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Home My WebLink About4-19-27� :} �tt� pf �P�tMSftMri �P)1t��P� � �P��i No. �':�`��i THIS INDENTURE MADE TW� ......l�t�l.......... day of ............ �y ............................ A. D.,M1[Za�, beb��een tlie Clty of Sebnstlan, a munlclpal corporatton e=let(ng under the lawe of the $tate ot Florlda, ee Grantor and ...............................................F'xed. R,..Czo�oat..and/.ox .Haz.e]..J. . Cr�f,�o.t.............................. 115 Harbor Point Drive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S eba s t i an,. . FT; . .3 29 58 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ot the Connty or . . . . Indian, River, , , , , , , , , , , , , , , , , , , , , , , .,,.a 8tate of . . . . . . . . . . . .�' 1.4xa-C�. . . . . . . . . . . . . . . . ................. te Grantee, WITNES9ETH: That the Grantor fox and in conaideraHon of the sum of Sl.}��' � ................ to it in hand paid, the receipt whereof is herewith ao- knowledged, does by thia instrument gcant, bargain, sell, release, convey and contum unto the Grantee , the7.r, heira, legal repreaentatives and asaigns the following property aituated in Sebastian, Indian Rivei County, Florlda, to-wlt: All of Lot(a�7&28 ,, Block, .,. 19. ., UHIT ,.,, 4,,,,,,,, af Sebastian munidpal cemetery as per Plat Number 1 thereof recoided in Plat Book 2, at page 65 of the pubflc tecotds in the of6ce of tha Clerk of tha Circuit Court of S� Lude County of Floiida; said land now lyIng and being in Indian River County, Flo�3da. To Hava and to Hold the same fomvec; provided that said proparty ahall be used aolely and exclusively for the intermant of the human dead and shall be used, kept and maintained at all times in accoidance wIth the rules and regulationa, o:dlnances and reaolutiona of the City of 3ebastian, Florida, heceto- fore, now and heteaftet adopted or provlded for tha government and operation of said cemetery. The condltions, reatrictions and requirements contained 3n this Instrument ahall be covenanta running with the land. In the event of the failute of the ownar of any pioperty aituated wlthin said cemetery to ob- serve and comply with such rules, regula$ans, resolutions and ordinances and the conditiona of the deed of conveyance thereof then the title of such owner in and to aaid propetty shall tetminate and the same shall revert to the City of Sebastian, Florlda. IN WITNESS WHEREOF, The said party of the f3rat part has wuaed thi� instrument to be executed in ita name and on ita behalf by its Mayor and attested by its City Clerk and its corporata seal to be hereto affixed, the day and year fust above wrltten. Attest �.�� I h Q�/YGC�C.�-L Q'`i�._� . .....:. . ............... ......... . � c�cr c�erk L Rigned, 3enled und Delivered 1n th Presence of: ... � ............... . �. �/..•.•..�.�ycr.�� ................ i STATE OF FLOiiIDA COUNTY OF INDIAN RIVER CITY OF 3EIiABTIAN, FLOAIDA B, 1�.�. u?...Y.�.a,.:�-�......:..... Ma�or (!Qi#q �exJ) I HEItEBY CERTIP'Y, Thet on thie ... ....... �.7�7. ...... .day ot ... .. . . .. . ..N]3� .................... . .......... .... ]3![��i]� before me personally appeared ,, WS�.t2T W. Barnes j�3th j`�. 0� jjal]_Or3R ... . ...... ....................................... and .....r�....... ..... .... respcctively Mayor and City Clerk ot the City ol 9ebastten, e municlpnl corporntlon under the lawa of thc State ot Florida to me known to be the 6�d3viduuls und officera desedbed ln pnd who executed tl�e torcgoing coxveynnce to Fred R. Crofoot and/or Hazel J. Crofoot ....................................................................................................:.................................. .............,.......................................... and severnlly acknowledged the executton thereot to be thei� free act end deed as such otticers tl�ereunto duly euthorfaed; and that the Official seul of satd corporatlon fa duly�iff�theteto, end the said conveyance is thc xct nnd deed of sald corporatlon. WITNES9 my eignature snd ofticlal oenl at Sebeetian, in the lest aturesaid. lT— urro�M.e�w.ev � MY COMMISSION t CC 740478 •• EXPIRES: June 18, 2002 otary eomleammNaldYwbAcunderw�lere , My cyel ot Floride, thc day end sear d Florida at t Name �i�i �:: l�.lQ a � �1,. �� .P t� �d tJ ! Unit � Block r �i Lot _ oCa ,f Date of Mark-out _ �� % � Date of Burial �� /' 41 � Time /� � � � !� �,-,�,..'�. Name of Funeral Home ��/t OJ f�': Authorized by 0 ._ _.. . __ .. ._ _ _..._... .._ ._... CROFOOT, FREDRICK R. LOT 27, BLOCK 19, UNIT 4 FREDRICK R. CROFOOT INTERRED 8/3/00 LOT 27 �� , Paid by CEMETERY Receipt No. . . . . . . . • • • . Dated .. 5/17/00 List Price $ 1 � ��; �� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maximum No. Burial S�ces . . Net Paid $ 1 � �0� . �0 • • • • • • • . . . . . . . . . . . . . . . . . . . . . Monument permitted . . . . . . . . . . . . . . . . . . . . (Data above t�hie line for City ii,ecurd only) NO. Y�� FW' etDA DEPARTMENT OF HEALT A. 1. Name of Deceased 2. Place of Death County St f Florida, Department of Health, Vital �tics �LICATION FOR BURIAL - TRANSIT PERMIT First Middle Last Date of Frederick R, Crofoot Death City, Town or Location Name of (If neither, give street address) Hosp. or !�7 � /,�' �a�� - Month Day Year Julv 30 2000 Indian River Vero Beach inst. Royal Palm Convalescent Center 3. Name of Medical Address Phone Number Certifier Richard Cunningham, D.O. 631 17th Street MedicaiExaminer Physician VefO Beach, FL 561-794-2227 4. Name of Funeral Home/Diwe49iapesal Address Fla. Lic. No./Reg. No: Phone No. (Area Code) Establishment 1623 N. Central Avenue Strunk Funeral Home Sebastian, FL 1228 561-589-1000 5. Check a. � The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box 6. Funeral Directod ❑irorf nic nn c� s. b, � Heather was contacted on 7/31 / 00 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, andtnat Dr. Cunningham willcomplete andsign the medical certification of cause of death within 72 hours. � of was contacted on within 72 hours. F.E. No./Reg. No. BURIAL - TRANSIT PERMIT He/she verified that , Medical Examiner, will complete and sign the Date Signed 7/31 d00 Permission is hereby granted to dispose of this body. Permit No. � 22$-00-0355 � A five (5) day extension of time for filing the death cert�cate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within 72 hours. � No extension of time for filing the death certificate has been requested. �� .,..� Date Date Certificate Subregistrar Signature , � v` �� Issued: '3 b a,.p Due: c, AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA Approval Number: Date Medical Examiner, , gave authorization by telephone to Funeral DirectodDirect Disposer. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is required for all cremations. �. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery �V BURIAL �STORAGE Date of Disposition �� /8U �CREMATION Signature of Sexton � or Person-in-Charge �OTHER (Specify) � � This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral DirectodDirect Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the county where disposition occurred. Distribution: White: Cemetery or Cremetory DH 326, 8/97 (Obsoleles all prevaus edRions) Yelbw: Funeral Diredor or Direct Disposer (Stock Number. 5740-000-0326-2) Pink: Local RepisVar The Sebastian Cemetery City of Sebastian, Florida pt is acknowledged in the sum of: � e 6�/ From: on this 1/ i day of described Cemetery Lot„(� Dollars ($ � �%�� , � ) _, 20 � for the purchase of the following the teims and conditions as sta.ted herein: Description of Property: 4 Cemetery Lot(s Block Unit � Purchase Pri �dZl Dollars ($ ��.� ) Terms and Condition of Sale: This contract shall be binding upon both parties, the seller and the pwrchaser, when approved by the owner of the property above described: I, or we, agree to purchase the above described property on the tezms and conditions stated in the foregoing instrument: � � � � signature � aov� � c C�f' Purchaser si�nature The City of Sebastian agrees to sell the above mentioned property to the above named is stated in the above instrument. Witness • City of Sebastian • 1225 MAIN STREET � SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589-5330 � FAX (561} 589-5570 May 30, 2000 Fred R. and/or Hazel J. Crofoot 115 Harbor Point Drive Sebastian, FL 32958 Dear Mr. & Mrs. Crofoot: Enclosed is Cemetery Deed No.1731 for Lots 27 & 28, Block 19, Unit 4. Also enclosed is a form - Retum 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, P. 0. Box 1028, Vero Beach, Florida 32960 or you may ca11 or call the Department of Revenue at (904) 488-9487 for more information regarding the completion of this form. We are enclosing two copies of each the receipt and ask that you sign and return to us 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, � �%% � 0 ��Z,��.� Kathryn M. 0'Halloran, CMC/AAE City Clerk KOH:Img Enclosures