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Home My WebLink About2-48-13tr w x U ti O z k O R H i Q m W F W H Q � 0 i V-1 o_ a IZ04 ! i I i uj{' m W F W H Q � 0 t e of ma--,---,-out o G e o f= :,;., -; al S .ion j -- Elm :: :,o u P nl STATE OF FLORIDA &PARTMENT OF HEALTH & REHABILIT *E SERVICES VITAL STATISTICS APPLICATION FOR BURIAL — TRANSIT PERMIT /_ /3 /�` /,' "/ - f "i A. (Type or Print) '7: Name of Fifst'- �— Middle Last DATE Month Day Year � DepegSecl• OF " Cecil Franklin Wells DEATH May 18 1985 ,. Place of peath „City, Town or Location Name of (If neither, give street address) County Hosp. or k..euad Micco Inst. 4645 Micco Road, Micco, Florida• 3. Name of Medical F-1 Physician Address Cegifigr ' D4niel,Will.iallk0i M.D. Medical Examiner 1350 South Hickory St., Melbourne, Florida. q. Funeral Homel•' Name Address Direct Disposer Strunk Funeral Home 916 17th Street, Vero Beach, Florida 32960 Cheek a ' The medical gertifipation has been completed and signed. A completed certificate of death accompanies , J Appro this, application. • � pnaa " b 8QX , was contacted on . He /she verified that this death was, from natural causes, that there was no accident nor other external cause of death, and that �i will complete and sign the medical certification of,, .! pause of death, p c JA111ceButeh was contacted on 5/23/85. Wshe verified that 'Dr. nsniel Wi liamra Medical Examiner, will complete and sign the medical certlfi4ation '- 6, Funeral Oirectgrl Signature Fla. Lic. No. /Reg. No. Date Signed 7 z,_ May 23 1985 BURIAL— TRANSIT PERMIT 1228 -85 -180 I Permit No. a� Prxnissipn is her�lzy. granted to dispose 4f this body. �] A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and gran if it cannot be filed within this time limit, a "Funeral Director /Direct Disposer Report" will Oe filed vuit th t-pGa1 Rf:9istrar of a County in which death occurred. >+ , Registrar or X0 Date Sub,-, Rp istrar $igne Issued i� C.+ AUTHORIZATION fQr CREMATION, DISSECTION or BURIAL —AT —SEA i Signature Medical Examiner Date or M 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: [X BURIAL E] STORAGE E] CREMATION E] OTHER (Specify) Signature of Sexton or Person -in- Charge CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition May 20,E 1985 Deborah C. Krages, City C1e?rk`�j 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.) Paid b �RY y Receipt No. . 26I. , . , . , , , „ . , Dated... Jtrxle, .2,3,E „l9.$1....... . *350 00* List Price . �........ • • . • • . • • • Maximum No. Burial spaces ... 2.. . Discount $ ...... 0.' ........ Total area in square feet********** Net Paid ................ $.. *.3.$,Q,,Qp* Monument Permitted . flat .............. R. & R. ISSUED WITH DEED (Data above this line for City Record only) WELLS, Cecil F. and /or WELLS, Phyllis 4546 Micco Road Sebastian, Florida 32958 (micco) DEED # 456 WELLS, CECIL F. AND /OR WELLS, PHYLLIS 4645 MICCO ROAD(MICCO) SEBASTIAN, FLORIDA 32958 UNIT #2 Addition BLK. 48 LOTS # 13 & 14 DEED # 456 Unit ZAddition BLOCK 48 , DOTS 13 & 14 CECIL F. INTERRED LOT 13 - 5/20/85 .r THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: FROM: P& lI. O \ y / �, J /i.w - ?`' - - ®/. Dollars ($ 1620, op this_ day of 1981 for the purchase ofjthe following described Cemetery Lot(W upon the terms and conditions as stated herein: Description of Property: Cemetery Lot (s) # /,(� Block# Unit# cl�l . Purchase Price: JTerms 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. Witness �j , A / r June 17, 1981 Ms. Phyllis Wells 3185 micca tibad Sebastian, Fleeida 32958 Dear Ns. Wells: On April 28, 1981, a Payment of $200.00 was made on Lots 13 and 14, Block 48, Unit 2 Addition. As it has been over 30 days, we would appreciate it if you would stop in and make final payment of $150.00. Thank you. Very truly yours, EZ.i zabeth Reid City Clerk FR/dh April 28, 1981 so. Phyllis wells 3185 Micco Read Sebastian, FL 32958 Dear Ms. Wells: Enclosed is your receipt for the $200.00 payment you made on Lots 13 and 14, Block 48, Unit 2 addition in the Sebastian Cemetery. The balance now due on them is $150.00. Thank you. Very truly yours, Elizabeth Reid City Clerk ER/jlf enclosure w � Pat Flood, Jr. Mayor .• Gs� v Q 6 �C PELICPN `$�,P Cite of Sebastian POST OFFICE BOX 127 ❑ SEBASTIAN, FLORIDA 32958 TELEPHONE (305) 589 -5330 April 22, 1981 Ms. Phyllis Wells Baj� 8 J /j'Y --- Micco Road Sebastian, Florida 32958 Dear Ms. Wells: According to our records, we are holding the following cemetery lots for you: Lots 13 and 14, Block 48, Unit 2 Addition As there have been no payments made on them, would you please let us know if you are still interested in them. If we do not hear from you within the next 30 days, we will assume that you do not want them. Very truly yours, r Eli eth Reid City Clerk ER/jlf Elizabeth Reid City Clerk