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N° 356
THTS INDENTURE MADE This 18th day of May A. D., 19 79 ,
be the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
Marguerite J. Hughes
342 Manly Ave
of the County of Indian Ri ver and State of ....2q.4ri da
as Grantee, WITNESSETH:
That the Grantor for and in consideration of the sum of $ .. *.2.00..00* to it in hand paid, the receipt whereof
is herewith acknowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee heirs, legal
representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit:
BLK 15 of LotS . 5 .. & . 6 in Section .Unit . #.2.. of Sebastian municipal cemetery as per Plat Number 1 there-
of 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.
To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of
the 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, heretofore, now and hereafter adopted or provided for the government and operation of said ceme-
tery. 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 observe 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,gJhetsaid party of the first part has caused this instrument to be executed in its name and on its be-
half by its Mayor and attested by -its City Clerk and its corporate seal to be hereto affixed, the day and year first above written.
Attest:
Signed, Sealed and Delivered
in the sence of:
Lt-til eZL-
STATE / OF FLORIDA
CITY OF SEBASTIAN, FLORIDA
By
City Clerk ' Mayor
COUNTY OF INDIAN RIVER
(City $ a1)
I HEREBY CERTIFY, That on this 18th day of May , 1979 .
before me personally :..e red Pat Flood, Jr. and . F2.L 1 beth . Reid
respectively Mayor a y Clerk of the City of Sebastian, a municipal corporation 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
Mrs. Marguerite J. Hughes
and severally acknowledged the execution thereof to be their free act and deed
as such officers thereunto duly authorized; 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 and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year
last aforesaid.
Notary Public, State of Florida at Large.
My commission expires:
Paid by General Receipt No. 13 Dated May. 2979
List Price * *200.00 **
$ Maximum No. Burial spaces 2
Discount $ Total area in square feet
Monument permitted
Net Paid $ **200.00**
Fiat
(Data above this line for City Record only)
DEED #356
Marguerite J. Hughes
342 Man1y Ave
$eb Hit
BLK 15, Lots 5 & 6 Unit 2
MIMES, MARGUERITE J.
342 Manly Avenue
Sebastian, Fl 32958
BLOCK 15 Its 5 & 6 Unit #2
(Transferred ownership of Lot No. 5 to
Lawrence A. McDonald 7/29/86)
DEED #356
Name
Unit
Block t
Lot
Date of Mark -out
Date of Burial
Name of..EunerallHom
•
Authorlted bL
A.
FLORIDA DEPARTMENT OF
HEALT
(TYPE)
St f Florida, Department of Health, Vital S tics
LICATION FOR BURIAL- TRANSIT PE T
4 3,,
/3/3
1. Name of First - - Middle Last
Deceased
Marguerite Julia Hughes
Date Month Day Year
of
Death Feb. 13 2000
2. Place of Death City, Town or Location
County
Indian River Vero Beach
Name of (If neither, give street address)
Hosp. or
Inst. Integrated Health Services of Vero Beach
3. Name of Medical
Certifier Muhammad Farooq, M.D.
nMedical Examiner MPhysician
Address
777 37th Street
Vero Beach, FI
Phone Number
561- 567 -2277
4. Name of Funeral Home /Direst- Diepesal
Establishment
Strunk Funeral Home '
Address
1623 N. Central Avenue
Sebastian;' FI
Fla. Lic. No. /Reg. No.
1228
Phone No. (Area Code)
561- 589 -1000
5. Check
Appropriate
Box
a.
b.
6. Funeral Director/
DiaeetDispeae•
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
B row i n was contacted on 2/14/00
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Farooq will complete and sign the medical
certification of cause of death within 72 hours.
was contacted on He /she verified that
, Medical Examiner, will complete and sign the
medi :Its. rtifica ' . n o - use of death within 72 hours.
ig r • ur / F.E. No. /Reg. No.
/ 1862
Date Signed
2/14/00
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228 -00 -0084
DA five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
EINo extension of time for filing the death certificate has been requested.
•
J di
Subregistrar Signature
Date Certifica
Due: Z rs t' ro
c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL - AT-SEA
Approval Number: Date
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
Method of Disposition: Place of Disposition Sebastian Cemetery
BURIAL DSTORAGE Date of Disposition
fCREMATION OTHER (Specify)
Signature of Sexton
or Person -in- Charge
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 County Health Department in the county where disposition occurred.
DH 326, 8/97 (Obsoletes all previous editions)
(Stock Number 5740 - 000 -0326 -2)
Distribution: white: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink Local Registrar