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BLOCK 48, Lot 6, Unit 2 -Add
Pearl Greever and Noel Greever
1235 W. Hyacinth Circle
Sebastian, Florida 32958
Noel Greever interred on 7111184
Paid by CEMETERY Receipt No.... 3 7 9. , . , , .... Dated ... 7 13 . 18 4 .
List Price $., 225, 0.0...... Maximum No. Purial Spaces ..... 1.......... .
Net Paid $ .. .. 5.... 0 . Monument permitted ......F 1 a•t
Lot 6, Block 48, Unit 2 -Add.
(Data above this line for City Record only)
Deed #1014
Recpt 379
NO.
1 -1�/4
Noel Greever - Interr
Pearl Greever
1235 W. Hyacinth Cir.
Sebastian, FL 32958
STATE OF FLORIDA
OEPARTMENT OF HEALTH & REHABILITOE SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL — TRANSIT PERMIT
A. (Type or Print)
1. Name of First Middle Last DATE Month Day Year
Deceased OF
Noel Jerome Greever DEATH July 6, 1984
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Roseland Inst. Humana Hospital Sebastian
3. Name of Medical U Physician Address
Certifier M Fgasirhar t khawa ja,,.�l. D.
17W1. I�1 Medical Examiner U.S. 1 Sebastian. Florida 32958
4. Funeral Home/ Name A dress
x 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
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
/I.S Q . I e a ertification.
tl 2368 July 9, 1984
6. Fine al Director/ nature Fla. Lic. No. /Reg. No. Date Signed
xQlf der
B. BURIAL — TRANSIT PERMIT 759 -557
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 Date
Sub - Registr ar Signature/�' % f Issued / G -p y
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 obtained before disposal by any of the above methods. A waiting period of 48 hours after death
is required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition:
xyB BURIAL ❑ STORAGE
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton )
or Person -in- Charge )
Place of Disposition RF.RASTTAN C:F.MFTF.RY
Date of Disposition July 11, 1984
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.)
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
Dollars ($
FROM:
on this /_�3 _day of y , 19 k�Vfor the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot (s) # Block# Unit# '19,612
Purchase Price: 1 '5 Zlars($
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.
��AS�c,LlC���'Z.�i1i`?�
City of Sebastian
Witness
01 -- - -- ---- �
3 918 `
POTTINGER & SON FUNERAL HOME, INC. ' 1.
SOUTH INDIAN RIVER DRIVE PH. 588 1000 6' 1
SEBASTIAN, FL 32858 � 63 - 6glij
S70 IJ
AM
,
A R POTTINGER. PRES.
VV MARGARET M. POTTINGER, 69C.: TREAD.
Southeast Bank, NIA DANIEL R. POTTINGER. JR.. V. PRES.
SEBASTIAN BANKING CINUK D;�IBflA R. $C NMAKER. OFC. SEC.
St AST IAN FL RIDA32950
11800 39 Lau• wi :06 70066 LOI: 342 4800 3 51
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