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' 'TON, `RITA V.
cJo Gary F. Gill
606 E. Oleander Circle
Barefoot Bay, Florida 32958
RECEIPT #426
DEED #1066
LOT 21, BLOCK 41, UNIT 1 ADDITMON
INTERRED 12110185
30 r, v 13Lrxfod #,,v -T) .04
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Date of Mark -out
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Date of Burial
Name of. FUneral Home
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Authorized by
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Paid by CEMETERY Receipt No... , 4 2 6 ........ Dated. , 12 /A 18 5 .................. NO.
List Price $ .. 150...00 ........ Maximum No. Emial Spaces .....1 ......... .
Net Paid $ .. 150 00........ Monument permitted ... Flat .............. 1 �l iJ b
Gary F. Burton
Lot 21, Block 41, Unit 1 Addition
c/o John F. Gill
(Dat, above this line for City Record only) 606 E. Oleander Circle
Barefoot Bau_ Fl. 32958
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Jim Gallagher POST OFFICE BOX 127 ❑ SEBASTIAN, FLORIDA 32958 -0127
Mayor TELEPHONE (305) 589 -5330
December 9, 1985
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Strunk Funeral Home
734 North Central Avenue
Sebastian, Florida 32958
RE: Rita V. Burton
Lot 21, Block 41, Unit 1 Addition
Sebastian Cemetery
Gentlemen:
In accordance with Section 8 -24 of the Code of Ordinances of
the City of Sebastian, I herewith submitt for request your
payment of Fifteen ($15.00) Dollars, for the location and
services of our Cemetery Sexton, Kip Kelso, on Saturday,
December 7, 1985, pursuant to your request of the same date.
Please make your check payable to the City of Sebastian and
forward to us within ten (10) days.
Deborah C. Kraps
City Clerk
Thanking you in advance for your prompt attention to this
matter. Should you have any questions please do not hesitate
to contact me.
Very truly yours,
M C.
Deborah C. Krages
City Clerk
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CC: Cemetery File
Public Works
Finance Director
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THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
AL
1GG
FROM:
J �6�
N"
) 0�6
Dollars ($ 1 SCG • UCH I
on this ay of \h E C ' _, 29 for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lot (s) # 0.2 ) Block# L) ) Unit# L/ . I A ) �.
�� J —�
Purchase Prjce�j,E��\u lQ `C . ti [ ��. � a a Dollars (S / S(3 �,(6i
Terms and'conditions 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.
City oT A-bakstian
Witness
E
STATE OF FLORIDA EALTH DEPARTMENT OF HV TAL STAT STICSIT�VE SERVICES Z_ ;V / , q
APPLICATION FOR BURIAL — TRANSIT PERMIT / l�
A. (Type or Print)
1. Name of
First
Middle
Last DATE Month Day Year
Deceased
RITA VERNA
BURTON DEATH DEC. 6 1985
2. Place of Death
City, Town or Location
Name of (If neither, give street address)
County
Hosp. or
INDIAN
RIVER
VERO BEACH
Inst. INDIAN RIVER MEMORIAL HOSPITAL
3. Name of Medical
® Physician
Address
Certifier N. Keith Kirby, M.D. ❑Medical Examiner
777 37th Street, Vero Beach, Florida 3296(
4. Funeral Home/
Name
Address
Xl)*KdQ)QXiY~
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
Box
b ®
Cornotanv Car-12
was contacted on12/1Of85. He /she verified that
this death was from natural causes, that there was no accident nor other external cause of death, and that
Doctor Kirby
will complete and sign the medical certification of
cause of death.
c ❑
was contacted on.. He /she verified that
, Medical Examiner, will complete and sign the
medical certification.
6. Funeral Director/ Fla. Lic. No. /Reg. No. Date Signed
N1FXi�td� d__
&.0 December 10, 1985
B.
BURIAL — TRANSIT PERMIT
Permit No
1228 -85 -399
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. 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 occurred.
Registrar or Date December 10, 1985
~
Sub- Registrar Signature M L7' * 148 Issued
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. Awaiting period of 48 hours after death
is required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian CEmetery
® BURIAL ❑ STORAGE Date of Disposition 19.11 OiA5
❑ CREMATION ❑ OTHER ( e if�yJ►
Signature of f�eten )
or Person -in- Charge ►
DEBORAH C. KRAGES, CITY Ct9K
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, APR. 81
(replaces previous editions which may be used.)