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Home My WebLink About2-50-04uJ � � �� O . „--- Paid by CEMETERY Receipt No. , , 3 41 . . . , . , . , , Dated . . . . . 2 � 16 � 8 3 . . . . , . . . . . , , NO. 150.00 ea. List Price $ . . . . . . . . . . . . . . . . . . Maximum No. Burial Spaces . . . . . . . . . . . . . . . . ♦ � � � 1 .L c.l Net Paid $ . . 3.Q � . Q�. . . . . . Monument permitted . . . . . . . . . . . , . . . . . . . 1.,0 t S 3 & 4 B 1 k . ) � � Uri � . ACj. � Mrs.,+Stella Hart�r 8520 U.S.l, Apt. C-9 (Data above thla line tor City liecord ouly) M1 C C O� F 1. 3 2 9 5 8 �it�g nf �p�tt��ittn C�Pri�P�P�� PP� NO. 1�� THIS INDENTURE MADE TLL .... .. S tYl . .. . . .. . . . dNy ot ... . ... ... . r�8� ....................... . . .. . A. D., i&. . $ 7� 6et��•een tl�e City of Sebustlan, a municipal corporstton exlsting undcr the laws of the 9tnte ot Florida, ne Grantor and .................................. ..... . STELLA HARTER . . . . . . . . . .S 5 2 0 � LT': S : . .1.� . .A.� � ... . .0 _ � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . Mz C.C.Q., . . k'.�.O�t ZU.A. . . . 3.2 9 5 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . or cne County ot . . . . _ . . . .I�TD �•AN• •RI•VER • • • . . • • • • • • • • • • an� Stnte ot . . . . . . .r�ORI•DA . . . . . . . . . . . . . . . . . . . ................. ae Grantee, WITNES9ETH� That the Grantor for and in consideration of the sum of S. 3��•�� . . . . . . . . . . . . . . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowiedged, does by this instrument grant, bargaut, sell, zelease, convey and confirm unto the Grantee ,, Y],E; �,, heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) 3,&, 4 Block 5� UNIT , 2, ADDN ;. � of Sebastian munici al cemetery as > > • • • • • • • • � p per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the ofSce of the Cierk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida 1 � �'- ::, ,�;��:.�d.� �- l r � %�� ., ��, � �� .��U ��- � ,�u�- To Have and to FIold 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 accoidance with the rules and regulations, 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 in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and.otdinances and the conditions of the dCed of wnveyance thereof then the title of such owner in and to said property s}ull terminate and the same shall ravert to the City of Sebastian, Plorida. IN WITNESS WHER�OF, The said party of the fust part has caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto aft'ixed, the day and year first above written. ` ` Attest: � �..�. .. ................ Gty erk Signc�, Scelcd und Dcllve�ed ln the re ence ul: . . . . �!.l. .. . . . . GMrG/�a . . . . . . . . . . . . . . . . . . -��" . . . �%�. � � J�I` . 7 . . � . '�, i • ��.i.........�... s•rn�i•i: o�� i��r.Oft1DA CITY ON` SE13A6'CIAN, P'LOR �t3 . ........... / ................. Mu�ur ��lf�t �Y211� STATE OF FLORIDA � j�/ � �'�' � � � -PARTMENT OF HEALTH & REHABILITAT"'F SERVICES � VITAL STATISTICS APPLICATION FOR BURIAL—TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased Robert Frederick Harter D ATH Feb. 15, 1983 2. Place of Death City, Town or Location Name of (if neither, give street address) County Hosp. or Indian Rivex. _____ __ Roseland Inst. �A Sebastian River Medical Center 3. Name of Medi al �] Physician Address Certifier �arhat Khawa ja, M.D. � Medical Examiner Fischer Plaza Sebastian Florida 32958 4. Funeral Home/ Name Address idid��aa�o�ottinger & Son Funeral Home S. Indian River Drive Sebastian Florida 32958 5. Check a� The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. ` priate �� was contacted on . He/she verified that Box this death was from natural causes, that there was no accident nor other external cause of dleath, and that wili complete and sign the medical c:ertification of cause of death. c � 6. Funeral Director/ x�DC4�S�[3{�DAetX cat#'on. . _ was contacted on . He/sh�e verified that ., Medical Examiner, will compiete� and sign the �� 2368 Feb. "15, 1983 Fla. Lic. No./Reg. No. Date Signed B. BURIAL—TRANSIT PERMIT 759-468 o Permit No. — Permission is hereby granted to dispose of this aody. [] 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 �y,,� � � J�'— " Date Sub-Registrar Signature J�/�:��--si�!�.-;--�� `"�—��'U Issued �, '�� ;i i Cf %�— C � AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telephone to Funeral Director/Direct Disposer. Date The Medical Examiner's approval must be ob?ained before disposai by any of the above methods. A waiting period of 48 hours after death is required for ail cremations. CEMETERY OR CREMATORY Method of Disposition: � BURIAL � STORAGE ❑ CREMATION � OTHER (5pecify) Signature of Sexton 1 or Person-in-Charge �f' _�___ ' _ ' _. Place of Disposition Sebastiari Cemetery Date of Disposition February 17, 1983 ,� CL' k'; ;� , t � �` xJ/ This permit rriust be endorsed by the Sexton,'or person-in-charge (or by the Funeral Direcior/Direct Disposer when there is no Sexton) and returned within 10 days to the local Cou�ity Health Department in the County where disposition occurred. HRS Form 326, APR. 81 (replaces previous editions which may bf� used. )