HomeMy WebLinkAbout2-41-04ABlock 41 Lots Y A, y r6 Unit 2
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Tity of behustian
trutettru Bert
NO.
1 i cj
25th November 97
THIS INDENTURE MADE Tkfs ...................... day of .............. ............................... A. D., 19......,
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
Madlyn Dallas
.............. ............................. .1 Dock AVelltle ' ................................... ...............................
' `3 ' "
Sebastian, FL 32958
...................................................................................................... ...............................
Indian River Florida
of the County of .............. ............................... and State of ........................ ...............................
as Grantee, WITNESSETHs
That the Grantor for and in consideration of the sum of S 500. :� ........... to It in hand paid, the receipt whereof is herewith ac-
knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee her , heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to -wit:
All si
of Lot(s) 4 , Block, .4 .... , UNIT . , , 2 , . , . , , , . , of Sebastian municipal cemetery as per Plat Number 1 thereof 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; said land now lying and being
in Indian River County, Florida.
To Have and to Hold the same forever; provided that saki 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 odd 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 said cemetery to ob-
serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the dead 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 Clerk
Signed, Scaled and Delivered
In the hence ofd
..... Z' 4 ......................
lY/%L/l4?i ...........
S ATE OF FLORIDA
COUNTY OF INDIAN RIVER
CITY OF SEBASTIAN, FLORIDA
By , V V.arm .. .1/.Y.. � �!" '. :.. : ............ .
Mayor
(0tv Seal)
I IIEItEIIY CERTIFY, That on this ...25th day of ...... November.. , 1957,
before me personally appeared Walter W. Barnes and Kathryn M, .0 .1HallOran
respectively Mayor and City Clerk of the City 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
................. ............................Mac 7n. Palm ........................................ ...............................
...................... ............................... and severally acknowledged the execution thereof to be their tree act and deed
as such officers thereunto duly authorisedt and that the Official seal of sold 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
last aforesaid.
k ES: June
11W01*11a Pab MNwMS
of Florida, the day and year
Nota Public, S of Florida at &t.
My ex tree r
Linda M. Galley
t
THE SEBASTIAN CEMETERY
CITY OF SEBASTIAN, FLORIDA
CPT IS EREBY ACRN, DGED OF THE SUM OF:
, lle - Dollars
FROM:
on thi day of 19 for the purchase of the
following described Cn6ein: t ry Lot(s) /Nick ( ) upon the terms and
conditions as state
Description of Property:
Cemetery Lot¢sD ' lock Unit
Purchase Price: Dollars
Terms and Condition 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 instrument:
The City of Sebastian agrees to
the above named purchaser(s) on
above instrument.
Witness
1 the above
0
ned property to
ons stated in the
Name
Unit
Block f
Lot ` !`
Date of Mark-out !lJ
/i ?
"7
of Burial,
Time
7'
Name of Funeral Home
t d41)
Authorized
i
J }
•
City of Sebastian
1225 MAIN STREET o SEBASTIAN, FLORIDA 32958
TELEPHONE (561) 589 -5330 o FAX (561) 589 -5570
December 1, 1997
Madlyn Dallas
185 Dock Avenue
Sebastian, FL 32958
Dear Mrs. Dallas:
Enclosed is Cemetery Deed No. 1610 for Lot 4 Block 41, Unit 2.
Also enclosed is a form - Return for Transfers of Interest in Real Property - which must be filled out by you
and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded If you
wish to have this deed recorded, you may do so at the office of the Clerk of the Circuit Court, P. 0. Box
1028, Vero Beach, Florida 32960.
We are enclosing two copies of Receipt No. 967 and ask that you sign and return to us the copy marked with
an "7C' and retain the other copy for your records. A stamped, self-addressed envelope is provided for your
convenience.
Sincerely
Kathryn M. O'Halloran, CMC /AAE
City Clerk
KOH:hng
Enclosures
FL,ORlDA D1�
��/
T ��
r�
OP
/^
State of Flo -da, Department of Health, Vital Statistics
APPLIC' FOR BURIAL — TRANSIT PERMIT
A. (Type or Print)
/v!'
1. Name of First
Deceased
Middle Last DATE Month Day Year
OF
Myrtle Smith DEATH Oct. 15 1997
2. Place of Death
City, Town or Location Name of (If neither, give street address)
County
Hosp. or
Indian River
Roseland 11t- Sebastian River Medical Center
3. Name of Medical
Certifier
Medical Examiner Address Phone Number
Mohammad Idrees,
M.D.
Physician 7762 Bay Street Sebastian, FI 561- 589 -0069
4. Name of Funeral Home /
Address
Fla. Lic. No. /Reg. No.
Phone Number (Area Code)
Direct Disposer
1623 N. Central Ave.
Strunk Funeral Home
Sebastian, Fl
1228
561- 589 -1000
5. Check a ❑
The medical certification has been completed and signed. A completed certificate of death accompanies
Appro-
this application.
priate
Box
b Pat was contacted on 10 / 15 19 7 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 Dr. Idrees will complete
and sign the medical certification of cause of death.
c ❑ was contacted on . He /she verified that
Medical Examiner, will complete and sign the
medical certification.
6. Place of Sebastian Cemetery In state cemetery/ Removal
Final Disposition: cre ory - name/ :Indian River from state Donation
7. Funeral Director/ 2�T. ure F.E. No. /Reg. No. Date Signed
�°r 62 10/15/97
B. I BURIAL — TRANSIT PERMIT
Permission is hereby 228 -97 -0428
y granted to dispose of this body. Permit No.
❑ 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 time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director /Direct
Disposer Report" will be filed with the Local Registrar of the County in which death occurred.
❑ No extension of time for filing the death certificate requested.
Reylstl 21 LB � Date Date CI ic t
Subregistrar Signature ^ _.__� 4 n Issued: S 9 9 Due: v
t C
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: Place of Disposition 50*s • — l °-- _ o
R BURIAL ❑ STORAGE Date of Disposition Qtjt�6,,_ t , l9 -21
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton )
or Person -in- Charge) •L.. 4.- ..r` • ac.,"4
This permit must be endorsed by the Secton 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. 10/96 (Replaces HRS Form 326 which may be used)
(Stock Number: 5740 - 000 - 0326 -2)