HomeMy WebLinkAbout2-51-03THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACK'POWLEDGED OF THE SUM OF:
✓ ,.� - "'Dollars ($ OkS D d )
FROM:
on this day of1OAL1h/jlA.,,, 1981 for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein-
Description of Property:
• Cemetery Lot (s) # X31/ x Block# IJ / Unit# 02 A--e- d"),- _
Purchase Price.NA.it- ��,,� ,�� � Dollars ($ e. 0-Z) )
Terms and conditions of sale:
1p..t . C"e 6;zo.
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:
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.
' � r
city o Sebastian
Witness
BASS, (MRS.) IRENE
P• 0. BOX 435 5A
FELLSMERE, FLORIDA 32948
UNIT # 2 addn.
BLOCK# 51 LOTS 3 & 4
Mr. Fred M. Bass interred 10 -21 -81
DEED # 475
Paid by C'Aece1Pt No.
DEED # 475
...284..........
Dated .... 10-1.9_81 ....
Mrs. Irene Bass
List Price
$. *. $3$,0, A0. *..
Maximum No. Burial spacer,
P. 0. Box 435
Discount
a ..... - .0 — " • • • • • • • •
.2..
Total area in square fat ** * * * * * * ** Fellsmere, Florida 32940
Net Paid
$..,350.00*
...............
......
permitted ..F.�dt .............
Monument LOTS 3 &4, BLK.5I,UNIT 2 addn.
R. &R. Issued
with Deed
(Data above this line for City Record only)
'Fred M. Bass interred 10 -21 -81
UNIT # 2 addn. BLOW 51
MRS. IRENE BASS
P. O. BOX 435
Fellsmere, Florida 32948
Mr. Fred M. Bass interred 10 -21 -81
LOTS# 3 & 4
DEED # 475
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
•
VITAL STATISTICS •
APPLICATION FOR BURIAL - TRANSIT PERMIT
NAME OF
First
Middle
Last
DATE Month Day Year
OF
DECEASED
(Type or print)
fted
Melvin Bass
DEATH Oct, 18 1981
PLACE OF DEATH
CITY, TOWN. OR LOCATION
NAME OF (if not in hospital, give street address)
HOSPITAL OR
COU Y
"indian River
p�
Vern Beach
INSTITUTION Indian River Memorial
Attending Physician IF
(Name of Medical Certifier) Suite 1 -E (Address)
Medical Examiners ❑
James Cain M.F. 1300 -
36th. St. Vero Beach, 1
Hom neral
(Name)
(Address)
e
Check A ❑ A completed certificate of death accompanies this application.
One
B Kj Dr. JamBB Cain was contacted on OCta 19 ,19 $1_.
He has assured me that this death was from natural causes and that he will complete and sign the medical
certification of cause of death.
C ❑ The attending physician was unavailable or this death comes within the Medical Examiners jurisdiction.
The body was released to me by
on ,19
BURIAL TRANSIT PERMIT Neormit 1228 -1
Permission is hereby granted to dispose of this body by burial, transportation out of state, storage or cremation. For cremation a
waiting period of 48 hours after death must be observed and the Medical Examiner's approval must also be obtained.
❑ A five day extension of time for filing the death certificate has been requested and granted.
Signature of
Registrar
Method of Disposition
®
BURIAL
❑
CREMATION
❑
STORAGE
❑
OTHER(Specify)
Signature of Sexton 76
or Person in Charge
Date
Issued Oct. 19, 19, 1981
CEMETERY OR CREMATORY
Date of October 21, 1981
Disposition
M
Place of
Disposition City of Sebastian Cemetery
This permit must be endorsed by the sexton or person in charge (or by the funeral director when there is no sexton) and returned
within 10 days to the local county health department.
HRS Form 326 (1/77)