: Description of Property: Ceme Lot(s) iche(s) Block o2/ 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. ,d,O P r_�z., I _ ay&4 ity of Sebastian Witness