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Home My WebLink About4-20-27THU of Orhastittn A. T r ut r t r r re NO. THIS INDENTURE MADE ThL .... 21.5 t........... day of ....... AUgUS t ........................... A. D.XW.9 9 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Harold and /sir Cynthia Baker ......................................................................................................... ............................... P.O. Box 294 12960 81st Avenue_.- ..Roseland,.,Florida_ 3295 .7 ........................... ... ........... of the County of ....Indian River .................... an] State of .... FlOri, d.4.,,,, ,.............................. ..... ... as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ 5.0 O . P O , ,, , , , , , , , , ,, , , to it in hand paid, the receipt whereof is herewith so- 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) .. 2 7 . , Block, .... 2.Q. , 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 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. CITY OF SEBASTIAN, FLORIDA Attest. �._ By . V U �.. V.V.. ............ City Clerk Mayor Signed, d Delivered in the r e of: RF STATE OF FLORIDA COUNTY OF INDIAN RIVER ((ffi#' pSeal) I HEREBY CERTIFY, That on this ..... 21 S.t............day of .... Au gUs. t ............ .........................s=2000 before me personally appeared Walter Barnes and Kathryn , 0!,Ha.jjp.,).gLn........ 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 Harold and /or Cynthia Baker .............. ............................... 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. SANDBERG.. ................. H. JOANNE fir: ,r MY COMMI r• tate o Florida at Lsr e. SSION4 CC 725842 Nota ubllc, S f B . EXPIRES: April 30, 2002 My c ission expires: Pl,t?< Bonded Thru iVobtry Fubk Undenuritera Block 0 - Lot Date of Mark -out Date of Burial i Name of Funeral Home /'If Authorized by Time ► 00 ¢/ t I ....... ... . J. BAKER, HAROLD AND /OR CYNTHIA DEED #1751 P.O.BOX 294 12960 81ST AVENUE LOT 27, BLOCK 20 ROSELAND, FLORIDA 32957 UNIT 4 STEVE BAKER INTERRED LOT 27 - 8/22/2000 V; Paid by CEMETERY Receipt No ................. Dated ..... U ?r.1 /.2 QQ Q List Price $ , , 5 � �, , Q Q Maximum No. Burial Spaces ......... . Net Paid $ . • 5 Q Q, Q Q • • • • • • • Monument permitted ...................... . (Data above this line for City Record only) Harold & Cynthia Bake Lot 27, Block 2040 Unit 4 t� r; Z LU N Ud 40� m N be ui N ig 0 LU O -11I �' I L jo O s a L Y 100 C V V OQ _ 07 N CL o 82 X f0 'mC G ,�^ �� O -� J LL (n,' d m co F- QN� C 7 CJ N N ZL C C = C d cc�Q�° �Q U E c E E S d Y E aZi cn C J C� 9 U } Z U U J c ?s Y U Qcli C4 � � m 1 CL S G O C F CL C g O Y • 4 O O CL O r A FLORIDA DEPARTMENT OF HEALT A. (TYPE) �a7 Statwlorida, Department of Health, Vital Stoics A (CATION FOR BURIAL - TRANSIT PE 1. Name of First Middle Last Date Month Day Year Deceased of Steven Wayne Baker Death Aug. 19 2000 2. Place of Death City, Town or Location of (If neither, give street address) County or rH Indian River Vero Beach Indian River Memorial Hospital 3. Name of Medical Address Phone Number Certifier Roberta Rose, D.O. 7915 Bay Street MMedical Examiner Physician Sebastian, Fl- 561- 388 -1100 4. Name of Funeral HomeAQk*eFWiaposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Avenue Strunk Funeral Home Sebastian, FL 1228 561 -589 -1000 o. cnecK a. ii I ne mealcal cemrlcatlon nas Dean completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. I wile was contacted on 8/21/00 He /she verged that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Rose will complete and sign the medical certification of cause of death wi 72 hours. C. � was contacted on He /she verified that Medical Examiner, will complete and sign the me,dig6l ce ificaf cause of death within 72 hours. 6. Funeral Director/ gn r F.E. No. /Reg. No. Date Signed mial"0 posc4, 1862 8/21/00 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -00 -0392 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. nNo extension of time for filing the death certificate has been requested. wReg091F8F Of Date Date Certificate Subregistrar Signature f u_ Issued: sda / 1 r a Due: 0OL ` *9 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 CREMATION Signature of Sexton or Person-in-Charge DSTORAGE FIOTHER (Specify) Date of Disposition h4e o2Z �z 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 Is, • e e `.`.t�G�'wJ.aaozk7'a." - 1225 Main Street, Sebastian, Florida 32958 Telephone (561) 589 -5330 - Fax (561) 589 -5570 Website: www.cityofsebasban.org - Email: city@cityofsebasban.org August 22, 2000 Harold and Cynthia Baker P.O. Box 294 Roseland, Florida 32957 Dear Mr. & Mrs. Baker: Enclosed is Cemetery Deed number 1751 for Lot 27, Block 20, Unit 4 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. 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 or you may call the Department of Revenue at (904) 488 -9487 for more information regarding the completion of this form. We are enclosing two copies of the receipt and ask that you sign and return the copy marked with an "X" and retain the other copy for your records. A stamped, self - addressed envelope is provided for your convenience. Sincerely, 9ddv�,��n. 0 Kathryn M. O'Halloran, MMC City Clerk KOH/ar Enclosure(s) 'te Sebastian Cemetty City of Sebastian, Florida Receipt is acknowledged in the sum of: From: Dollars ($ it ON ' / ♦ �� . on this /, day of , 20DU for the purchase of the following described Cemetery Lot(s)/Nir_h4 upon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)/Niche(s) ,-7 Block Unit Purchase Price: Dollars .($ —1 , ) 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 instnunent. 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. ity of Sebastian Witness