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THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
3�d"
on this day of , 19d for the purchase of the following
described Cemetery Lots) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot(s)# Block# / Unit #�
Purchase Price: % 'id 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.
.a& Udil,,exez
C' of ebastian
Witness
STATE OF FLORIDA �7 Z/
PARTMENT OF HEALTH & REHABILIT E SERVICES
VITAL STATISTICS 0
APPLICATION FOR BURIAL — TRANSIT PERMIT
A. (Type or Print)
1. Name of First Middle Last DATE Month Day Year
Deceased OF
GEORGE DEWEY HOEHN DEATH April 22, 1983
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Indian River Sebastian Hosp.or Sebastian River Medical Center
I nst.
3. Name of Medical
R Physician
Address
Certifier Nasar Rizwi,
MD ❑ Medical Examiner
US1-Fischer Bldg., Sebast i an,FFor i da
4. Funeral Home/
Name
Address
Direct Disposer
Strunk Funeral Home., 734 North Central
Avenue., Sebastian, Florida 32958
5. Check
a
The medical certification has been completed and signed. A completed certificate of death accompanies
Appro-
this application.
priate
b
Dr. 1?izwi
was contacted on A/25/83 He/she that
Box
verified
this death was from natural causes, that there was no accident nor other external cause of death, and that
Tie!
will complete and sign the medical certification of
cause of death.
c F-1 was contacted on . He /she verified that
Medical Examiner, will complete and sign the
medical certification.
6. Funeral Director/ Signature Fla. Lic. No. /Reg. No. Date Signed
Direct Disposer
2088 April 25, 1983
B. BURIAL— TRANSIT PERMIT 1228-83-118
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. If it cannot be filed within this time limit, a "Funeral Director /Direct Disposer Report" will be filed
with the Local Registrar of the County in which death occurred.
Registrar or
Sub - Registrar Signatu
Q__
Date
Issued April 25, 1983
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
C
Signature Medical Examiner Date
or
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.
Method of Disposition:
BURIAL STORAGE
CREMATION OTHER (Specify)
Signature of Sexton ►
or Person -in- Charge )
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
Date of Disposition April 26 , 1983
City Clerk
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.)
1 f�
.Dated. 4 -25 -83 NO. 0
Paid by CEMETERY Receipt No .... :348.... • .. • Robert Hoehn
150.00 Maximum No. EurialSpaces .................28 Spruce Lane
List Price $ .................. Spring Lane Heights, Va. 07762
Net Paid $ ' 5 0• •. Q Q• • • • • • • • • • Monument permitted ...... .fl A t ............
LOT #11, BLOCK 49, UNIT #2 Addnt.
R & R Issued (Data above this line for CRY Record only)
DEED #S26
FIOEHN, ROBERT Receipt # 348
28 SPRUCE LANE
SPRING LAKE HEIGHTS, VA 07762
LOT #11, BLOCK 49, UNIT #2 ADDNT.
GEORGE DEWY HOEHN, INTERRED IN LOT #11, BLOCK 49, Unit #2 ADD.
April 26, 1983