HomeMy WebLinkAbout2-16-09Deed # 314
Cemetery �& 86 2/Z4��� & 2/23/�_: James T. Pattison
Paid by �eneral Receipt No. . . . . . . . . Date�. . . . . . . . .
. % P� O. Box 7Z
List Price �. ?00.00..... �aximum No. Burial spaces ...?..... ROSe13nd, FZa.
Discount $...... ...... Total area in eqnare feet ......... .... Lots 9 6 10, Blk Zt
Net Paid $..200.00....... Moaument permitted . Flat......... Unit 2. '
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COZBY, ANNIE (See PATTESON JAMES T.
� � Deed 314
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Interred Lot 9, Blk. 16, Un, 2 `��! ���
- 2/3/86
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NEwCEM
City af Sebastian, FL — Cemetery Lots
COZBY First Name ANNIE
State
314 Date
2— Black # 16
9 Interred COZBY, pNNIE
Interred
Interred
Interred
SEE JAMES T. PATTESON
Amount
CF>wrd <B?ack <E>dit CD�elete {M>ext CF3reU CR
Tuesday, Feb 01, 2005 12:32 PM
Zip
Dte Interred 02-03-86
Dte Interred
Dte Interred
Dte Interred
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Unit�
Block__..J �3
Lot —_ �
Date of Mark-out .� � � � �S �7
p
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Date of Burial "� _� �,�? ^ � �^'° Time � �� � �� r-� ,�";i �r`i ,
Name of Funeral Home =� .� �^�::' �-_ ,�t i� `"� .u` �`�� �-' �"? ; F i"� , ,� �^ ���
__ _ _ __ .. _ . .._.._ _.. d _._
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Authorized by � � t����,3e,'2..t � �
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A. (Type or Print)
Name of First
Deceased
STATE OF FLORIDA
ARTMENT OF HEALTH & REHABILITAT�ERVICES
VITAL 5TATISTICS
APPLICATION FOR BURIAL—TRANSIT PERNiIT
Middle
last
� �%�
� %�i
� �
DATE Month Day Year
OF
ANNIE LAURIE COZBY DEATH FEB. 1 1986
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
INDIAN RIVER VERO BEACH Inst. INDTAN RIVER MEM
3. Name of Medical Physician Address
Certifier ROBERT MOORE, M.D. ❑ Medical Examiner 2045 15TH AVENUE, VERO BEACH. FLORIDA
4. Funeral Home/ Name Address
�irect Disposer STRUNK FUNERAL HOME 916-17TH STREET VERO BEACH FLORIDA 32960
5. Check a[� The medical certification has been completed and signed. A completed certificate of death accompanies
Appro• this application.
priate b� Secretary Marge 2/3/86
Box was contacted on . He/she verified that
this death was from natural causes, that there was no accident nor other external cause of death, and that
DOCtOr MOOrB will complete and sign the medical certification of
cause of death.
�� was contacted on . He/she verified that
, Medical Examiner, will complete and sign the
6. Funeral Director/
Direct Disposer
B.
C
�
medical certification.
Signa
Fla. Lic. No./Reg. No.
r.�•` �C� � Z
BURIAL—TRANSIT PERMIT
Date Signed
2-1-86
Permit No. 130-86-33
Permission is hereby granted to dispose of this hody.
�A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and
granted. If it cannot be filed within this time limit, a"Funeral Director/Direct Disposer Report" witl be filed
with the Local Registrar of the County in which death occurred.
Registrar or
Sub•Registrar Signatu
Signature
or
Medical Examiner,
Date
Issued 2-1-86
AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA
Medical Examiner Date
, gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained befo�e disposal by any of the above methods. A waiting period of 48 hours after death
is required for all cr�matiaris.
Method of Disposition:
� BURIAL ❑ STORAGE
� CREMATION � OTHER (Speci
Signature of Sexton ►
or Person-in-Charge 1
CEMETERY OR CREMATORY
�
Place of Disposition Sebastian Cemetery
Date of Disposition February 3� 1986
This permit must be endorsed by the Sexton or pers ir �rge (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.
HRS Form 326, APR. 81
(replaces previous editions which may be used.)
Apt�1 2�, 19�8
Mrar. Jame;s T. P�ttterso�'t
286 27t1t Av�ue
t�era Ha+ach, F2orida 3,2960
DeB,t Mr�'. PBtte�oitt
Thf�r wi11 a�ow3ec3ge receipt af your iett�ar of Apr3I 8,
�t978 c�onc�erning your req�est to i�a1d ttan .Iats fos yri�
whfch adjo.in Lc>ts 9 aizd 10, B2ock .26, ifiit 2, S�b�stian
Cernetery.
Unfortunately, aI1 .Iots 3n BZcack 26 .hav� been so1d. When
we rece:ived no respcx�se to our I�tter af �Tovember 22, 1977,
are were ob3igated to se.IS th� 3ot,��i �s requests were
recei ved.
For your �nfor�tia�a, a11 1at� in B2ack 17 have been sold
but there are �oaie Ia�s avai2ab.�e 3n BZock 15, Black 15
is Zocated arest of HZocic l6. If yon are int�rested �Yn
purchasr.fng some Zots in Block 15, i s�g�gest you cantact
this office as soon as passible. As stated pr�v.tousl�, we
are rmable to ho2d Iots open for an .fndef�nite per.tod.
Kind regards.
Sincerelr�.
F3o.rertce �. Phelan
�i t� CI erk
Ft.��ee�
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