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Home My WebLink About2-15-14/0 /3 /5 Paid by CEMETERY Receipt No List Price $ .... 7 50.00 Net Paid $ L Dated 8/6/93 Maximum No. Burial Spaces Monument permitted (Data above this line for City Record only) BiockS4111 Unit 2 NO. 1419 (City of Orbaotiatt Tentettrg 1PP11 NO. '1419 THIS INDENTURE MADE s 6th day of August A. D, Ie 3 Tld between Ibe City of Sebastian, • municipal corporation existing under the laws of the State of Florida, as Grantor and Charles E. Williams 12626' 91st Stre*et Fellsmere, FL 32948 of the County of I11d.ian..Riv.ez and State of Florida as Grantee, WITNES8ETH8 That the Grantor for and in consideration of the sum of $ 750.00 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 his heirs, kl representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) 14 , Blodr 15 , 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 said property shall be used solely and exclosively 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 exe ed 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 1 1. Dr 1 OGie - O._ Signed, Sealed and Delivered In the Presence of ) STATE OF FLORIDA City Clerk CITY OF SE By (011tg Aral) COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That on thin 6th day of .AL1gi19t , ia.93 before me personally appeared Lonnie R. Powell ,ndKathryn M. O'Halloran respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the individuals aril officers described In and who executed the foregoing conveyance to Charles E. Williams 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 1s duly affixed thereto, and the said conveyance is the net and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the Coun y of In n River and e of Florida, the day and year last aforesaid. UNOA Id. WOOL Nary Publbgist.dti ANI ,SalmasalanIi iUSJUN N.1Nd COWS COEMU ota Public, State My lesion expl r Linea M. Lohsl a at Large. Name #.1,f -vv Unit Pky ofe, Block Lot Date of Mark -out 8' c.1 Date of Burial 8/6/9 3 Time Name of Funeral Home Authorized by • EIPT IS REBY ACKNOWL / / FROM: (Mi k" / 26oz i(.4aWbLej on this -�1� -- day of following described Cemete stated herein: THE SEBASTIAN CEMETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA DGED OF THE SUM OF: die C -� • 77i Dollars (S v .02-' , 19 95 for the purchase of the Description of Property: Cemetery Lot(s) Purchase Fri Lot(s) upon the terms and conditions as Unit 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 sell the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. State of Florida, Department of Health and Rehabilitative Services, Vital Statistics APPLICAT4111 FOR BURIAL — TRANSIT PERMIT • A. (Type or Print) 1. Name of First Deceased Helen Middle Louise Last Pryor DATE Month Day Year OF DEATH 08/02/1993 2. Place of Death County Indian River Wabasso City, Town or Location Name of (If neither, give street address) Hosp. or Inst. 3. Name of Medical Certifier ME -Hobin 4. Name of Funeral Home/ Direct Disposer Strunk Funeral Homes, P.A. 5. Check a ❑ The Appro- this priate Box b ❑ Medical Examiner 7 Physician Address 4859 87th, St.rppt Address Phone Number Fla. Lic. No. /Reg. No. Phone Number (Area Code) 1623 North Central Avenue Sebastian, F1 32958 1228 (407)562 -2325 medical certification has been completed and signed. A completed certificate of death accompanies application. was contacted on within 72 hours after death. He /she verified that this nor other external cause of death, and that and sign the medical certification of cause of c ® Dee ME -Hobin death was from natural causes, that there was no accident will complete death. - - medical certification. 6. Place of Sebastian Cemetery Final Disposition: 7. Funeral Director/ Direct Dis• •ser In state cemetery/ Zigmatory - - me/ noture was contacted on .0.11,441.19gtfe /she verified that Medical Examiner, will complete and sign the unty: Removal Indian River n from state n Donation F.E. No. /@egg Date Signed 7 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 ,('�- death certificate re•ueste Registrar or Subregistrar Signature Permit No 1228 -93 -0364 Date Date Certificate Issued. z9:- g-913 Due 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. Methods of Disposition: ® BURIAL ❑ CREMATION Signature of Sexton ) or Person -in- Charge ) ❑ STORAGE ❑ OTHER (Specify) CEMETERY OR CREMATORY A!,740' . Place of Disposition Date of Disposition , 9 93 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 Public 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)