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STATE OF FLORIDA
WPARTMENT OF HEALTH & REHABILITOE SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL — TRANSIT PERNIIT
A. (Type or Print)
1. Name of First
Middle
Last
DATE Month Day Year
Deceased
OF
FRIEDA MEYER
DEATH August 11, 1984
2. Place of Death
City, Town or Location
Name of
(If neither, give street address)
County
Hosp. or
Indian River
Sebastian
Inst.
Humana Hospital- Sebastian
3. Name of Medical
" Physician
Address
Certifier Steven
W. Wright, D. 00 Medical Examiner
115
N.W. Palm Bay Rd., Palm Bay,FI.
4. Funeral Home/ Name
Direct Disposer Strunk Funeral Home., 734 N. Central Avenue., Wxxexjj&axtcla, Florida
5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies
Appro- this application.
prate b E@X Linda (sec' y) was contacted on 8 1 13 verified that
Box this death was from natural causes, that there was no accident nor other external cause of death, and that
Dr. Wr ioQ t will complete and sign the meciical certification vt
cause of death.
c was contacted on . He /she verified that
Medical Examiner, will complete and sign the
medical certification.
6. Funeral Director/ Signature Fla. Lic. No. /Rey. No. Date Signed
Direct Disposer �
August 13, 1984
B.
BURIAL— TRANSIT PERMIT
Permit No
1228 -84 -256
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. If it cannot be filed wit in this time limit, a "Funeral Director /Direct Disposer Report" will be filed
with the Local Registrar of the Cclunty in which death occurred.
Registrar or
Sub - Registrar Signatu
C j Date
Issued August 13, 1984
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
Signature
or
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. A waiting period of 48 hours after death
is required for all cremations.
CEMETERY OR CREMATORY
Method of Disposition:
BURIAL [] STORAGE
E] CREMATION E] OTHER (Sp)
Signature of Sexton y'�
or Person -in- Charge
Place of Disposition Sebas t i an Ceme to r
Date of Disposition August 14, 1984
Deborah C. Krages, City C1erke��
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.
HRS Form 326, APR. 81
(replaces previous editions which may be used.)
Henry W. and or Deca Mae Meyer
207 Poinciana Street
Paid by CEMETERY Receipt No..... 317........ Dated ... Septembsr. lb , .19 82 ... Sebas ti an , F1 a . 32958 NO. 0504
List Price $415.a.04. FACU., FRNOO 00 Maximum No. Purial Spaces ...4 ............. BLOCK 49, Lots 5,6 , 7, 8, Unit #2 A
Net Paid $ 600,00, ..... , ... Monument permitted . Flat
DEED #504
(Date above this line for City Record only)
DEED #504
RECEIPT #317
PURCHASED 9/16/82
MEYER, HENRY W., AND /OR DECA MAE MEYER
207 POINCIANA STREET
SEBASTIAN, FLORIDA 32958
BLOCK #, LOTS, 5,6,7,j, UNIT #2 ADDITION
HENRY MEYER, INTERED 9- 20 -82, LOT #6
(FATHER)
FRIEDA MEYER,INTERED 8/14/84, LOT #5
BLOCK 49 LOTS 5,¢,7,8 UNIT # 2 ADDN.
e
Henry W. Meyer, and Deca Mae Meyer
207 Poinciana Street
Sebastian, Florida 32958
R.R. Issued
Deed #504
Receipt #317
Henry Meyer, Interred 9- 20 -82, Lot #6
(Father)
Frieda Meyer, Interred 8114184, Lot #5
0 0
3 1 r f
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
Dollars
FROM:
on this day of , 198,2 for the purchase of the following
described Cemetery Lot s) u n the terms and conditions as stated herein:
Description of Property:
Cemetery Lot (s) #i Block# Unit#� QQ�
JI
Purchase Price: /�,r� ��) p/1P�, Dollars($
Terms and conditions 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:
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.
.�
g�fty of Se26stian
Witness
January 13, 1987
TO: HECTOR FRANCO
FROM: KIP KELSO, JR.
Itl ?: PLACEMENT OF STONE AND DISINTERMENT '
Pursuant to our conversation of January 12 concerning the changing
of Henry and Freida Meyers' double stone from Lots 15 and 16 to
Lots 5 and 6, Block 49, Unit 2 Addition, which are presently occupied
by a marker for Lloyd Myer.
With the chanLIng of the stones, we also have to exhume Mrs. Freida
Mayer who Is pr. sent ly interred in Lot 16, Block 49, 4o was placed
in the wrong lot because of the stone being misplaced. She will go
.in Lot 5, Block 49.
The pricer of exhumation is $385.00 and Purchase Order No. 395 will
he sent to Inter L.ine Vault Company, Fort Pierce.
KK:Ir
L. GENE HARRIS
Mayor
C141 o f Sebastian
POST OFFICE BOX 127 ❑ SEBASTIAN, FLORIDA 32958 -01
TELEPHONE (305) 589 -5330
January 13, 1987
TO: Kip Kelso
FROM: Hector Franco
Engineering /Public Works
RE: Placement of Stone and Disin erment
I am in receipt of your memo d ted January 13, 1987
and authorize you to contact Inter Line Vault Co.
and order the exhumation at a cost of $385.00.
If you have any further questions or comments,
please feel free to contact me.
for A. Franco
Citv-NZnqineer