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Home My WebLink About1-41-17w Al 61� Akl-_'U-� / Red Oft/ ir �EUutS � 3 Y 41 °b R,ii� Lj o 5 io lag �EUutS 41 °b R,ii� Lj o lag to LL) 3r 3z% 4 • (.9itg of Wrb astif r �rmittrrg a t r b NO. 1056 THIS INDENTURE XADB Thos ....31st............ day of ......... Jul. y .............................. A. D., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida. as Grantor and JohnH. & Bessie ..C:.. Shivers .................................................. ............................... ... ... .. . .. ....... 167 Concha Dr . rAgn,..FAQX!9';... 3. z9. 58 ......... ............................... ............................................ ofthe County of .....Indian River ...................... awl State of .. Florida............ ............................... as Grantee, W ITNR ITH & That the Grantor for and in consideration of the sum of $ .. , ,300:00 , .... , , , to it in hand paid, the receipt whereof is herewith so- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee ,their , heirs. legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lots) 17& 1A Block, ..j 4 . , , , . UNIT 1, . Ad d i t i on , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 6S of the public records in the office of the Clark of the Circuit Court of St. Lucie County of Florida; said had now lying and being in Indian River County, Florida. To Have and to Hold the sane 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 regulation&, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted of 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 deiad 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 WIIEREOF, The said party of the first part has cawed 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. Attes ..(f..!.: ...... City Clerk Signed, Sealed and Delivered In the Presenc&041 ............. .. q/n, ............ STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEB TIAN, F RIDA lay .. ...._..ok. ,�` .................... OWN AW) - r I HEREBY CERTIFY. That as this ....31st ..............day of ......... Ju1-4... ............................... , li. A5, before me personally appeared Jim Gallagher and „Deborah..... ..... . . ............................... ............ 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 and officers described In and who executed the foregoing eoaveyauoe to ........... John H. &. Bessie ...... Shivers .................................................... ............................... ....................._..... ............................... severally acknowledged the and rally ac a kdged t execution thereof to r free act and deed as such olfipers'awreumt,.o d81y authorlsedl and that the Official seal of said corporation Is duly affixed theretN and the acid conveyance is the act `i�4 dead of m* corporation. WLTN .� slaataro and altkW see! at Sebastian, In the County of Indian River and State of Florida, the day and year ast starema. - - bUe, A2. - Notary fate of Florida at Lan • • • • • .... .. My commission aNpbqsPAk, State of Rorida 1Ay Commission Expires Aug. 22, 1988 " aunded Tbry Troy Fain • in cone. Inc. THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUN OF. FROM: L/ S' . , irb Dllars Q4 Z A. 2(010-01) ) on this =jZ!V day of , 19 Frfor the purchase of the following described Cemetery LotW upod the terms and conditions as stated herein: Description of Property: Cemetery Lot (s) # / -) .L / F/ Block# Y l ,U�n'i.t# 1 1.l f!!�( Purchase PriceA��- �, «r/,,.. y y Dollars ($ 'Dye •,gra_) Termss and'conditions of sale: 6wa4 - 7 - -:v/ - PS 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: r 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. 'r ity of "SeUsitian 4 i on this =jZ!V day of , 19 Frfor the purchase of the following described Cemetery LotW upod the terms and conditions as stated herein: Description of Property: Cemetery Lot (s) # / -) .L / F/ Block# Y l ,U�n'i.t# 1 1.l f!!�( Purchase PriceA��- �, «r/,,.. y y Dollars ($ 'Dye •,gra_) Termss and'conditions of sale: 6wa4 - 7 - -:v/ - PS 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: r 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. 'r ity of "SeUsitian 4 STATE OF FLORIDA 1, 17 OPARTMENT OF. HEALTH & REHABILITA& SERVICES ;,, VITAL, STATISTICS APPLICATION FOR BURIAL — TRANSIT PERMIT A. (Type or Print)' 1. Name of First Middle Last DATE Month Day Year Deceased OF BETTY C. SHIVERS DEATH MARCH 5, 1988 Z. riace or ueatn City, Town or Location Name of (if neither, give street address) County Hosp. or INDIAN RIVER ROSELAND Inst. HUMANA HOSPITAL- SEBASTIAN J. Name of Medical ®(Physician Address Phone Number Certifier GEORGE A MITCHELL, M.D. Medical Examiner 13855 U.S. 1 SEBASTIAN, FLORIDA 589 -8992 4. Funeral Home/ Name Address Phone Number (Area Code) STRUNG FUNERAL HOME 1623 NORTH CENTRAL AVENUE SEBASTIAN, FLORIDA 305 -589 -1000 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate Box b SHELLY was contacted on 3/5/88 within 48 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 DR. MITCHELL will complete and sign the medical certification of cause of death. c ❑ was contacted on . He /she verified that medical certification. Medical Examiner, will complete and sign the 6. Funeral Director/ gnature lZises� Fla. Lic. No. /Req- {pie.• Date Signed er - - /l��Z �• % -Y'J' B. BURIAL— TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No 1228 -88 -126 ❑ 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" will be filed with the Local Registrar of the County in which death oc- curred. ❑ No extension of time for filing the d q certificate reques Registrar or Date 3/5/88 Date Certificate Sub - Registrar Signature Issued: 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. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition BURIAL ❑ STORAGE Date of Disposition- •�' ' �� ❑ CREMATION ❑ OTHER (Specify) Si R @F-e a of Sexton) J(� (I - �57_27 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. HRS Form 326, May 86 (Replaces Apr 81 edition which may be used) (Stock Number: 5740 -000- 0326 -2)