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HomeMy WebLinkAbout4-20-09( itt of Webastian F .17 u _ rut�etrry IDrr NO. y� THIS INDENTURE MADE Thla .... 20.th........... day of :.... Jul. Y .. ............................... A. D.XYB. 2QQ0 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ... ............................... d Herder. x.. Sr.... ............................... 11145 Airport Drive - P.O. Box 397 - Roseland, Florida 32957 ......................... ............................................... of the County of .Indian River... aml State of ..... Florida as Grantee, WITNESSETH: .... .... That the Grantor for and in consideration of the sum of $ r 5 D.Q:.QQ ...... . ...... 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) , �,� , , , , Block, .2D. . . . UNIT . , , A , , .. , , , 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 defied 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. CITY OF SEBASTIAN, FLORIDA Attest: •`�� �%' City Clerk ..... 5ign�cly$ I d and Delivered In t Pr ce of: , t- f. � ....................... STATE OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this ......... 20th day of By . Y.V. �"`J..Y.V...k!......... Mayor ..... July........ I $ . 2,0C before me personally appeared .......,G115'll ter _$ L114'r9 . and Ke -thr. 11..m.., respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the�State of Florida t xmexknown to be the individuals and officers described in and who executed the foregoing conveyance to Ed Herder' Sr. ........... ............................... ................... ............................... ....... . "* " " '' " .. •.....• •....•••....I...... and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorised; 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 last aforesaid. . Indian River and State of Florida, the day and year H. JOANNE 8ANDBEiCi i -�... *= MY COMMISSION # CC 725842 Not Public, State of F oA rlda at rgt EXPIRES: Apra# 30, 2002 My ommiasion expires i , '� ' Bonded Thm Nolery h 6k Underndters HERDER, ED P.O. BOX 397 ROSELAND, FLO 11145 AIRPORT ELEANORE RIDA 32957 DRIVE - ROSELAND LOT 10, BLOCK 20, LOTS 9,11,12, BLOC 0. HERDER INTERRED DEED #1745 JULY 10, 2000 UNIT 4 - DEED #1745 K 20, UNIT 4 - DEED #1748 7- ti-zcecl LoT►t) #Iiq - I� I 3 CD w` 1 �J r• Z w m .. s 3 m ^. m x m ro ro � N U] a � n 0 0 x O y 1 :o I� I 3 CD w` 1 �J r• C�- r-' m �:l 0 P� Z w m V p., a ro ro � N U] a � n 0 0 x N O :o :o w :o :o b 0 o z o .. d 0 C w � a m st a d : p : C�- r-' m �:l 0 P� FA. c r rr cx m V p., V V N U] 0 td 0 0 x N O w v+ �CVYix x o x o x r en (D M. ID ID CD O p�'' p O � p K :4 ' Pi O�r tl G c K C P� - ¢, K ��j 9 O q C- 0 C Z . CD CD ` CD ` ID cb '"Y .��' •.� '-'. ►�yi . ig 7j (D Cp Y CD n cgv x� G70 Rl cn CP .1129LLLE0 0000t:,9L0900L90:1 .II056100.11 00`SL ** 00 r Z W sU. god w u W O -Jd' O V a a c 0 E ae � z � w • I i I I I q 1 - d o s C I V i e • c e O e v $ O p • O e 4p� c S O O p_� O S t00 n c `o U U a O m ca CO O O W 0 -j U i § ai o o` �i g 1 - d o s C I V i e • c e O e v $ O p • O e 4p� c S O O p_� O S t00 S 'Vs a - d o s C d V i e • c e O e v $ O • L e FLORIDA DEPARTMENT OF HEALT A. (TYPE) -,"o- 0 � D State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of EDMUND HERDER Death JAN. 6, 2006 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or INDIAN RIVER SEBASTIAN Inst. SEBASTIAN RIVER MEDICAL CNETER 3. Name of Medical Address Phone Number Certifier TALIB HUSSAIN, MD 7768 BAY STREET Medical Examiner X Physician SEBASTIAN, FLORIDA 32958 (772)589 -7177 4. Name of Funeral Home /Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 735 FLEMING ST SEAWINDS FUNERAL HOME SEBASTIAN, FL 32958 2617 772- 589 -1933 5. Check a. ® The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box 6. Funeral Director/ Direct -lisooser B. 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. F.E. No. /Reg. No. 2294 BURIAL - TRANSIT PERMIT Date Signed 1/6/06 Permission is hereby granted to dispose of this body. Permit No. 06- 2617 -007 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. X® No extension of time for filing the death certificat s en requested. Registrar or Date Date Certificate Subregistrar Signature Issued: 1/6/06 Dye: 1/14/06 G 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: E*URIAL ®CREMATION Signature of Sexton or Person -in- Charge DSTORAGE OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition SEBASTIAN CEMETERY Date of Disposition 1/10/ 2006 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. Distrib7ion: 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 Regcld SPqe '►e Sebastian Cemet�'y City of Sebastian, Florida Receipt is acknowledged in the sum of. Dollars ($ 4 j5_ &e' ) • I . • , 1// for the purchase of • .,, • M • • - / .1 • - upon - terms • conditions - • J - Description of Property: Cemet Lots) iche(s)' 9 //. / Block o2Q 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. 2"O'eI7 — AV '11'r" 'I, �ity of Sebastian Witness 0 0