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Paid by General Receipt No. .131
List Price
Discount
Net Paid
200.00
$ 200.00
Dated... March . 2.8.E ..1979
Maximum No. Burial spaces 2
Total area in square feet
Monument permitted Flat
(Data above this line for City Record only)
DEED #351
Edwin & Mildred Kohl
843 Schumann Drive
Sebastian
Lots 3 & 4, Blk 15, Unit
• z88
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED F THE SUM OF:
V /0-0 Dollars ($ Aa !l Q )
' )(u» & do . , cAl_.
FROM:
4 oW c o. fG e. b / _ J/, 7_c.,,i1 AQa 5afro
on this /62... day of 1981 for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein:
Description of Property:
)1�jo,er C4 Lot tS,Z,# ' Block# /„� Unit # 022/
Purchase Price: Dollars($ �Q, o o )
Terms and'conditions of sale:
0110.°C P73E}I)1;i:t 1
ax �
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 S.fiastian
1 - *.
Artistry in
Memorials
Granite - Marble
Bronze
Merritt Monument Company, Inc.
4820 South U. S. Highway 1
Fort Pierce, Florida 33450
Phone: 464 -5547 or 464 -3755
Nov. 9, 1981
Approval For
Sebastian Cemetery
SIZE: 24" x 12" x 4"
NAME & DATES:
EDWIN KOHL
1900 - 1981
LEGAL DESCRIPTION
SECTION: Unit 2
BLOCK: 15
LOT: 3 & 4-
SPACE:
SQUARE FEET:
CHECKED BY:
BY:
Merritt Monument Co.,Inc.
4820 S JS 1
Ft.Pierce, Fla. 33450
Granite
APPROVED
DATE: ,//' `
' THEY HAVE NOT BEEN FORGOTTEN "
•
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABIL' -A \'E SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL - TRAIT PERMIT
NAME OF First Middle Last
DECEASED
(Type Or print) EDWIN KOHL
DATE Month Day Year
OF
DEATH OCTOBER 28, 1981
PLACE OF DEATH
COUNTY ORANGE
CITY, TOWN, OR LOCATION (' -' ME OF (If not in hospital, give street address)
WINTER PARK j �. sTPT TiooNAMERI CANA HEALTHCARE
Attending Physician (Name of Medical Certifier) (Address)
Medical Examiners ❑ Dr. Neil R. Newberg, MD., 601 E. Colonial Drive, Orlando, Florida
Funeral (Name)
Home Semoran Funeral Home,
(Address;)
622 W. Semoran Blvd., Altamonte Springs, F1. 32701
Check A ❑ A completed certificate of death accompanies this application.
One
B X( Dr. Newberg was contacted on October 29 1981 .
He has assured me that this death was from natural causes and that he will complete and sign the medical
certification of cause of death.
C ❑ The attending physician was unavailable or this death comes within the Medical Examiners jurisdiction.
The body was released to me by
,19
bi-71‘ re/
(Signature)
Funeral
Director
2
ERIK L ANDERSON
955
(FTs. Lic. No.)
October 29, 1981
(Date Signed)
BURIAL TRANSIT PERMIT
Permit
No 873 -2466
Permission is hereby granted to dispose of this body by burial, transportation out of state, storage or cremation. For cremation a
waiting period of 48 hours after death must be observed and the Medical Examiner's approval must also be obtained.
❑ A five day extension of time for filing the death certificate has been requested and granted.
Signature o
Registrar
7,C4ieddi
Method of Disposition
® BURIAL
❑ CREMATION
❑ STORAGE
❑ OTHER(Specify)
Signature of Sexton
or Person in Charge
This permit must be endorsed by the ,1xton or person in charge (or by t e funeral director when there is no sexton) and returned
Date
Issued
October 29, 1981
CEMETERY OR CREMATORY
Date of
Disposition
October 31, 1981
Place of Sebastian Cemetery
Disposition Sebastian, Indian River Co.., Fla
within 10 days to the local county health department.
HRS Form 326 (1/77)