Loading...
HomeMy WebLinkAbout2-44-13� i yk 4 293 THE SEBASTIAN CEMETERY 3� City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: Dollars ($�Q® �• ) FROM: on this © day of 1981 for the purchase of the following described Cemetery Lot(s) upon the terms and conditions as stated herein: Description of Property: • Cemetery Lot(s) #I 1ock# Unit v4 Purchase Price: �_ D Dollars($ Terms and'conditions of sale: ����.� C� c.L �a�3 . �aoo. off• 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 10� -. - UZ stian�r� _0 V CEMETERY DEED # 479 Paid by Q'WXffiX Receipt No. .293 ....... .... Dated. .Januaxy..4., . 1982• ..... UNIT 2 ADDN, BLK. 44, LOT 13 & 14 Last Price $...;200.00 • • • • • • • • • • Maximum No. Burial aces 2. . sp • • • • • • •EUGENE &PATRICIA EWERT Discount $.... _q_ ..... • • . • Total area in square feet * * * * * ** *409 S. W. Pine Street ................ Net Paid $...$200.0.0..... Monument permitted ... Flat _ Sebastian, Florida 32958 R. & R Issued with deed (Data above this line for City Record only) J EWERT, EUGENE EWERT PATRICIA 409 S. W. Pine Street Sebastian, Florida 32958 UNIT 2 ADDN. I )k DEED # 479 BLOCK 44 LOTS 13 & 14 George Ewert Interred 6118183 In Lot #13 Marie Ewert 5/2$/88 " #14 STATE OF FLORIDA DEPARTMENT OF HEALTH & REHABILIIWE SERVICES a� VITAL STATISTICS APPLICATION FOR BURIAL— TRANSIT PERMIT A (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF George L. Ewert DEATH June 17, 1983 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland Inst. Sebastian River Medical Center 3. Name of Medical ysician Addr ss Certifier Kip Kelso, M.D. ❑ Medical Examiner Sunset Blvd. Sebbastian Florida 32958 4. Funeral Home/ Name Address 3DiwzcRkx=wPottinger & Son Funeral Home 1200 S. Indian River Drive Sebastian Florida 32958 5. Check a 17�XThe medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. xb [3 Bo 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 6X Funeral it b-fr / er B. C cause of death. c ❑ will complete and sign the medical certification of was contacted on . He /she verified that ., Medical Examiner, will complete and sign the '1/0' 2368 June 17, 1983 Fla. Lic. No. /Reg. No. Date Signed BURIAL — TRANSIT PERMIT Permit No. 759 -493 Permission is hereby granted to dispose of this body. ❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted. It 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. Registrar or Sub - Registrar Signatu Signature or Date Issued AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA , Medical Examiner Date 7 /9or�� 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. Awaiting period of 48 hours after death is required for all cremations. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery FX—UU STORAGE June , ❑ Date of Disposition ❑ CREMATION ❑ OTHER (Specify) Signature Sexton 1 �� 7[ (' A� or Person-in-Charge ► This permit must be endorsed by the Sexton or person -in- charge (or by(Ae 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.) I