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Home My WebLink About4-19-36tt� Df ��M��tMIt • C��I�iP�P�� PPi� NO. i� y 4�, t.J i:y TNI3 INDENTURE MADE Thb .... � t�? ...... .... ... day ot ..��.P.��mbex........................... n. D.� �. ZQOO bet�ceen tl�e Clty of Sebastian, a municlpal corporatton exiating undcr the Iswa ot the 3tate oi Florida, ne Grantor and Paul Fashona ..................................................85�5� C1�earmont��Street.................................................. . . . . . . . . . . . . . . . . . . .. . .. ...... ...... . ..... .. . . . . . .S.ebas.tian,. . E�or.ida . .32� 5 8. . . . . . . . . . . . . . . . . . . .. . .. . .. ... . . . .. . .. . . .. . ot the County ar ......Indian, Riyer,,,,,,,,,,,,,,,,,, e�:� State of ......�IO�l.C�.,$,,,..,.,,,,.,...,..,...,.,... .. se Grantee, WITNES8ETH: That the Grantor for and in consideration of the sum of $.:?.Q � r Q Q, ,,,,,,,,,,,,,, to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, releax, 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) . . .� 6 , , Block, . , .� 9 . . , UNIT . . . .�i . . . . . . . . , 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 Flocida; said land now lyutg 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 intetment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ocdinances 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, reatrictions and tequirements contained in this instrument shall be covenants running with the land. In the event of the failuce of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and ordinances and the wnditions of the de'ed of wnveyance 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 fust pazt 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 yeaz fust above written. � � . � . . � ��Z?��!"�' . Attest: . . .... �. .. ..... City Clerk Fj gned, S led und �elivered 1n the ence s . . �. .'. . . . ,4! ' '. .!`�,--�� . . . . . . . . . � . . . . . '. . � . . ./ . . . . . . . . . . . . . . . . . . STATE OF FLORIDA COUNTY UF INDIAN RIVER CITY OF SEi3A6TIAN, FLORIDA B, .�%l�C�,��..�/�l. �?o4�Y.''�!d........... Ma�or ((Qii� �fexl) I HEItEBY CERTIFY, That on thie ....5�.� ...............day �r ......Se.p.tamb.ex.........................,....,KOC..�� befure me personally �pPearea ...Walter., Barnes _. 8�d Kathr.yn..M,,.O'.Ha;lloran., respeetively Mayar and City Gerk of the City ot 9ebastien, a municipal corporatiun under the laws of thc Stnte ot Florida to me known to be tlie individuttls unJ officers described in und who executed the forego3ng cowveyunce to . . ... .. ...... ...... .......................... . . .. . Paul, ,Fashona...... ............. .. . ..... .... . . ... . .... ...................... ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, snd severally acknowledged the executIon thereof to bt thefr free act and deed as such officers thereuntu duly authorized; and t6at the Officisi seal of said corporstion is duly affixed thereto, and the said conveyance is thc act and deed of sa3d corporetion. WITNESS roy signature and official seal at 3ebaetian, in the County of Indian River and Statc of Florida, the dny and �ea; last afurras[d. ' ,F�1i��' �,, H. JOANNE 9ANDBE�G �� 1': . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :.. .- MY COMMISSION # CC 725842 Notery b�e, State of Florida st Ls ge: � �= EXPIRES: April 30, 2002 My c isston exptreo: '? j� �d:` Bonded Thru Notary Public Undetwrilere �n Name �� C. �i � 2 � �� l �) F �; �-e �-f'_ • Unit �� Block � �% _ _ ----- __---- __ _ Lot � � Date of Mark-out � I`� �� Date of Burial '� � 7! Q U Time %I =��) Name of Funeral Home �� L! r.� �. � 5 � . — ,I f Authorized by ;� ; ',�i�, � /�; �.r� S,,s` . � ,�'� /,, �f I f �� ,.. � FLORIDA DEPARTMENT OF HEALT Sta� Florida, Department of Health, Vital S ics AP'�LICATION FOR BURIAL - TRANSIT PER A. (TYPE) 1. Name of First Middle Deceased Richard J . 2. Place of Death City, Town or Location County I ndian River Vero Beach 3. Name of Medical Addre: certirer Curtis Dalili, M. . Medical Examiner Physician Last Date Month Day Year of Bertele �eatn Aug. 31 2000 Name of (If neither, give street address) Hosp. or inst. Indian River Memorial Hospital Phone Number 2208 8th Avenue Vero Beach, FL 561-56�-4336 4. Name of Funeral Home/Diroct-9ispvsal 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 b� �] Janine wascontactedon $/31�00 Helshe verified thatthis death was from natural causes, that there was no accident nor other external cause of death, and that Dr. �81111 will complete and sign the medical certification of cause of death wfthin �2 hours. � 6. Funeral Directod was contacted on He/she verified that , Medical Examiner, will complete and sign the of death within 72 hours. F.E. No./Reg. No. 1862 Date Signed 8/31/00 � . B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose ofthis body. Permit No. � 22$'00—Q417 � 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 cert�cation of cause-of-death section of the death certi�icate within 72 hours. �No extension of time for filing the death certificate has been requested. }�gl5�dr�r Date j Date Certifi te Subregistrar Signature %� � — _ i '' Issued: � �, 3 � ` C� Due: q �� f"O c. Approval Number: AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA 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. p. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery �BURIAL �STORAGE Date of Disposition �/ `(S� ��r �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 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. Distributio�: White: Cemetery or Cremetory DH 326, B/97 (Obaoletes ell previous edNions) Yellow Funerel Director or Direct Dispoeer (Stock Number: 5740-OOo-032E2) Pink: Local Registrar �e Sebastian Cerne� City of Sebastian, Florida Receipt is acicnowledged in the sum of: /�.� � From: ��s� �� . on this � � da.y of described Cernetery Lot(s)� Description of ProperLy: Dollars ($ ,�DD• O D ) �'f�� 20�� for the purchase of the follawing s) upon the terms and conditions as stated herein: Cemet Lot(s iche(s) c� � Blocic /% Unit � Purchase I'rice: �.�eJ ,� ;�Yi.��.i�� Dollars .($ �S�DD.d � ) Terms and Condition of Sa1e: 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 sta.ted in the foregoing instxument: Purchaser signature Purchaser signature The City of Sebastian agrees to sell the above mentioned property to the abwe named purchaser(s) on the terms and conditions sta.ted in the above instrument. ity of Sebastian Witness FASHONA, PAUL 855 CLEARMONT STREET SEBASTIAN, FLORIDA 32958 LOT 36, BLOCK 19 UNIT 4 ,�JL: L:;Ci � % �5( RICHARD J. BERTELE INTERRED 9/7/00 - LOT 36 �n Z�J �� r � s ��;� � y �loc1� \�i �--- �� 3 �� 4.S�vn� �n � � �:_>,�. C�,��j� . Paid by CEMETERY Receipt No . . . . . . . . . . . . . . . . . Dated . . .�% �?.� 2.Q � Q, , , , . , . . , List Price $ . . . 5 � � e � �, , , , , , Maximum No. Burial Spaces . . . . . . . . . . . . . . . . . Net Paid $ , , , S O O . O O Monument permitted . . . . . . . . . . . . . . . . . . . . . . . (Data above this line for City R.ecord only) i / LOT 36, BLOCK 19, UNIT 4 PAUL FASHONA NO. 1 a"�� r�� 1225 Main Street, Sebastian, Florida 32958 Telephone (561) 589-5330 - Fax (561) 589-5570 Website: www.cityofsebastian.org - Email: city@cityofsebastian.org Septemberl l, 2000 Paul Fashons 855 Clearmont Street Sebastian, Florida 32958 Dear Mr. Fashons: Enclosed is Cemetery Deed number 1756 for Lot 36, Block 19, 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 offce 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, � �• � G�k'� a�. �� Kathryn M. O'Halloran, MMC City Clerk KOH/j s Enclosure(s)