HomeMy WebLinkAbout4-21-28Tity of #Phasllari
(Dent
""1850
r t r r y B r i p b NO.
THIS INDENTURE MADE T61a ......... Z�?TH...... day of .......J UNE ............................... A. D., »..2Q02
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
.......................... THQMAS ..E.... AND RATR.1G IA. A.... MURRAX..................... ...............................
933 MAJESTIC AVENUE
........ ..................SEM- SIIA.N.,. rLORIDA•• 329. 58 ..................... ..... .......................................
of the County of .... INDIAN RIVER anal State of . .FURZDA .........................................
as Grantee, WITNESSETH:
That the Grantor for and in consideration of the sum of $ , .7 Q Q.1 Q Q ............... 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) , , 2 $. , , Block, , , Z 1... , 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: -i .... ........................
City Clerk
Signed, Sealed and Delivered
In the esence of:
................
STATE Q)F FLORIDA
COUNTY OF INDIAN RIVER
CITY OF SEBASTIAN, FLORIDA
By W w 'I Pv.iY .................
Mayor
((tIitg Seal)
I HEREBY CERTIFY, That on this ......... 26th ........ day of ......... June ...... ..............................x "..2.902
before me personally appeared ..Wafter W. Barnes Sall A. Ma O
and ........ ..y...........? ................
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
Thomas E. and Patricia A. Murray ............. ...............................
..... ........... .
.................. ............................... 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. �ttllI1110110"
WITNESS my signature and official segogkt" tj •�° a County of Indian River and State of Florida, the day and year
last aforesaid. 0N s ��
O� #CC812716 Qz N, ry Public, State of Florida at Large.
!, y �� commission expires:
E
Name
I r
Unit
I I
Block
Lot ;a Y
Date of Mark -out
Date of Burial
Name of Funeral Home
Authorized by
Time '
MURRAY, THOMAS E. AND PATRICIA A.
933 MAJESTIC AVENUE
SEBASTIAN, FLORIDA 32958
772 - 388 -3761
LOT 28, BLOCK 21, UNIT 4
Paid by CEMETERY Receipt No.. 0 8 ? 5 , , . , , , , , Dated .... 6 2 6 2 0 0 2
List Price $ .... 7QQ:.QQ.... Maximum No. Burial Spaces .................
Net Paid $ , . , , . 7 QQ.,Q Q , , . , Monument
permitted .......................
(Data above this line for City Record only)
DEED #01850
MURRAY, THOMAS E. AND
PATRICIA A.
NO.
..,1850.
LOT 28, BLOCK 21, UNIT
FLORIDA DEPARTMENT OF
HEALT
A. (TYPE)
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT %� A r0)%--7
1. Name of First
Middle
Last
Date
Day Year
Deceased
Signature of Sexton
or Person -in- Charge
47 -
THOMAS
EDWARD
MURRAY
MARCH 16, 2004
Death
2. Place of Death City, Town or Location
Name of (If neither, give street address)
ffthN RIVER SEBASTIAN
Hosp. or933 MAJESTIC AVE
Inst.
3. Name of Medical
Address
Phone Number
Certifier NOOR M. MERCHANT,
MD
13060 US1
Medical Examiner
Physician
SEBASTIAN,
FL 32958
772 -589 -0879
A. Name of Funeral Home /Direct Disposal
Address
Fla. Lic. No. /Reg. No.
Phone No. (Area Code)
Establishment
735 FLEMING ST
1772-589-1933
EAWINDS FUNERAL HOME
SEBASTIAN, FL 32958
2617
�. cnecK a. Lffl 7 he medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b• F-1 was contacted on
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that 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
medical certification of cause of death within 72 hours.
i. Funeral Director / ignat F.E. N22R9eg. No. 3 pl7 /Signed
Direct Disposer .tom(/ wry 4 / 04
3. BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 04- 2617 -061
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 eat c rtificate has been requested.
Registrar or Date Date Certificate
Subregistrar Signature Issued: 3/17/04 Due: 3/21/04
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 waiting period of 48 hours after death is
required for all cremations.
Method of Disposition:
DURIAL
STORAGE
CREMATION
OTHER (Specify)
Signature of Sexton
or Person -in- Charge
47 -
CEMETERY OR CREMATORY e
Place of Disposition 5,6 /J
Cf
Date of Disposition ,3 A C> / D
his 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
tithin 10 days to the local County Health Department in the county where disposition occurred.
Distribution: while: Cemetery or Crematory
-1326, 6/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer
tock Number 5740- 000 -0326 -2) Pink: Local Registrar
TO THE
ORDER
SEAWINDS FUNERAL HOME
735 FLEMING STREET
SEBASTIAN, FL 32958
C— - -kt, <;c
4075 1
63- 643/670
DATE
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June 28, 2002
Thomas E. and Patricia A. Murray
933 Majestic Avenue
Sebastian, Florida 32958
Dear Mr. & Mrs. Murray:
Enclosed is City of Sebastian Cemetery Deed number 01850 for Lot 28, Block 21, Unit 4.
Also enclosed is a copy of your receipt.
If you have any questions, please contact our office.
Sincerely,
Sall Ni �.®... --
Clerk
SAM J s
enclosure
romw
I he Sebastian Cemetery
City ®i Sebastian, Florida
Receipt is acknowledged in the sum of:
Dollars ($ 7DO - O e )
From:
FhCM:
on this day of 20�2a for the purchase of the following
described Cemetery Lots) iche(s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot(s)/Niche(s) ;28 Block a21 Unit
Purchase Price: Dollars .($ 700 • eO )
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.
L 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
(��`
Cl ity of Sebastian Witness