HomeMy WebLinkAbout4-14-10Paid by CEMETERY Receipt No... ~,9 4 9... , , , , ,Dated ... AU~ U S t 2 ~ , 2 ~ ~ 2 NO
List Price $ .. ~ ~~ : ~~....... Maximum No. Burial Spaces ...... l......... .
~~j i
Net Paid $ .. ~ ~ ~ : ~ 0....... Monument permitted ....................... ~ ~ ~ "
Unit 4, Block 14, Lot 10
(Data above this line for City Reeord only)
~tt~, it~ ~'P~tMS~tMIt
~PIItP#Px'l~j.' ~PP~ No. ~1.85~
THIS INDENTURE MADE Tl;ls .....?'0 .............. day of .... AUgUS t .............................. A. D.,~'t8.. 202
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor arrd
Leon Correll and/or Theresa Newell
1362 Scroll Street, Sebastian, Florida 3295$
.....................................................................................................................................
of the County of Indian..River ....................... an.1 Stnte of .Florida
..................................................
as Grantee, WITNESSETH:
That the Grantor for and in consideration of the sum of $ . ~ ~ ~ • ~ ~ , , , , , 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) , .1 ~ , , ,Block, , 14 , , , ,UNIT , , ~} , , , , , , , , , , 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 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 aft"ixed, the day and year first above written.
~' 1.
Lam.: ` ~ /
~ ,,
Attest: ........~~ ~~.• :..............................
`- °' City Clerk
Signed, Sealed and Delivered
in t}te Presence of:
STATE OF FLORIDA
COCtNTY OF INDIAN RIVER
CITY OF SETIASTIAN, FLORIDA
~~
Mayor
(~tl~r ~~ettl)
~~~~.
I HEREBY CERTIFY, That on this ...2:O.trl ..............day of . ~U~USt,•,...•_......,........................, ~{?002
Walter W. Barnes
before me personally e.ppeared .................. ................. and .Sa~;l•Y..A. Ma10
.................... ........................
respectively Mayar 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 cowveyance to
Leon Correll and/or Theresa Newell
.......................................................................................................................................
•• ••• ~•••••~•••~.•••••~~~ .......................... and severally acknowledge the execution thereof to be their free act and deed
as such officers thereunto duly authorised; and that the Official seal of said cor ratio is duly affixed a o, a the said conveyance
is the act and deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the Co y of I an River and State of Fl rda, the day end lea-
lest aforesaid.
;~;~^~ .eye, ANN V. ROUSSEAU
.:~., .... ..... .....r.. ..... .................
;.. .~ ~~ . _ ~,~, r CQMMISSION ri DD 089531 otary Public, State of Flor a at Large.
~., '': EXPIRES: March 18, 2006
''~~Hf~~F~; ` ` ~~" -'ts Thru ~Jctary Public Undenvrilers My commission expires
Named ,c-ni
Unit
e~
Block /
Lot
~ I ~ r /rJ '2'`~
Date of Mark-out
Date of Burial Time
Name of Funeral Home 5 ~ ~ ~' ~ n ~
J/., '
Authorized bye
~~~_~
- ~LO~if_/r.
CITY OF SEBASTIAN O 9
CITY CLERK'S OFFlCE /
,t~b RECEIPT
^ Cash
/56(0
AmountPald
001001 2oeool
001501 322900
001501 341920
001501 341910
001501 362100
00,50, 362,00
001501 362150
001501 343800
601010 343800
001501 369400
001501 369400
680800220681
680800220682
680800 220683
Sales Tax
Garage Sales
CopiesBid Specs.
LDC/Code of Ordinances
Community Center Rent
Yacht Club Rent
Non Taxable Rent
Cemetery Lots
Cemetery Lots
LotMiche ,Block ,Unit
Interment Fee
Weekend Service
Yacht Club Security Deposit
Community Center Security Deposit
Riverview Park Security Deposit
G~~.
~.~°/r%, G ~ ~, ~ oft, ~C ~~ .
~~ ~ ~
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~~y . Si2~~~ .
. .
Total Pald ~~~
InWals
Whits - Dspt. of Orrin • Tallow - Rnsna • Pink - Appliant y
7[`~i~ Seb~.st~~ Ceane~.e~y
City of Se~a.sti, ~loa~d~
jp is acknowledged in the sum of:
~f
~iDe~~ ~,/~ Di
Dollars ($r°~'d~ - r~ )
S ~'
~_7~S~S-~7~~
on this~~ day of ~Le.~~- 20 ~~? for the purchase of the following
described Cemetery Lot(s)/Ni (s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot(s)/Niche(s) ~ ~ Block 1~ Unit
/ ~/>
Purchase Price: ~~.~ ,~~~~~ ~ ~~'~ ~ `-` Dollars ($ ~~ d- ~ )
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 si~rtatur~~
--._ __ ____ --- .__ .------- _-_____ _----__-____ _~_. ___- - .~~ .._ .._.__. __ -f'~c~-E.-- -_ _.__...._.._.._.
Pur aser 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.
~~
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~~~~
'City of Sebastian fitness
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^ Cash
heck # ~~~~
AmountPak
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501 341910 LDClCode of Ordinances
001501362100 Community Center Rent
001501362100 Yacht Club Rent
001501 362150 Non Taxable Ren
t
001501 343800 J
'
Cemetery Lots ~-l ~ ~'~ %C~-- ~/® QCJ,. ll~„1
601010 343800 Cemetery Lots
LoUNiche ,Block ,Unit
001501 369400 Interment Fee
001501 369400 Weekend Service
680800 220681 Yachf Club Security Deposit
660800 220682 Community Center Security Deposit
680800 220683 Riverview Park Security Deposit
,/~, Total Paid ~ ~° ~!~
Initials
White -Dept. of Origin • Yellow -Finance • Pink -Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
ocrGro~r ~ f , ~.
'I`~ie 5e~a~s>~a~ Ce~e~~~y
City ®~ Se~as~i~.>~, ~.®~d~
is acknowledged in the sum of:
%~
QOpp
Dollars ($~~ Cr - ~ )
S~
~_ 7~''R= ~ f~
_ __.
on this ~ ~y of vGex-~u~~` 20 cs~ for the purchase of the following
described Cemetery Lot(s)/Ni (s) upon the terms and conditions a~ stated herein:
Description of Property:
Cemetery Lot(s)/Niche(s) / O Bloclc ~~ Unit
`~.~.-~~ '~~"~`_~~ Dollars ($ ~~~- ~ )
Purchase Price: ~~~-~~
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 vve, agree to purchase the above described property on the terms. and conditions stated in
the foregoing instrument:
er signaLUre
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.
~,
I(~ j V ' F'~`.r~'"GYM/
f `City of Sebastian
Purchaser si~natur~--~
fitness
~~
A}
.."~`b~,
r1i N {. "'~C~4r-.. ~ 'e
- .'YY~.~
-~ .~~.
H~3ME ~~ F'EL~.1~ ISL~N~
August 22, 2002
Mr. Leon Correll
1362 Scroll Street
Sebastian, Florida 32958
Dear Mr. Correll:
Enclosed is City of Sebastian Deed Number 1856 for Cemetery lot 10, Block 14, Unit 4. Also
enclosed is a copy of your receipt.
If you have any questions, please contact our office.
S' cer y,
~~_
ally A. M 'o, CMC
City Cler
SAM:ar
enclosure
a
FLORIDA DEPARTMENT OF
HEALT State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
A. (TYPE)
1. Name of First Middle Last Date Month Day Year
Deceased of
FSANCES CLAIRE CORRELL Death AIIGIIST 18, 2002
2. Place of Death
County
INDIAN RIVER City, Town or Location
SEBASTIAN Name of (If neither, give street address)
Hosp. or
Inst. 1362 SCROLL STREET
3. Name of Medical Address Phone Number
Certifier ~T~R J, SPLEAIDORIA, >NID 1265 36TH STREET
Medical Examiner hysician VERO BEACH, FL 32960 772-567-6340
4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 735 PEENING ST
SEAWINDS FONERAL HOME EBASTLAN, FL 32958 2617 772-589-1933
5. cneclc a. ~ t ne mealcal certlncatlon nas been completed antl signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. ~ was contacted on
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that 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
medi certification of cause of death within 72 hours.
6. Funeral Director/ SigJ~ature /~ F.E. No./Reg. No. Date Signed
Direct Disposer _ i_/ Lam- 2294 8/19/ 02
B. BURIAL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 9nA9_91/,17-045
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 wilt 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 filin the ath cert~c a has been requested.
--~tegis4rere~. Date Date Certificate
SubregistrarSignature Issued: 8/19/02 Due: 8/24/02
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. Awaiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition
BURIAL STORAGE Date of Disposition S/ ~,/~D~
T'
CREMATION OTHER (Specify)
Signature of Sexton
or Person-in-Charge } ~,~ Cj, ~~ [~
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, 8197 (Obsoletes all previous eddions) Yellow: Funeral Director or Direct Disposer ij`/y)l/
(Stock Number: 5740-000-0326-2) Pink: Local Registrar '