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Home My WebLink About4-21-31Ti#u of #rhafi#iau (� •1848 Ty� r ut r t r r r r NO. THIS INDENTURE MADE Thh ....24TH........... day of ........... my ............................. A. D., *X.2902 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and DOREEN GUENIN .......... ........................4.0.7.. PERIWINKLE *DRIVE ........................... ............................... ......................................... S. EBAS1IAN,... FL ORIDA.. 3. 29 58. ...... ............................................ of the County of ....INDIAN RIVER .... an] State of ......FLORIDA as Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of $ 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) , 31, , , , Block, , , ,? 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 dried 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: . . . W ...................... City Clerk Signed, Sealed and Delivered In the Presence of: _ 1 11yV0L .............. > . ..n ................ �, STATE OF FLORIDA 7 COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By . W. (.�J..� ... � � V!.-;........... . Mayor ((Ility Meal) I HEREBY CERTIFY, That on this ......24th ...........day of ......... May .......... ............................=.. 2002 before me personally appeared .. Walter W. Bar . nes . . .... . and . Sally..A...Mai.o ............... .................... 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 cossveyanee to ................ ............................... DOREEN GUENjN.................................. ............................... ......................... ............................... and severally acknowledg execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said cor ration s 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 Coun of India River and St of Flo da, the day and Year last aforesaid. vA' ANN V. ROUSSEAU MY COMMISSION I DD U89531 o ry Public, State of Flor a at Large. EXPIRES: March 18, 2oo6 My commission expires s ;RF, ,.• e«dad 71ru Naffiy RW Uwwreers 3 Name Unit__—_ " Block I Lot al Date of Mark- out er4- Date of Burial _[ /+'i Time -T' r Name of Funeral Home ST/, IJAIRS Authorized by GUENIN, DOREEN DEED #1848 407 PERIWINKLE DRIVE SEBASTIAN, FLORIDA 32958 388 -0710 LOT 31, BLOCK 21, UNIT 4 RICHARD R. GUENIN INTERRED 5/20/02 DOREEN GUENIN Paid by CEMETERY Receipt No.... 07.49 , , , , , , Dated .... 5 /.4A/P2, N0. List Price $ ..7 Q Q,., Q Q ....... Maximum No. Burial Spaces ................. Net Paid $ ..7QQ:.OQ ....... Monument permitted ...................... . 1-848 LOT 31,BLOCK 21, UNIT 4 (Data above this line for City Record only) CITY OF SEBASTIAN 0737 CITY CLERK'S OFFICE RECEIPT Name f' 'r1� ❑ Cash Date —,!I C hock 0 AmowttPaid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501362100 Community Center Rent 001501362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501 343800 Cemetery Lots 601010 343800 Cemetery Lots Lot/Niche � , Block. "V 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 716-1 d Total Paid 73. Initials White - Dept. of Origin • Yellow - Finance a Pink • Applicant IS to o ryy�� N CB N Q Q I— 0 O N 6q O O N a O W - ru Ln 0 ru O z Q �m Ln (A LLI O t aPL I ru Oz ;N N O 0 LL _0NJ •' 0 -Si LD cc V 0 p NJ ro m p m 0V z > LLI Ln Y Q a1 rM z> 7 sail rrn F a - O p II a „Z II� W �II� 0 aoo 0 FORIDA DEPARTMENT OF State Ha fcs zX!E APPLICATION FOR BURIAL TRANSIT PERMIT A. (TYPE) 1. Name of First Middle Last Date Month Day Year Deceased of Richard Ronald Guenin Death May 15 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 Certifier Syed Mahmood, M.D. 7754 Bay Street Phone Number Medical Examiner Physician Sebastian, FL 772 - 589 -3000 4. Name of Funeral Home /Direet-6iepeael Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Avenue Strunk Funeral Home Sebastian, FL 1228 772- 589 -1000 5. Check a. r-1 The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Pat was contacted on 5/20/02 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. MahuKmd will complete and sign the medical certification of cause of death within 72 hours. C. M was contacted on He /she verified that Medical Examiner, will complete and sign the mecliqw-jertipotion of of death within 72 hours. 6. Funeral Director/ ire ire • F.E. No. /Reg. No. Date Signed Dir2ispeeer 1862 5/16/02 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -02 -0230 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. Regist at Date Date Certificate SubregistrarSignature Issued: 5/16/02v Due: 5/21/02 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 STORAGE Date of Disposition %?} O � / CREMATION Signature of Sexton t or Person -in- Charge Jj OTHER (Specify) 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. 3H 326, 8197 (Obsoletes all previous editions) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Stock Number: 5740-000-0326-2) Pink: Local Registrar June 7, 2002 Doreen Guenin 407 Periwinkle Drive Sebastian, Florida 32958 Dear Ms. Guenin: Enclosed is City of Sebastian Cemetery Deed No. 1848 for Cemetery Lot 31, Block 21, Unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office. Sincerely, all City CCIerk�7- SAM.js enclosures r CITY OF SEBASTIAN "I ,r a 4 9 CITY CLERK'S OFFICE RECEIPT Total Paid Initials White — Dept. of Origin • Yellow — Finance • Pink - Applicant ❑ Cash Date Check 0 " AmountPak 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC /Code of Ordinances 001501362100 Community Center Rent 001501362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501 343800 Cemetery Lots 601010 343800 Cemetery Lots Lot/Niche _, Block , 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 Initials White — Dept. of Origin • Yellow — Finance • Pink - Applicant The Sebastian Cemetery City of Sebastian, Florida Receipt is acknowledged in the sum of: From: E/11lr1) Dollars ($7& . ee ) on this oq"�la day of 20 D o7 for the purchase of the following described Cemetery Lot(s)/Nich upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)/Niche(s) Block a?/ Unit Purchase Price: Dollars ($ 74-e , D 6 ) 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. 1, 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. 0ty of Sebastian Witness