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Home My WebLink About2-50-02W � � /��, � � �o y� -_ j � � 6 , - . .r , -- � �� _�— —; � -- ; pJ � � 1 o� _,( , `V' , � . , ; Q'o�"'� .i P', � �� S � � �` � I �� ;/ � !�� k� �� J , i, � �� i ��,� � � �'t �� ,��,� �,� � �� x��'� J�� y` .. � I � `k r '.,% �, �,i� � �: I �`�� `�� i/ � �'�� 9r' iv;i �i i r � � �3 � � � � i � ' k: , �A �� N� , I � I J' i � -�• / � �.� � � � � � � ±, �� '�U � � t1 �� ~ � � �y�\�I� ��a� � � � ;, �r,.�� , Name ^ ��3r�r.?� �� ,r.,�T • � �"'2 i # , �. ,. Unit Block Lot � Date of Mark-out� �_' �� `l Date of Burial� .'�t ' _> / ;�'�� Time � 1 ;:? �.> �''� . ?�`r , l 02 � State of Florida, Departme of Health and Rehabilitative Services, Vital istics �3 �� APPUCA�FOR BURIAL — TRANSIT PERMIT � � �, � �� A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased Donald Peltier �F 0'l/12/94 DEATH 2. Place of Death Count�r Indian River 3. Name of Medical Certifier Noor Merchant, M.D. City, Town or Location Roseland 4. Name of Funeral Home/ DKCC�.Disposec. Strunk Funeral Homes, P.A. 5. Check Appro- priate Box Name of (If neither, give street address) Hosp. or Inst. Sebastian Hospital J Medical Examiner Address 7744 Bay Street; Suite 2 Physician Sebastian, Florida 32958 Address Fla. Lic. No./l9eg..tUc 1623 North Central Avenue Sebastian, F1 32958 1228 Phone Number (407)589-0879 Phone N ��r (Area Code) /OO C� (407)" a❑ The medical certification has been completed and signed. A completed certificate of death accompanies this application. b� Li2 was contacted on 02/14/94 Within 72 hours after death. He/she verified that this �eath vy�s frpm n�turaL.c,�uses, that there was no accident nor other external cause of death, and that oor inerchan , M ll will complete and sign the medical certification of cause of death. c ❑ was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. 6� Place of e as 1an eIDe ery In state cemetery/ Removal Final Disposition: matory - nam ounty: Indian River from state Donation �� Funeral Director/ Signatur F.E. No./Reg"fdb. Date Signed Bi�es#-Bie�esor ' � 1672 OZ/14/94 g. BURIAL — TRANSIT PERMIT 1228-94-0067 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 as undue hardship would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a"Funeral Director/Direct Disposer ReporY' will be filed with the Local Registrar of the County in which death occurred. ❑ No extension of time for filing t e death certificate requested. Registrar or � Date Date Certificate Subregistrar Signature Issued: — — Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA � Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telephone Co _ 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. Methods of Disposition: � BURIAL ❑ CREMATION Signature of Sexton ) or Person-in-Charge ) ❑ STORAGE ❑ OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition �� A� .04 ��1 Date of Disposition �• �+•. i / 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 HRS Counry Public Health Unit in the County where disposition occurred. HRS Form 326. Feb 89 (Replaces Oct 87 edition which may be used) IStock Number: 5740-000-0326-21 ` Paid by CEMETERY Receipt No. ...� 9 8. •.. n.c�a ....?. .18 9 4 I.O C i � �... � .................. ' S00.00 BLOCK Liet Pdce S . . . . . ... .. .. . .. .. . Maximum No. Burial Spaa . .. .. ..... . .. ... . UNI T 2 DDN Net Paid S . S.QQ . Q0. . . . . . . . Monument permitted . . . .. . . ... . .. .. . . .. .. . . � (D�t� �bo�e tlJ� line for CJty lteeord only) f�ifg nf �rhtt�#ittn �Pllt!'#P�1„� �P�i1 No. No�.447 � 14-4 7 TH19 INDENTURE MADB '11b .......... .L.S.GIl .... d�y of .......... F2b.Y'118T.j� ..................... A. D., �e. �4►.., between lbe City ot 9eboeti�n, ■ municip�! eorporstlon e:lotins undcr the lawe of the 9tste ot Flortdy s� (irantor and Francia N, Peltier . . . . . . .. .. ..... ................................ . . 8 56• • i:ance• • STree t ...... ......... ... .... ... ... . ............... ............. Sebastian, Florida 32958 ............................................. ............................................ ..... ...................................... ot the Counly ot ....Indian River,...,.., ,., ,,,.� ara�� ot .,...Fl,orida,,,,,,.,.. .............. ............................ u Gnnteq WITNE88ETH� That the Grantot for and In consideraUon o[ the eum of S,,, 5 �0 . OO ...,,.,,, to tt In hand paid, the roceipt whereof la herewith ac- ......... knowkdged, does bq thie inatrument grsnt, bsrgein, ee0, releaae, convey and confitm unto the Grmtee he r, ,,, helra, legsl reptexntativea and aaalgna the following property dtusted in SebaaHsn, Indian River County, Florids, to-wit: All ot Lot(a) ,. 2..., Bbdc, ,, 5 �, ,,, UNIT ?, ,ADDN :. ,, of Sebastian munidpel ametery aa per Ptet Numbet 1 themot mcorded in Plat Book 2, at page 65 of the pub8c rocorda in the of8oe of the Ckrk of the Ctrwlt CouR of SG Lude County of Fbrlda; eald hrid now lying and beirg in Indisn River County, Fbdda. To Have and to Hold the aeme fo�evet; provided that esid property ehall be uaed sokly a� exclualvely for the intetment of the human dad and shall be used, kept and maintalned at all Hmee in �coordance �vlth the tulet and rosulaHom, otdinsncea and teeoluHona ot the City ot Sebaatian, Florids, heroto- Coro, now and hereaRet adopted or provlded [or the Sovarnment end openNon of eeld ametery. The oonditione, roetdctlona end �equlremente contained in this Inatrument shstl be mvemnta running wdth the land. In the event of the tailure of the ownat o[ any property dtusted within asid xmettty to ob- eeive and comply with such ruka, regulaUone, reeoluUom end ordinanae and the co�kiona of the deed oC conveyance thereof then the titb ot auch owner in and to sald property ehatl terminate and the a�me ahall revert to the Cky of 3ebestian, Fbrida. [N WITNESS WHEREOF, The eaid psrty of the t3rst part haa auaed thia instrument to be executed in its name and on ite behelf by ita Mayor a� atterted by its Cky Clerk and ib cotporate eeal to be hereto aftixed, the day and year tlrat �bove en. CITY F SE ABTI , FLORIDA Attest ��. . : . : !. . . `�. , �«� �%c!,`;L �". . B� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . City Qerk M��oe {gne� eled und Dellve In th rc�ence of . . .. ...... ... ............................ (Qlitq �eb[) VY• .. . . . . . .. ........... ST fE OF FT.ORIDA COL'NTY OF iNDIAN R1VER I FIE1iRBY CERTIPY, Th�t on thls .....�,$.t�i............dry of .........��:$�1[�P18x31 ............................. fY..9.�i brfure me pereonally sr�eT�a Lonnie R. Powell a�a ,Kathryn M. 0'Halloran .................................... ...................... nep�•ctively Meynr end Clty C.Icrk ot the Clty of 9ebestlen, a muMcipel corporation ueder the la�-e o/ thc Stste of Floride to me known to br the Indfviduule anJ otficere descrlbed In rnd aho executrd the foregoins co�veyence to ..........Franc.is..N �.. Pe�.t.��F .......................... ..................................... .............................. ........................................................ snd eeverally acknowledgn! the eaecution thereot to be ae auch offkers therrunto duly sufhoriud; and t6st the O/fidal seel ot tdd rnrporoUon is duly �ffixed thereto, � is thc nct end derd of uld rnrporatbn. WITNE99 my slgnstan and offlcial red at Sebutl�n, !n the�County ot n en ver� Sbte � lesl eforrsald. UNDA M. 911LL.EY a : MY COM�ISSION ► CC9�Iet7 FXPNiES Jar 18. tiil �� IOI�EDTNI11bYF�NN�IANLE.NIC. PuWk, 3tate of My lulon explrc,r Lin a M. Gall free act and deed e wid eonveyence �nd �e�r . ., � I � i � 't � ', ; � O M O m � M �� M �m �� Q � a `\ J \` i O � O � � � � r � N l W � Ow � z c, J w rn Q ¢ � Wa� �?� {a. U Q zm� ZNCn � � � H ( `� V LL � W 2 Q~S a°o � a� � N • % � W . v = o �LL �'�� " •- e�� \ sa� Z � � r�.i a � O � O � � L11 L� � PLJ rn J �.D O � N c� O 0 IY1 � M O O �-� V� ' � . � - . . . �r�n� 1�. �5� �ep �- ��.-ia,�1, ��-- �� -��lo. ►�7 �� a �� n� � c-� ��-��o�J �� C.�.�.�. a j�%9 �� BLOCK 50, LOTS 1& 2, UNIT {12, ADDITION RODENHIZER, ALVAN L. & E. 589 SLOANE STREET SEBASTIAN, FLOIRDA 32958 DEED #523 RECEIPT #1345 R & R Issued �...�"LO ..t%`�,� � G -�/- �� / J � IPT IS . i FROM: on this /Cr` foZZowing desc stated herein: • T�lE SEBASTIAN CF�'rERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA � '�9� ' ACRNOWLEDGED OF THE SUM OF: ' �� Doiz�-S �s G�G � , , � da f , Z9_�� for the purchase of the y ed Cemetery Lot(�) upon the tez-ms and conditions as Description of Propert�: Cemetery Loths�j' BZock �� U� �/ ' , . D�Purchase Pri DoZZars ( � ) Terms and Condition of sa1e: This contract sha11 be binding upon both parties, the seZler and the purchaser, when approved by the owner of the propert� above descri.bed . Z, 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 seZ1 the above mentioned property to the above named purchaser(s) on the terms and cond' ons stated in the above instrument. � � / Wi ss � � . � � City of Sebastian 1225 MAIN STREET o SEBASTIAN, FLORIDA 32958 � TELEPHONE (407) 589-5330 � FAX (407) 589-5570 February 24, 1994 Francis N. Peltier 856 Lance Street Sebastian, Florida 32958 Dear Mrs. Turner: Enclosed is Cemetery Deed No. 1447 for Cemetery Lot 2, Block 50, Unit 2 Addition. Also enclosed is a form - Return for Transfers of Interest in Florida Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded. If you wish to have this deed recorded you may do so at the office of the Clerk of the Circuit Court, 2145 14th Avenue, Vero Beach, Florida. We are enclosing two copies of Receipt No. 798 and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided for your convenience. Very truly yours, �` � ��ila�Gd��.. Kathryn . O'Halloran City Clerk KMO:lmg enclosure (\ws-form-cem.rec)