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HomeMy WebLinkAbout2-52-15alitg of Otbastot Trwrtrrg Betb NO. 1051 THIS INDENTURE MADE This .......15 th ......... day of ...... May .... ............................... A. D„ 14.85 ..r between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and 0; . ... . Fowler .....r...: .................................................. ............................... . .... 776 E. Wren Circle ................ 9�X� R4Z. � ..k'�.4�: da... 3, 29.5 6 .................................. ............... I............................ ofthe county of .. Indian River ....................... and State of .....Florida... ,... ............................... as Grantee, WITNMUTHc That the Grantor for and in consideration of the sum of $ .. , ,7 QA, QA , , , , , , , , , , , , to it in hand paid, the receipt whereof is herewith so- knowledged, does by this instrument gru►t, bargain, sell, release, convey and confirm unto the Grantee ,their , heirs, representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lots) . -151&. 11. 6, Block, . 52.... , UNIT , ?, ,additions of Sebastian municipal cemetery as per Plat Number I 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 lyWS 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 ropUtions, 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 lo this instrument shall be covenants rennin ynitb the land. In the event of the failure of the owner of any property situated within said cemetery to ob- servo and comply witb such rules, regulaticas, resolutions and ordinances and the conditions of the delod of conveyance thereof then the title of such owner In and to said property shall tormbw o and the ow shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has cawed this instrument to be executed in its name and on its behalf by its Mayor and attettod by its City Clerk and 44 cotporate no to be hereto affixed, the day and year first above written. CITY OF SEBASTIAN, FLORIDA AtterstI r4 `;�'"1G -� r�- reG,.l..:�r -r•`. B ....... ................ City ` LSlstls ce — May . iiigned, :sealed and Delivered In a Prwwm of j .w .,. ........ 4 STATE OF FLORIDA ' COUNTY OF INDIAN 41Y AR 111EURRY CERTIFY. %, kat oo .....15th .............day of .... M ?y ............... , .........................., '3 before the personally appeared L Gene. Harris and Deborah .C. , Krages ..... ...... respectively ]Mayor and City Clerk of the C � City of Sebastian, a municipal corporation under the laws of the State of Florida to rue known to be the Ipdividuala and officers owribcd in and who executed the foregoing conveyance to Frank & Irene J. Fowler ........... __.. ........... ............................... and severally acknowledged the execution thereof to be their free act and deed as suo4jVicers thereupto duly authorisedi and that the Official seal of said corporation Is duly affixed tbereto, sad the said conveyance f4 t[m, act ,sad deed of said corporation. ;'WIT,I!lY.fi$ _&ay alSp4are and official seal at Sebastian. In the County of Indian River and State of Florida, the day and year Last ator4isdd. - .................... N ry Public. State of Fier at Slots of Florida Hy na nmisalon esplrau - Mr Canmiuion Espies Aug. 22, IM ` -. ",.. bd*d Timm Tay falq : Inwosce, Icy 1 BLOCK 52, LOTS 15 & 16, UNIT 2 ADDITION RECEIPT #410 DEED #1051 FRANK & IRENE J. FOWLER 776 E. WREN CIRCLE BAREFOOT BAY, FLORIDA 32958 Frank interred 3/20/86 Name � !"C i� vV' Unit 7'"' 1 y ZY Block IS7 2 Lot © /8 C Date of Mark-out _ �. � Pate of Burial Y _� �.2 / C7 6 Time j Name of Funeral Home11U n %' �f w Authorized by `' jOgO24 STATE OF FLORIDA &RTMENT OF HEALTH & REHABILITAT•SERVICES VITAL STATISTICS APPLICATION FOR BURIAL— TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Frank Fowler DEATH March 190 1986 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland Inst. Humana Hospital Sebastian 3. Name of Medical XE] Physician Address Certifier Mohammad Siddiqui, M.D. [:]Medical Examiner 935 Barefoot Bay Blvd Barefoot Bay, Fla. 4. Funeral Home/ Name Address OxXODBUMMC Pottinger & Son Funeral Home 1200 S. Indian River Dr. Sebastian Fla. 32958 5. Check a The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate b ❑ was contacted on . He /she verified that Box 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. t: 6. F6nerarDireclpd OXXWOL0iIXINIXX c ❑ was contacted on . He /she verified that Medical Examiner, will complete and sign the medical certification. 4 2558 March 20, 1986 Signature Fla. Lic. No. /Reg. No. Date Signed B. BURIAL— TRANSIT PERMIT 759— 659 Permit No. Permission is hereby granted to dispose of this body. ❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted. It it cannot be filed within this time limit, a "Funeral Diregtor /Direct Disposer Report" will be filed with the Local Registrar of the County in which death occurred. C Registrar or ` .�.o ��J Date Sub- Registrar Signature y" Issued - -T Signature or AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA , Medical Examiner 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: BURIAL ❑ STORAGE []CREMATION ❑ OTHER (Specify) Signature of Sexton 1 or Person -in- Charge ) Place of Disposition Sebastian Cemetery Date of Disposition March 21, 1986 This permit must be endorsed by the Sexton or person- in- chdrye (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. HRS Form 326, APR. 81 (replaces previous editions which may be used.) THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: v FROM: y�o Dollars ($_ 72 pO /n7 ) aza on this (S u day of 1980-for the purchase of the following described Cemetery Lot(s) upo the terms and conditions as stated herein: Description of Property: Cemetery lot(s)#_ / S B1ock#1 S -2, Unit# , T Purchase Pri ce . �p Dollars ($ Terms and conditions of sale: This contract shall be binding both g on p 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 pr rty to the above named purchasor(s) on the terms and conditions stated in the above instrument. City of Se Aian Witness