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Home My WebLink About4-20-13Tito of Orhastiatt T rut r t r r y B e i b NO. THIS INDENTURE MADE Thla ....... 1.Qth........ day of .......... Se.ptPIAb- eT ................... A. D.,xlK.2001 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and ............ ............................... QhAr. 1. e>.9.. R... Ho. f. er................................ ............................... 12950 U.S. I ............ ............................... Seba- stan•, • - Fl•o•r• ida• • 329* 58 ... .............. ............................... of the County of ....... I. ad.i. au. Ri.ver ................. an -] State of ........ F 1or1da.................................. as Grantee, WITNESSETHI That the Grantor for and in consideration of the sum of $ . 599 • 00 .......... . .. . . 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) ..13 .. , Block, ..ZQ ... 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: !\ .......................... City Clerk and Delivered of: f STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA By ..�.w............ Mayor (tllitg Seal) 10th .day of ...... September ........ .....................�Fec..?001 I HEREBY CERTIFY, That on this ....................... before me personally appeared ........ W-I! t P_r.. W:.. .Dar.ae,S ...................... and .... Sally-A.—Maio ............ 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 Charles R. Hofer ......................................................................................................... ............................... ......................... ............................... 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. EEH. JOANNE SANDBERG .................. MY COMMISSION # CC 725842 Nota ublic, State of Florida at Large. EXPIRES: April 30, MM My a isslon expires: Banded Thru Notary Public Undanvriters Name Unit Block Lot l 3 Date of Mark -out Date of Burial ti /0.1 Time a Name of Funeral Home Authorized by HOFER, CHARLES R. 12950 U.S. I DEED #01816 SEBASTIAN, FLORIDA 32958 LOT 13, BLOCK 20, UNIT 4 PETER I. TOVES INTERRED 9/8/01 LOT 13 MORMA DEPARTMENT OF HEALT l 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 of Peter I riarte Toves Death Sept. 5 2001 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 Phone Number Certifier Timothy Sigman, M.D. 8005 83rd Avenue F—lMedical Examiner MPh ysician Sebastian, FL 561- 388 -2110 4. Name of Funeral Home/Wveet- � Address Fla. Lic. No./Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. Strunk Funeral Home Sebastian, FL 1228 561- 589 -1000 o. uneCK a. LJ I ne mealcal cernticatlon nas Deen completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Carmen was contacted on 9/6/01 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Sigman 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 mpdical gbrtification of f death within 72 hours. 6. Funeral Director/ nature F.E. No. /Reg. No. Date Signed 106 eet B* 1862 9/6/01 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228- 01-0432 F1 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. F1 No extension of time for filing the death certificate has been requested. "egist's. W Date Date Certifi to Subregistrar Signature AA Issued: C4 J� t7 ► Due: q 1 O 10 1 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 DSTORAGE Date of Disposition ?A5 / CREMATION nOTHER (Specify) Signature of Sexton 1 or Person -in- Charge 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. DH 326, 8197 (Obsoletes all previous editions) (Stock Number: 5740 -000- 0326 -2) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar ou September 13, 2001 Charles R. Hofer 12950 U.S. I Sebastian, Florida 32958 Dear Mr. Hofer: Enclosed is City of Sebastian Cemetery Deed No. 01816 for Cemetery Lot 13, Block 20, Unit 4. Also enclosed is a copy of your receipt. If you have any questions, please contact our office. Sin i • Maio MC City Clerk SAM:js enclosures The Sebastian Cemetery City of Sebastian, Florida Receipt is acknowledged in the sum of. Dollars ($ '5-2V, ee From: 4�9',U 71 .-LI on this day of 20c)/ for the purchase of the following described Cemetery Lot(s)/Ni e(s) upon the terms and conditions as stated. herein: Description of Property. Cemetery Lot(s)/Niche(s) Mod,, c-2 0 Unit Purchase Price: za'/ 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. t y 0 of Sebastian Witness