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THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
Lf(�1 0 �/ .U/1'/��� ��1!�J1�J DolZars (S 3� . D � )
FROM:
on this�day of��� 1982 for the purchase of the following
described Cemetery Lot(s) �pon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot (s) #��`�j y� %� Blocx#�,� unit#� �q��a�,�.
Parchase Price: 'f'� �QQ, �� Dollars ($ , QUj
J
Terms and'conditions of sale;
U�--e �.�,c-ec�, � i��e-� �1 c�-e�i �c/'i � /�,� �3��D �� .�.-- ��--�
�` ���o, od - .�
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This contract sha11 be binding upon both parties, the seller and the purchaser, when
approved by the owner of the propertr� above described.
I, or we, agree to purchase the above described property on the terms and conditions
stated in the foregoinq instrument: ,�
, �
l/ � �'�'� , � 1,1�
The City of Sebastian agrees to se11 the above mentioned property to the above named
purchaser(s) on the terms and coni3itions stated in the above instrument.
.;/�_ i.% /.1_ � , �
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Witness
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Paid by CEMETERy Receipt No. ..,325
•••••....Dated..... 1?-15-82
I.ist P ' .300 00 • • . .. . ... .. . . . ..
nce5 ..................
Net Paid S.. .. 300: 00. .. ...
R 6 R ISSUED
NO. � �. ,� -
MaximumNo.Puria(Sp$ces.... -2- William P Descovich
............. � _, .� �
Monument permitted ... F'1 a t and /or
"""•••••••••••..Anna E. Descovich .
P.O. Box 6, Bay Street, Roseland
(Data above tbis line !os (�( F'Iorida 32958
��0D1� °p�y� LOTS 15 & 16, B1ock 50, Unit #2 ,
DESCOVICH, WILLIAM P& ANN�LE. J
P.O. Box 6 BAY STREET DEED }t 511
ROSELAND, FLORIDA 32957 RECEIPT {i325
R & R ISSUED
LOT �{ 15 & 16, BLOCK 50, UNIT {�2 ADDITION
,....
I�nna_.�.�e�Vi�--�err�i�� '�
'R�e.''r�cQ 517�i3 �.o-� 1 �c�
STATE OF FLORIDA
�PARTMENT OF HEALTH & REHABILITA� SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL—TRANSIT PERMIT
� %Jr��� � � C%
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A. (Type or Print)
1. Name of First Middle Last DATE Month Day Year
Deceased
William Peter Descovich D ATH Dec. 25, 1982
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Brevard Melbourne Inst. Carnegie Gardens Nursing Home
3. Name of Medical �C cPhysician Address
Certifie�uhammad Idrees, M.D. � Medical Examiner 115 N.W. Palm Bay Rd. Palm Bay, Fla. 32905
4. Funeral Home/ Name Address
��c Pottinger � Son Funeral Home 1200 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 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
6. Funer
C
�
cause of death.
c �
ic certification.
j
�r/ Signature
X
P�f:3
will complete and sign the medical certification of
was contacted on . He/she verified that
., Medical Examiner, will complete and sign the
December 27, 1982
Fla. Lic. No./Reg. No
BURIAL—TRANSIT PERMIT
Date Signed
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"Funera� Director/Direct Disposer Report" will be filed
with the Local Registrar of the County in which death occurred.
Registrar or
Sub-Registrar Signatu
Signature
or
Medical Examiner,
Date �� ,C L� l'Y� G� � vZ �l , l CI ��
Issued
AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA
, Medical Examiner Date
, gave authorization by telephone to
Funeral Dlrector/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 Cemetely
Date of Disposition DeCembei' 2�� 1982
Deborah C. Krages, City C1erk "
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.)