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Home My WebLink About4-20-10NO. THIS INDENTURE MADE Tkla .... I.00th........... day of ..... July .. ............................... A. D., III. 2RQO between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and .......... ............................... Ed Herder............................................... ............................... P.O. Box 397 - Roseland, Florida 32957 ....................................................................................................... ............................... of the County of ...Indian River and State of .... Florida as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ .5 0O ................ 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) , 1 Q .. , Block, , 2 , .. , 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 sane 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 Sig Scaled and Delivered In he r ce of: F................... . .- ....... .� ...... STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBABTIAN, FLORIDA By...`'.". :. ............ Mayor (0tg exl) I HEREBY CERTIFY, That on this ..........IQ0) ....... day of ..........J.Ua, y ..... ..............................I fi..2900 before me personally appeared ....Walter Barnes Kathr n Nf O'Halloran 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 Ed Herder ..................................... . .............................................................. :.................................. .................. ............................... 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 and year last aforesaid. :0tr!sr 7 &Tt's H. JOANNE SANDBERCi . - MY COMMISSION CC 725842 Nota ublic State of Florida at Lsrge. EXPIRES: April 30, 2002 My c isslon expires: IF P Bonded Thru Notary Pubsc Underwriters Unit Block Lot Date of Mark -out Date of Burial_ Time Name of Funeral Home L� Authorized by` Paid by CEMETERY Receipt No ................. Dated .... 1AIY . 10 , . ,2000 List Price $ .. 5.N . Q Q ...... Maximum No. Burial Spaces ................. Net Paid $ .. 50.0..QQ ...... Monument permitted ....................... (Data above this line for City Record only) Lot 10, Block 20, Un: Ed Herder NO. FLORIDA DEPARTMENT OF HEALT A. (TYPE) Statj& Florida, Department of Health, Vital Sjoics LICATION FOR BURIAL - TRANSIT PEKIM 1. Name of First Middle Last Date Month Day Year Deceased Eleanore 0. Herder 7 -7 -00 Death 2. Place of Death City, Town or Location Name of (if neither, give street address) County Hosp. or Indian River Roseland Inst. 11145 Airport Drive 3. Name of Medical Noor Merchant MD Address 777 37th Street Suite C -104A Phone Number Certifier Vero Beach, FL 32960 Medical Examiner ffiPhysician 4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 735 Fleming . Street Young & Prill Funeral Home Sebastian, FL 32958 % 2415 561 - 589 -1933 5. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box r7, Dr. Merchant was contacted on 7 -10 -00 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that he 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. 6. Funeral Director/ F.E. No. /Reg No Date Signed Direct Disposer mow✓ ZZ�� /O -ro� B. L BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 2415 -006 -00 17-1 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 ce Cate has been requ Registrar or Date Date Certificate Subregistrar Signature Issued: 7 -10 -00 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 Sebastian Cemetery ® BURIAL ❑ STORAGE Date of Disposition CREMATION E10THER (Specify) Signature of Sexton or Person -in- Charge J -J,,�, 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, 8197 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740 - 000 - 0326 -2) Pink: Local Registrar 'Ae Sebastian Cemei�y City of Sebastian, Florida Receipt is acknowledged in the sum of- /7, Dollars ($ SdO. D d ) on this l0 7Z day of , 20 DO for the purchase of the following described Cemetery Lot(s) the ) upon the teams and conditions as stated herein: Description of Property: Cem et 4 Lot(s) iche(s) //� Block r,2lj Unit Purchase Price: C.,Gr 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 instn ment 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 i .10 It ity of Sebastian Witness iCA