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Home My WebLink About2-18-15id b ! EMETERY Receipt No 75 Dates 4/23/93 800.00 List P.;° S NUAb.. Block 18 Monument permitted Lots 1• & 16 Unit Maximum No. Burial Spaces Net P I S (Data above this line for City Record only) NO. �r01 ftifg of 'rhoottan Trittrtprg. Emit. THIS INDENTURE MADE 'This 23rd day of April NO. "14t)i between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Beatrice Arand 342• • Gi•1son • •Avenue Sebastian, Florida 32958 93 A. D., 19 of the County of Indian River ant state of Florida u Grantee, WITNESSETH, That the Grantor for and in consideration of the sum of S to it I 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: AR of Lot(s)15&16, Block 18 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 Tying and being in Indian River County, Florida. 800.00 To Have and to Hold the same forever; provided that said 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 said 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 deed 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. 127 0/ee Signed, Sealed and Delivered In the Freaenee ofe City Clerk STATE. OF FLORIDA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on this before me personally appeared respectively Mayor and City Clerk of the City of to be the individual., and officers described In and 23rd CITY OF SEIIASTIAN, FLORIDA Francis J. Oberbeck day of %tice yor ' 1/f ni 0147/ 0 2 April (ON Seal) , 1093•, and Kathryn M. O'Halloran Sebastian, a municipal corporation under the laws of the State of Florida to me known who executed the foregoing conveyance to Beatrice Arand and severally acknowledged the execution thereof to be their tree act and deed as such officers thereunto duly authorised; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corporation. WITNESS my signature end official seal at Sebastian, In the my of In River and ate of Florida, the day and year last aforesaid. Note Public, State o My mission expires Lima M. Lohsl a at Large. Name R41 figemd Unit Block `1 Lot /is Date of. Mark -out Date of Burial Name of Funeral Home,, 3•'1'q , Authorized by--'- Time /0.'00 A -asir;ee cR-b? ;%on Avenue 5i 1Co kckt� Falph"vazdt",17riaZitillerred //.Z3/93 ikkol BLOCK 18 (Unit #2) HS State of Florida, Departme *Health and Rehabilitative Services, Vital APPLICATION FOR BURIAL — TRANSIT PERMIT A. (Type or Print) 1. Name of First Deceased Ralph Middle N. Last Arand DATE OF DEATH Month Day Year 04/19/1993 2. Place of Death County Brevard 3. Name of Medical Certifier Kyle Anderson, M.D. 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Homes, P.A. 5. a ❑ The medical certification this application. City, Town or Location Cocoa Beach Name of (If neither, give street address) Hosp. or Inst. Cape Canaveral Hospital J Medical Examiner Address 5270 Babcock Street Physician Palm Bay, Florida 32905 Phone Number (407)724 -9496 Address 1623 Sebastian, Check Appro- priate Box b CSC Lima c 0 Fla. Lic. No. /Reg. No. Phone Number (Area Code) North Central Avenue /0e, stian, F1 32958 (407) has been completed and signed. A completed certificate of death accompanies 1228 was contacted on �,4,L21,/1.9.9 1thin 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 Kyle Anderson. M.D. will complete and sign the medical certification of cause of death. medical certification. was contacted on He /she verified that Medical Examiner, will complete and sign the 6. Place of Sebastian Cemetery Final Disposition: 7. Funeral Director/ Arm In state cemetery/ atory - n Removal ounty: Indian River n from state (• Donation F.E. No./Reg-No? Date Signed 11..72 04/2111292_ 1993 B. BURIAL — TRANSIT PERMIT 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 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 t - death certificate request Registrar or . , / / ' ` Date °`'/— �� Date Certificate Subregistrar Signature - Issued: 7� Due. Permit No 1228 -93 -0188 7 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 5 i/-3 Tyr,/ ( Zi✓-) i / y ■ BURIAL ❑ STORAGE .c� �� 3 / Q 3 Date of Disposition ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person -in- Charge) 7" 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 Pubiic 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)