HomeMy WebLinkAbout2-45-12(r
W
W
x
W
W
W
H
O
�
1
I
A
+.
F
�
i
r °�f
1
`
THE SEBASTIAN CEMETERY
City of Sebastian'
Sebastian Florida
RECEIPT IS BEREBY ACKNOWLEDGED OF THE SUM OF:
/ collars ($45o• �)
on this �� day oA-Ac-e— , 198,2,,for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein;
Description of Property:
Cemetery Lot (s) # Block# unit#
Purchase Price ao_t_ collars ($ rto )
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 intrument:
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
City of astian /`T�7/
ERLEMANN, GERHARD -A. DEED # 495
850 Gilbert Street
Sebastian, Florida 32958
UNIT 2 ADDN. BLOCK 45 LOT 11 & 12
Maria interred in Lot 11
%/
o�
DEED # 495
Dated................. 850 Gilbert Street •
CEMETERY 006 & 306 Ma 24, 1982 ERLEMANN, GERHARD A
Paid by �rg�ljtjll Receipt No. ....... I
Sebastian, Florida 32958
List Price $... p Q ..Q.Q..... Maximum No.; Burial spaces ...2.. .
Discount $ ...... - .Q......... Total area in square feet *.............. UNIT 2 ADDN, BLK. 45,Lot11 &l;
Net Paid $.. 30.0.. D19 ..... Monument permitted ... FLAT ........... MARIA ERLEMANN INTERRED IN l.i
(Data above this line for City Record only)
2 & R ISSUED WITH DEED
i
QState of Florida, Departrri of Health and Rehabilitative Services, Vittistics
APPLICATION FOR BURIAL — TRANSIT PERMIT
A. (Type or Print)
1. Name of First Middle Last DATE Month Day Year
Deceased OF
Gerh,ard Andreas ERLEMANN DEATH Oct. 18, 1991
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Vero Beach Inst. Vero Beach Care Center
3. Name of Medical Medical Examiner Address Phone Number
Certifier
M. Faroaq, M.D. 7X Physician 777 37th Street Suite A 104 Vero Be ch Florida
4. Name of Funeral Home / Address I Fla. Lic. No. /Reg. No. Phone Number (Area Code)
Direct Disposer 1010 E.Palmetto Ave.
Brawnl.ie & Maxwell Funeral Hare Melbourne, Florida 32901 0000049 407 771-91eq
5. Check
Appro-
priate
Box
a ❑
The medical certification has been completed and signed. A completed certificate c
this application.
accompanies
b KI Dr. Faroog's offi cp was contacted on10 /21/91 within 72
hours after death. He /she verified that this death was from natural causes, that there was no accident
nor other external cause of death, and that he will complete
and sign the medical certification of cause of death.
c ❑
medical
was contacted on . He /She verified that
, Medical Examiner, will complete and sign the
6. Place of Sebastian Cem. Sebas a cemet VY R emoval
Final Disposition: atory - cou ty: from state Donation
7. Funeral Director/ F.E. No. /Reg. No. Date Signed
Direct Disposer //� 890 Oet.ber 21,1991
B.
BURIAL — TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 49X36
91 A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship
would result from filing within the normal i e limit If t certificate cannot be filed within this extended time limit, a "Funeral Director /Direct
Disposer Report" will be filed with ti al R ' tral of the ounty in which death occurred.
❑ No extension of time for filing th t rti a que
Registrar or Date 1991 Date Certificate
Oct. .
Subregistrar Signature Issued: Due:
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
Methods of Disposition:
El BURIAL
❑ CREMATION
Signature of Sexton )
or Person -in- Charge )
❑ STORAGE
❑ OTHER (Specify)
Place of Disposition
Sebastian Cem. Seb astian, Fla.
Date of Disposition le A e A9 /
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 HRS County Public Health Unit in the County where disposition occurred.
HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used)
(Stock Number: 5740 - 000 - 0326 -2)