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Home My WebLink About1-38-26� ��C'�'�L � � � . e �------ ,. 4- '�— i� , C� - i �.� �. ��..�� 1� �� . � Name � "' Unit � !� =�� - � J �� Block � .r� � Lot � � � 1 i C.� ? �Z.�. ��'� Date of Mark-out �— j (� 1 c� �Z, �..;? �1 �; ' C�:�C:; Date of Burial Time � ( ��\.. ��/ CN�: 1 � -�- :.�t �-, �'k'C.�� 1, Name of Funeral Home � t� t�`'�� t�"� � T� Authorized by � �=�1--�:.... � Obituaries � Death Notices � Newspaper Obituaries � Online Obituaries � Newspaper D HAZEL H. RUND Page 1 of 1 Hazel H. Rund, 99, died Oct. 2, 2008, at Anchor Care and Rehabilitation Center in Palm Bay. She was born in Rappsburg, Ohio, and moved to Roseland in 1963 from South Charleston, Ohio. Survivors include one grandson; three great-grandchiidren; stepsons, Ray Hines of Findlay, C3hio, and Gilbert Rund of Washington state; stepdaughter, Elizabeth Gordon of New York state; and 14 step-grandchildren. SERVICES: Visitation wiil be from 10 to 11 a.m. Oct. 10 at Roseland United Methodist Church, followed by a service at 11 a,m. with the Rev. Ann Godbold officiating. Burial will be in the Sebastian Cemetery. Arrangements are by Brownlie-Maxwell Funeral Home in Melbourne. Published in the TC Palm on 10/8/2008 Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Por�ered by ��r1G�'.G411'1 � obituaries nationwide I � �3� Back r I http://www.legacy.com/tcpalm/Obituaries. asp?Page=LifeStoryPrint&PersonID=1185 6... 10/8/2008 F•LORtDA DEPAR7'MFNT OF HEALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Deceased of Hazel Hopkins Rund Death october 2, 2008 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Brevard Palm Bay inst. Anchor Care and Rehab. Center 3. Name of Medica John H. POtOmskl, D.O. Address 720 E. New HBVen Ave. Phone Number Certifier � Medical Examiner Physician Melbourne Florida 32901 321-724-4545 4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No./Reg. No. Phone Number (Area Code) Establishment 1010 E. Palmetto Avenue Brownlie - Maxwell Funeral Home Melbourne, Florida 32901 0000049 321/723-2345 5. Check a � The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box Year b� � Linda @ Dr. Potomski was contacted on 10/3/08 _-- - - - - --- - He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, SebaStian Cemetery and that Dr. Potomski will complete and sign the medical certification of cause of death within 72 hours. �. C 6• Funeral Director/ Direct Disposer I certification of cause of death within 72 Sig was contacted on He/she verified that , Medical Examiner, will complete and sign the F F Nn iRPn Nn Date Sianed F044250 October 2, 2008 B BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 4088149 � 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 ot 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 c ificate has;�6een equested� Registrar or �� ;� ` ' J� j� /`E fi�� Date Date Certificate �, �r; �, L f October 3, 2008 Subregistrar Signature ,' �' �� " u� 6- � Issued: Due: C � AUTHORIZA e Approval Number: for CREMATION, DISSECTION, or BURIAL-AT-SEA Date Medical Examiner, __ __ _ ___ _� , gave autholization_by tele�hone 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. Method of Disposition: � BURIAL ❑ CREMATION Signature of Sexton l or Person-in-Charge f � STORAGE ❑ OTHER (Specify) CEMETERY OR CREMATORY Sebastian Cemetery Place of Disposition Sebastian, Florida Date of Disposition i f} /jp /p � This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Director Disopser when there is no SeMon) and returned within 10 days to the local County Health Department in the county where disposition occurred. DH 326, 8/97 (Obsoletes all previous editions) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer (Stock Number: 5740-000-0326-2) Pink: Local Registrar CITY OF SEBASTIAN CITY CLERK'S OFFICE . /, � O n RECEIPT �'E �� Name u:,J 1'U(A) h� � C� �L l�iC.� X(..� (� ( �ate ��= � V'� V J No. 001001208001 001501 322900 001501 341920 001501 341910 Sales Tax Garage Sales CopieslBid Specs. LDC/Code of Ordinances ❑ Cash �Check# � ��5 Amount Paid 001501 341930 Election Qualitying Fees 601010 343800 Cemetery Lots ��'�' �"� LoUNiche ��, Block �, Unit �� 001501 343805 Cemetery Fees Q`� �� ! ` _ Total Paid l V �C Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant d