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Home My WebLink About1-37-32j V � �.. �.� f �' 4 J 'Of`� {' j � �., I � �, �Y' �, k �� h. � Name � �"' '� � . ; ,� Unit 4f '� ,� Block � " - Lot -�%�� Date of Mark-out �� ' �~ � j� ,,,5 '� .--r ..� :,:. r ; t a'}�'l Date of Burial ' � _ � .. �V� � Time � � '" Q��.-^��- .. � � � j,�.� � � � Name of Funerai Home '� �-y °'�'�' p ; Authorized by - `-� ' ` '' �-" I - __ _ _. -- - - _ -- - - -- . .- - _ __ . _._ _ L .. : ��.. _ • ; ry�a��-r�'� ,:` -� ,1 �, ,�;- 3 .�' . z �'r� �` �x�� % ' ' '" ,' ��' J e w,� - V �, � . �� . " � �:d vv. � a ^a �" ' ' � ' � � � ' � `� �, � ' ' ��-o�'�` � �� : �.. ,: � ;�Cb� � �,� �� . � ! � ,.e �y�. � - �y � +.. � �: � y � ;r, /L: � ar�:�� ' ��,• �/ + � � ":. � 1 � �f � ��% e�. ^� �� w �`,�;� y�: � �C u � �; � � �i� : '�r � . � � � �� 1�i�, � `� �� _ `�� '� _ " Y/� I1�. q , i�{�' �'�' . � . 1 . �V� . .'(�./ , I ` L� „ . 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Q ' f ; - , ' ��`' � . �� . � . � + ; �4 � , � .,� . , ::; � t�,,d � �� j � . �-..: i :- � - �� --�--_— _ . . _ ...: . . . . .. . « . , ,. , i CITY OF SEBASTIAN �� 'S OFFICE �- 2 41 1 RECEIPT Nam � ❑ Cash Date � �k� d No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDGCode of O�dinances 001501341930 Electlon �ualifying Fees 601010 343800 Cemetery Lots LotMk:h��, Biock � Unit !� 001501343805 Cemetery Fees �� a a /%��A � /r%C�iid 7 -`- Total Pai� ��d Initlals �� White - Dept ot Oripin • Y�Ilow - Finmw • Pink • Applivat STRUNK FUNERAL HOMES, P.A. 4048 CASH ADVANCE ACCOUNT-SEBASTIAN 916 77fH ST: VERO BEACH, FL 32980 e��e� PH. 561�62-2325 DATE � a• �a� I�3 a� PAY � � c� E� 0.J�.��.t O.�' $ � S- mO OFlDER OF �"""r�•— �p � i �k� � �� t � � - DOLLARS � = -� t r��MYn 011lw 9S�40N%�a� . • VqeM�dl.fl 329C0 �1IdU� �YK Nl�jOCv BYO�I �J� • c � Q� — M M -- - - -- FOR__._ -----.. --�----- __----- __.._._.. .. . _.--- - --�--- - ---___._.__ u■004048i�' �:0670 L 2057�: 0 2D6 L i�'0 L _ � FLORIDA DEPARTMENT OF / — J �'��,.c� .� HEALT StaAPPLICATION FOR BURIAL HTRANSIT PERMIT�cs �� A. (TYPE) � 1. Name of First Middle Last Date Month Day Year Deceased of Melba Phelps McLain Death Dec. 20 2003 2. Piace of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Brevard Micco _ inst. 9801 Honeysuckle Lane 3. Name of Medical Certifier Michele Maholtz,M D. Medicai Examiner Physician 4. Name of Funeral Home/DFree4-Bi�esal Address Establishment i. Check a. � Appropriate Box b. d c. � . Funeral Directod �� /` 3725 12th Court Vero Beach, FL Phone Number 772-567-0081 Fla. Lic. No./Reg. No. Phone No. (Area Code) 1623 N. Central Ave. I 1228 I 772-589-1000 Sehactian FI The medical certification has been completed and signed. A completed certificate of death accompanies this application. Jane wascontactedon 12/22/03 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that DI'. Maholtz will complete and sign the medical certification of cause ot death within 72 hours. was contacted on . Helshe verified that , Medical Examiner, will compiete and sign the medi I certifi tio f cause of death within 72 hours. F.E. NoJReg. No. 1862 Date Signed . - 12/20/03 � BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-03-0523 �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 cerGfication of cause-of-death section of the death certificate within 72 hours. � No extension of time for filing the death certificate has been requested. �� . Date Date Certificate SubregistrarSignature /'�,L, Issued: �2�20/03 Due: 12/25/03 AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT SEA Approval Number: Date Medical Examiner, , gave authorization by telephone to Funeral DirectodDirect 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 ail cremations. Method of Disposition: bBURIAL �CREMATION Signature of Sexton. � o Person-in-Charge � STORAGE � OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition % � i° � ,.�j � di..,� (� � s permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and retumed iin 10 days to the local Counry Heatth Department in the county where disposition occurred. 326, 8/97 (Obsoletes all previous edftions) Distribution: White: Cemetery or Crematory �k Number: 57�W-000-0326-2) .._ Yelbw: Funeral Diredor or Dfrect Di�oser Pink: Local Registrar �'z�-�' ��'� �-�- � L�`'�'� .�---- Name '�--� l,� �� 1�� t..� i. _ _ _ __ _ _- _ _ _ -_ _ ___ --;-_ . r� - 1 '+_- ! 1.��. } ��..., /'� ),, l �� \ �. � ' . s Unit � ` ' " ,----, � Block � Lot � � Date of Mark-out C� � -L �; �� E�:� .� � _�-� � �; 2 c:��(�: �, � C..� �;�� ,, �-:� <. � ��-� �c � Date of Burial Time � � � Name of Funeral Home `---�'', r`��, �` , � , �-1 ��C, �� ._(��k �,;��..., �t.,-� �L �. (,'�-��" �- Authorized by , ; I ' In Memory of James (Pat) M. Mc�ain r�� ,�''� '�; I rr I i i :{�i �'. r .;,e��s,a.: 5, �,.,`i June 22, 1940 - August 18, 2009 James (Pat) M.. McLain, 69 of Fellsmere, FL died August 18, 2009 at his home. Mr. McLain was born June 22, 1940 in Cocoa, FI and lived most of his lifetime in this area. He was a retired construction mason and was a member of Shiloh Youth Ranch Church and the Chevy Club and he loved 4-wheeling. Survivors included his son, Patrick McLain of Roseland,; daughter, Melanie Zugay of Fellsmere, FL,; brother, Irvin McLain of Richton, MS; a sister, Laverne Conley of Micco, FI. 3 grandchildren and special friend Glenda Patterson of Vero Lake Estates. A Memorial service will be held at 11:OOAM on Saturday, August 22 2009 at Seawinds Funeral Home Chapel Sebastian, FI with Rev Jimmy Hinkle officiating. �� Sebastian, Florida � 735 Fleming Street • Sebastian, Florida 32958 www seawindsfh.com (772) 589-1933 We hereby certlfy that these are the remains of JAMES M. MCLAIN from SEAWINDS FUNERAL HOME Cremation Permit No. 09-2617-192 Date of Death AUGUST 18, 2009 The remalns were received luued at INDIAN RIVER Date of Cremation AUGUST 21, 2009 gy SAM COBURN Cremator � �� . � �� 0 �� d z � � � � • � , I N � � cSo � � � � ' � � � Z 7 � 0 � U r Q f� \ � �v �� d(�o� J O � � 1 � I� � o � ~ �� cn O` LC� � 2 W g � y0 ��v Or�� C � �� v �. :� a � O ' `. � � a � L Y A � �..i � � �, a, � � , 0 � � � � , � � m z c �1 � O .� S � � ✓� �/ ^ `� � 3 �� J �1 „ 1 J W� �� L � M c c � � J � � � � � � � � a O � I � � � � c g � o :� � � o � o LL � � � � � m � r � �' a � � � �q� t�PJ U'� U � W U � U 0 0 � g �i c�i arn rn � rNi c� �i � e� 0 g �i �i �i �i o z° `� $ 8 8 8 � $ � u°� g 0 O � C a g � ,: e 'o. � m W e _ a • � "s .` 0 e � 0 l � 8 s , � 3 � � . � � O � ,� �� n��r�� 1207 US Hwy 1* Sebastian, FL 32958 Phone:7?2-589-9311 Fax:772-589-9312 ATTN: Kip Phone: 772-589-2545 Cemetery Sexton Fax: 772-228-9927 City of Sebastian � /,�� For Sebastian Cemetery `� f -U''�- ��v`��'S� �m ��l ��lv� Size: `-� �C �'O � 0—� E� �y � Names & Dates: �L' ��n �i � . . �a�'��S ��-�" J�iC�� I�a)yo 8/�� Legal Description Sertion: $ /- � ' Block: 3 T. . ,� Lot: 3� �/�..o,�,.�r� _ , �u% ,N Space: Replat: Squa�e Ft.: '`-- Approved: Checked By: �! �. � Date: !/�>v�d�- I hereby certify that the original o the foregaing was faxed to the Sebastian Cemetery on � C��7 Everlasting Stoneworks By:lamie Hicks 6'd Zl£668SZLLl s�aoMeuolg 6ui�selaeA3 dlb�ZO 60 06 ^�N � , � Z•d C—, � r- �~ L1 � � r^ .7 � �` L. n ; -� `� �J � � � -=' `�' t�..: ,�„3 � ` -. r� — � � � J_ � � ,--. J � � , . r"" ., � �---� � � �i � — � � � �.� � ;� . :,� .; - � � ., . � ZL£668SZLL6 � �, 1 � , \� � � � � � z r a � � 0 � r � � � _ O 0 m � � --,� % _�. r-- � � ��:r. -� - �� J r= `� �r I � � � m � � � �� tl- �� l s�aoMeuo�g 6ui�se�aan� � � �: � 4 ^ dZb�ZO 60 OL ^�N