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THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
.1 RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF
/_ �-e
FROM:
Dollars ($L3OD.
3o_
on this day of 1982 for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot (s) # l3 V / 4 Block# 4�'_ Unit# c-2- A-0406-1v'
Purchase Price:Ok Dollars ($ Q D . )
Terms and conditions of sale:
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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.
City of Sebastian
Witness
UNIT 2 addn, Block 45 LOT 13 &14
J Son/ l.vT�/Zf'!�� 7//y
1�rn, C- aixtU2>:� oterced P-1 I Ab q5
CEMETERY DEED # 491
Paid by l MrVReceipt No. ..301 ........... Dated..4. -,2.7. n 8.2................ ERNA CURTISS AND /OR
JASON CURTISS
List Price $.. 3 Q 0...Qi1....: Maximum No. Burial spaces .2.......... P., 0. 8 0X 152
Discount $......p:, ......... Total area in square feet ._ __._ __ : ro s e l a n d, f l o r i d a 32957
Net Paid $.. 3 Q ., 0 0 ... Monument permitted . F.l a t ............. UNIT 2 a d d . , B LK . 4 5 ,LOT 13&14
R & R ISSUED WITH DEED (Data above this line for City Record only)
STATE OF FLORIDA A��
PARTMENT OF HEALTH & REHABILITAir SERVICES
VITAL STATISTICS � �
APPLICATION FOR BURIAL— TRANSIT PERMIT
A. (Type or Print)
1. Name of First Middle Last DATE Month 1 Day Year
Deceased OF
Jason Post Curtiss DEATH July 17 1986
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Roseland Inst. 12995 Bay Street
3. Name of Medical ysician Address
Certifier Farhat Khawaja ❑ Medical Examiner 7754 Bay Street Sebastian, Florida
4. Funeral Home/ Name Address
DiFeet -Big r Strunk Funeral Home 734 N. Central Avenue Sebastian Florida 32258
5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies
Appro• this application.
priate b Theresa 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
Dr. Khawa 1 a
will complete and sign the medical iaertification of
cause of death. "'"
c ❑ was contacted on . He /she verified that
Medical Examiner, will complete and sign the
medical certification.
6. Funeral D' tor/ ignature Fla. Lic. No. /Reg. No. Date Signed
13 ? 7 -18 -86
wo-
B. BURIAL— TRANSIT PERMIT Permit No. 1278 -86 -288
Permission is hereby granted to dispose of this body.
Co""A five day extension of time for filing the death certificate (exclusive of weekends) has been 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.
RogisuzFa.. Date 7 -18 -86
Sub Registrar Signature C!6:
:,&t Issued
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
Signature •:�- :.
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 hqurs after death
is required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition:
❑ BURIAL ❑ STORAGE
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton ►
or Person -in- Charge )
Place of Disposition
Date of Disposition
This permit must be endorsed by the SextW or person -in- charge (or by the Funeral Director /Direct Disposer when thege 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.)