HomeMy WebLinkAbout2-03-01-Aid by CEMETERY Receipt No.... A ...... Dated ... M$I O. 1$0..19$4..... 0 NO.
List Price $ ....300..00 ...... Maximum No. Purist Spaces ... 2 ............
Net Paid $ ....300.00 ...... Monument permitted... Fl at .............. 1674
Lots 1 & 2, Block 3, Unit 2 Edith M. Wilkes
(Data above tbu line for City co
Rerd only) 197 Delmonte Road Sebastian. FL 32958
ettiv of brbnotiatn
Mrutrtrr1,J• 1)ttb No. 1674
THIS INDENTURE MADE 71sk .UQUTURTH....... day of .. MARGH .... ............................... A. D,
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florhla, as Grantor and
.............EDITH.M:, WALKES................................................................... ...............................
............. 1,A7 DE4MOIVTF�. RoRR .,.. .ASTIAN., . FL.. 32951S .............................. I .............................
of the County of ..INDIAN „RIVER ........... awl state of ...F OWDA ............... ........................
................ ...
as Grantee, WITNESSETHr
That the Grantor for and in consideration of the sum of $ 300:00 . , , ...... , , , to it in hand paid, the receipt whereof is herewith w
knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ..HER ... bobs, >ogal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to -wit:
All of Lot(s) ..1 & ?. , Block... A.... , UNIT ... Z ........ , of Sebastian municipal cemetery as per Plat Number I thereof recorded in Put
Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being
in Indian River County, Florida.
To Have and to Hold 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 accordance 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 asid cemetery to ob-
serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the doled of conveyance thereof then the title of such owner
in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of the first 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 affixed, the day and year first above written.
CITY OF SEBASTIAN, FLORIDA
n
Att. ... �!� �"� By` . . ........... ......... r. ..........
City Clark !�
Signed, Sealed and Delivered
In the Presence •oft
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
.......... "`
I HEREBY CERTIFY, Tbat on this A�rx;rEFt�I:IH ......... say of ....E1ARGd ......................................... 39-86
before me personally appeared .. AH130RAH . Q . ..KROES ............................... and .L... GENE..HARRIS..................
respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known
to be the Individuals and officers described In and who executed the toregWag conveyance b
............EDITH. M... WILKES ...................................................................... ...............................
........ - .t........... and severally acknowledged the execution thereof to be their tree act and deed
as suol%_offtcsrs thereunto duly authorised; and that the Ottletal seal of said corporation is duly affixed tbesei% and the said eon•eyanee
is *6 -set -and deed of -so corporation.
VIT)W,88- my -s pasture and official seal at Sebastian. W the County of Indian River and State of FlorWa, floc day and yes
last aforesaid,
....................
ry State of Flo rda at
- - My commission expires Notary Public, tact of RWWI
(omajuion 6pires Auq. 22, 1984
aoudad rhm rroY Fda • la{WOR", lac.
Name � 'D ti� 1
LO I1KeS
Block A-0—
Lot t
Date of Mark -out
c q j,Date of Burial Time
Name of Funeral Home
Authorized by
h
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i
O O O O S
W NN
O O O
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Edith Mildred "Millie" Wilkes
Edith Mildred "Millie" Wilkes, 82, died July 22, 2009, at Royal Palm
Convalescent Center in Vero Beach. She was born in Medford, Mass.,
and lived in Sebastian for 24 years, coming from Tucson, Ariz. She
volunteered at Sebastian Elementary School with the reading program
and assisted with preparing packages for soldiers overseas. Survivors
include her sons, Edward Wilkes of Macedonia, Ohio, Robert Wilkes of
Burlington, Mass., and John Wilkes of Anchorage, Alaska; daughter,
Nancy Mossali of Sebastian; brother, Arthur Lacey of Portsmouth,
N.H.; sister, Violet Mae McDonough of Sebastian; five grandchildren;
and one great - grandchild. She was preceded in death by her husband,
Edward S. Wilkes; brothers, Donald and Robert Lacey; and sister,
Helen Wormwood. Memorial contributions may be made to a charity of
one's choice. SERVICES: Visitation will be at 6 to 8 p.m. July 24 at the
Strunk Funeral Home in Sebastian. A service will be at 11 a.m. July 25
at the funeral home. Burial will be at Sebastian Cemetery.
Permission is hereby granted to dispose of this body. Permit No. 1228 -09 -0337
❑ A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
[:]No extension of time for filing the death certificate has been requested.
"egiT+ Date Date Certificate
Subregistrar Signature Issued: 7/22/09 Dye: 7/27/09
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA
I
Approval Number: Date
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:
BURIAL
CREMATION
Signature of Sexton
or Person -in- Charge
FISTORAGE
DOTHER (Specify)
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
Date of Disposition /� —/'5 2
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.
DH 326, 8/97 (Obsoletes all previous editions) Distribution: white: Cemetery or Crematory
Yetlow: Funeral Director or Direct Disposer
(Stock Number: 5740 -000 -0326 -2) Pink: Local Registrar R-1d ` �'v
DEPARTMENT OF
ALT
f
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
A.
(TYPE)
1.
Name of First Middle Last
Date Month Day Year
Deceased
of
Edith Mildred Wilkes
Death July 22 2009
2.
Place of Death
City, Town or Location
Name of (If neither, give street address)
County
Hosp. or
Indian River
Vero Beach
Inst. Royal Palm Convalescent Center
3.
Name of Medical
Address
Phone Number
Certifier Eileen Fermin, M.
1515 U.S. #1, #204
Medical Examiner I Physician
Sebastian FL
772589 -0300
4.
Name of Funeral Home /@Oeet•Bispvsal
Address
Fla. Lic. No. /Reg. No.
Phone No. (Area Code)
Establishment
1623 N. Central Ave.
1
Arunk Funeral Home &
Crematory
Sebastian, FL
1228
772- 589 -1000
5.
Check a.
The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate
application.
Box
b.
Judy was contacted on 7/22/09
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Fermin will complete and sign the medical
certification of cause of death within 72 hours.
c. F-1
was contacted on He /she verified that
Medical Examiner, will complete and sign the
medicpMertific gtiqy cause of death within 72 hours.
6.
Funeral Director/
F.E. No. /Reg. No. Date Signed
Di�tBispeael�
zilit
44048 7/22/09
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228 -09 -0337
❑ A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
[:]No extension of time for filing the death certificate has been requested.
"egiT+ Date Date Certificate
Subregistrar Signature Issued: 7/22/09 Dye: 7/27/09
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA
I
Approval Number: Date
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:
BURIAL
CREMATION
Signature of Sexton
or Person -in- Charge
FISTORAGE
DOTHER (Specify)
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
Date of Disposition /� —/'5 2
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.
DH 326, 8/97 (Obsoletes all previous editions) Distribution: white: Cemetery or Crematory
Yetlow: Funeral Director or Direct Disposer
(Stock Number: 5740 -000 -0326 -2) Pink: Local Registrar R-1d ` �'v
Sep 26 2008 2.45PM HP LRSERJET 3200
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENI G IN SEBASTIAN MUNICIPAL CEMETERY
SEBA"TIAH lumb
For inforrnatior contact:
Ki Kelso - Cemetey Sexton
So�astian Municipal Cernefery
(772) 589 -2545
City Clerk's 0t6ce
iry Hal;, 1225 Main Street
i Sebastian, FL 32958
01llc� (772) 388.8215 or 388.6214
Fax: (772) 589.5570
FUNERAL HOME:
ADDRESS:
PHONE #:
(Check One)
OPEN BURIAL LOT
OPEN CREMAINS LOT
._OPEN COLUMBARIUM NICHE
BURIAL DATE AND SERVICE -TIME:
FOR DECEASED: Edith M. Wil
.1423 No. Central
_Block 3 : Unit 2
._.._Siock Unit —'
he Block -- -Unit
12sln4 » e u�i � ~
I VPI.IV
NAME AND.SIGNATURE OF LOT OW ER OR REPRESENTATIVE:
(PAuil provide proper documentation of c wnership)
►vame Sign lure Date �
I certify that I have detennined the owne ship of the above described site that all site fees and
administrative fees have been paid and uthorize opening of sf
NAME AND SIGNATJF�KOF LICENSE FUNERAebIR6(`.Yc�a
NameSig Ore Date............ .............................................. _------ ----- -------------------- •......................
Cemeery Sexton Certification
1 certify (hall have -.hacked the owners ip information by viewing the owner's deed and confirming
with Clerk's office and that 811 fees have been paid
/. 4; 1) a. /�yz, Ce tery a on to
This form1 to be provided to Clerk's Off.c 1 by Sexton for permanert record upon compietton.
.1.
p.I
at
BLOCK 3, Lots 1 & 2 WILKES, EDWARD & EDITH
UNIT 2 197 DELMONTE ROAD
DEED #1074 SEBASTIAN, FL 32958
RECEIPT #q3 2-
Lots 1 & 2, Block 3, Unit 2
Edward interred 3/18/86 - Lot 2
Block 3 ots 1 and 2 unit
Roe3nek3, Actor and Ina
49 Alieey'brivs, Whispering Palms
Sebastian k
Deed # 330
3
0
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED of THE SUM op:
41
arm 0 !=�O' QQ .)
Fi- 329ST
on this day of , 29 for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot(s)#flW ti 4VO Block# attex- unity A00
0
Purchase Price, -o Dollars
Terms and'conditions of sale:
#0 $
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,
cu a
City of/seb4stiaji
tees
Fri
THU of #Ph "tt' _
� � N° 330
THIS INDENTURE MADE This ..... 2 3rd ...... , , , , day of ................. March, , , , , , , , , , , , , , , , , , , , A. D., 19.7$..,
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
........ V�.gtQr..and..Tn-A .RQs R-5 k ................... ...............................
49 A1isa Drive
.............. ............................... ......Whispering -Palms .............. ............. ...............................
Sebastian, Florida
of the County of ............I11d1a11 R1VGT ........ and State of .............. ... �47„ _ ...............................
as Grantee, WITNESSETH:
- That the' Grantor for and in consideration of the sum of $.... *350_000 ........ ::....... to it in hand paid, the receipt whereof
is herewith acknowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee. thlel r . heirs, legal
representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit:
2
BIOCk..3... of Lots... l . & . 2........ in � ern t ............. of Sebastian municipal cemetery as per Plat Number 1 there-
of recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie
County of Florida.
To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of
the dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions
of the City of Sebastian, Florida, heretofore, now and hereafter adopted or provided for the government and operation of said ceme-
tery. The conditions, restrictions and requirements contained in this instrument shall be covenants runrdng with the land. In the event of
the failure of the owner of any property situated within said cemetery to observe and comply with such rules, regulations, resolutions
and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate
and the same shall revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF r hp sid�arty of the first part has caused this instrument to be executed in its name and on its be-
half by its Mayor and attested b r s„ erk and its corporate seal to be hereto affixed, the day and year first above written.
..�Attest: .. .................
Assistant CR Clerk
Signed, Sealed and Delivered
in the Presence of:
IZGrreli ........................
- ............. .............
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
CITY OF SEBASTIAN, FLORIDA
By...... 'f7 ...............
Mayor
I HEREBY CERTIFY, That on this ....... 23rd day of ..............!... March . . . . .... . ....... . .......... . ., 19 78.,
before me personally d,, Pat Flood Jr. Elsie M. Cam bell
`t'f ............. ............................ and ........ ................F?.............
respectively. Mayor an w i y erk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known
to be the individuals and officers described in and who executed the foregoing conveyance to
Victor and Ina Rosinski
........................................................................................................ ...............................
............ and severally acknowledged the execution thereof to be their free act and deed
as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance
is the act and deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year
last aforesaid.
............
N ary Public, State of Florida at Large.
My commission expires:
Notary Public, State of Florida at Large
My Commission Expires April 18, 1980
Bonded by Aetna Insurance Company-
TO:
FROM:
MA 29, 1984
FINANCE DEPARTMENT
CITY CLERK'S OFFICE
•
Please refund Victor and Ina Rosinski $350.00
for cemetery lots 1 & 2, Block 3, Unit #2,
Sebastian Cemetery, since they are moving out
of the area and have requested that the city
buy these lots back.
Attached please find copy of Deed # 330, dated
March 23, 1977, and copy of receipt #309 in the
amount of $350.00.
Please make check payable to Victor and Ina
Rosinski, and mail to 1209 Apple Grove Road
Melbourne, Florida 32901
Thanks.....
•
�iy•+Y P n ,'�
City of Sebastian
Jim Gallagher POST OFFICE BOX 127 ❑ SEBASTIAN, FLORIDA 32958 Deborah C. Kr*W
Mayor TELEPHONE (305) 589 -5330 City Clerk
March 29, 1984
The City of Sebastian, Florida is in receipt of
Sebastain Cemetery Deed No. 330, issued to:
Victor and Ina Rosinski
49 Alisa Drive
Whispering Palms
Sebastian, Florida 32958
Lots 1 & 2, Block 3, Unit #2, Sebastian Municipal
Cemetery, purchased on March 23, 1978 in the total
amount of $350.00.
The City of Sebastian will refund the amount of $350.00
on or about 10 days from this date.
� C
Deborah C. Krages
- City Clerk
I
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44
04/13/2010 10:08 7725892583 STRUNK FUNERAL HOME PAGE 02
0210112010 (FAX) P.0011001
Order Acknowledgement
ranite
Acknowiedgcrrent NO 71387
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UP a mac Sales Order Date: 01!2900
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Pape: 1
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To' SEBASTIAN C -;AP -H
DAVID HINCEMAN
1623 VORTH C =N TRAL AVE.
EEBAS" IAN. FL 32956
Phone' 77:?- 589.1000
`ax . ?2.5&4 -23e3
Sho Via PJO., —RUCK
Ea rrtitiod Ship Dale
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F're1.;',t PREPAY
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To STRUNK F!'NERAL HOME
JUANITA
916 17TH ST,
VERO BEACH, FL 32960
Phone 772- 466 -1955
Fax.
C,jstomer ID 4199
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