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Home My WebLink About4-21-33Tttu of #rhastian • THIS INDENTURE MADE This ....1.1.TH... day of ..... DECEMBER ...... . ............. A D, W..2QOO between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and FRANCIS & EVELYN ERICKSON C�O..RENE VAN DE VOORDE, 3663 15TH AVENUE ... ATTORNEY "AT "L'AW " " "' ........................................... VERO ..BEACH., ..F.L.ORIAA.. 329.60... ............................................ of the County of .... ZND.IAN..R.Z`lER ................... and State of .... � .Q ��A........ .......:....................... as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ '1 ,.5 Q Q...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)3 3.&.34 , Block, . 2,1.... , 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. .. ..... a. - /.! /„ G.` ...................... City Clerk Si ed, S led and Deliver i the esence of- f 0'71 G � STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By �! V..14�!T� . ............. . Mayor (Civ'Seal) I HEREBY CERTIFY, That on this ..... 11TH............dy of ........DECEMBER X000 before me personally appeared .......W.AI TER. W..... BARNES ........................ and SALT Y..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 cowveyance to FRANC I ............... ............................... . .. S.. &..EVELYN..ERICKSON ....................................................... 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. 1 WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year T Name �' /��,.�LA'% Unit_ J Lot Date of Mark -out -Z— Date of Burial 7 4. Time -a Name of Funeral Home Authorized by K"ti ERICKSON, FRANCIS & EVELYN 3663 ,5TH AVENUE DEED #1767 VRRO BEACH, FLORIDA 32960 LOTS 33 & 34 BLOCK 21, UNIT 4 BEING HANDLED BY: RENE VAN DE VOORDE, ATTORNEY—AT- LAW 1327 NORTH CENTRAL AVE. SEBASTIAN, FL 32958 I/ Paid by CEMETERY Receipt No..........., .....Dated 12 / 1 l,/ 2000 FRANCIS FRANCIS & EVELYN ERICKSON List Price $,1,500.00 .. ...... . .... Net Paid $ Maximum No. B Burial spaces ................. LOTS 3 3 NO. & 34, ..... • " "' ' ' ' Monument permitted UNIT 4 � BLOCK 21 (Data above this line for City Record only) M 0 p � r N m c6 r/ J � O Q 1 i .9 i I � F I _j a O 0 FU Ln ru r. O ru O Z Ln a O ru Q Q a am ^W $ O N W N La 0 o O ~ (2 aA ■■ =ZrC- a� �NJN O=LLN �. CC Z U �W°'0os- or W Z > Z p I • �a Q 0 O V =w Oa.0FQ U. CITY OF SEBASTIAN 08,74 CITY CLERK'S OFFICE RECEIPT Name • ./_ ! Z: ❑ Cash Date 7 Checkk -C��- AmountPaid 001001 208001 001501 322900 001501 341920 0015013419`10 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 "� lerso"" ) Weekend Service Yacht Club Security Deposit Community Center Security Deposit Riverview Park Security Deposit . I/ Total Paid Initials White - Dept. of Origin • Yellow - Finance • Pink • Applicant FLORIDA DEPARTMENT OF Hixil A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased Evelyn M Erickson of July 14, 2002 Death 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or 1 ndian River Vero Beach Inst. Integrated Health Services of Vero Beach 3. Name of Medical Address Phone Number Certifier C nthia S. Crawford,M.D. 1820 43rd Avenue, Ste 1 1(772) Pon Medical Examiner IA 1 Physician Vero Beach, FL 32960 778-2107 4. Name of Funeral Home /Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Avenue 1(772) Strunk Funeral Home: Sebastian, Florida 32958 1228 589 -1000 5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Marie was contacted on 7/15102 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Crawford 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 med' I rtifi cause of death within 72 hours. 6. Funeral Director / Sig t F.E. No. /Reg. No. Date Signed Direct Disposer ""9 ----r (g o-A 7—IS-0-7, B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -02 -0309 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 fling the death certificate has been requested. Date Date Certificate Subregistrar Signature Issued: 87— S—O'Z� Due: 7— {g --OZ- C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA 0 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: FIBURIAL OCREMATION Signature of Sexton or Person -in- Charge STORAGE OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition Date of Disposition 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 editions) Yellow: Funeral Director or Direct Disposer (Stock Number. 5740 - 000 -0326 -2) Pink: Local Registrar 0 9 arf OF SF,BALSTIAN HOME OF PELICAN ISLAND December 12, 2000 Rene Van De Voorde, Attorney at Law 1327 North Central Avenue Sebastian, Florida 32958 Dear Attorney Van De Voorde: Enclosed is Cemetery Deed number 1767 for Lots 33 & 34. Block 21, Unit 4 in the name of Francis & Evelyn Erickson. 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. A copy of the receipt is enclosed for your records. 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. Si ly, Sally A. o, CMC City Clerk SAM/js Enclosures CIO t-L ca qo LL. O.j im 'Ap -W Ams—_- is 0 0 co CL F= E S J U > z 0 0 74 93 MRAWN O CL 3. • c �4 A Pae M IL 30" i:26 ?0134 L99i:012000L?41236llo 0093 • 98 SPAMW M $ c3D GBf ouar I hd rAWL PL 3"" i:26 ?0EIIIL991:012000L?4L22811' 0098 $ 7so, r --------------- . :r . a ; a U "Im - �.k. A Pae M IL 30" i:26 ?0134 L99i:012000L?41236llo 0093 • 98 SPAMW M $ c3D GBf ouar I hd rAWL PL 3"" i:26 ?0EIIIL991:012000L?4L22811' 0098 Ite Sebastian Cemete City of Sebastian, Florida Receipt is acknowledged in the sum of- on this //Z% day of , 20 for the purchase of the described Cemetery Lot(s)/Niche(s) upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)/Niche(s) 33 -,- Oy Block o21 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. Witness (9 960