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Home My WebLink About1-40-06`f ° w s � � ZG�u.� / �.,.�.�, /„ Paid by CEMETERY Receipt No. . . . . . . 5 2'.� . , Dated . . . . . . . .5 � ? 4 / 8 8 . . . . . . . . . List Price S . . . 2 � � : � �. . . . . . Maximum No. Burial Spaces . . . . . . . . . . . . . . . . . 400.00 NetPaid $ . . . . . . . . . . . . . . . . . . Monument permitted . . . . . . . . . . . . . . . . . . . . . . �` � N�cDede interred LO t 6� 5/ 2 5/ 88 �n8t8 .�o� m� u� ror c�cy x�ra odr) ,-, � °Jame � .� � u ,' � � . �� . �,,�.�a ... � � ,�" f��s Unit �� ,�� .�� %� Lot Date of Mark-ou �� ' ,...- � .:,, / � � Lo t s 5& 6 No. Blk. 40 Un. 1 Add. ��"�l� �Dorothy E. Lyons 853 Barber St. Sebastian, Fl. 32958 � r~' ,/ � ''�i' � :, � � ,1 i;�'1 . Date of Burial -' ' `�' � / � � Time � �f`� .�` Name of Funerai Home - `' '�F ''J � Authorized by ' .20 Paid by CEM T� Y Receipt No . . . . . . . . . . . . . . LiscPrice$ ,2 �•��,,,,, Net Paid $ . . . . . . � . � � . . . . . � ='� �u A R �e�- r�cDede interred Lot 6, 5/25/88 ..vated........5/24/8�3 Maximum No. Burial Spaces . . . . . . . . . . . . . . . . Monument permitted . . . . . . . . . . . . . . . . . . . . . . (Data Qbuve thle Une !or City Record only) Lots 5 & 6 Bllc , 40 Un. 1 Add, Dorothy E. 853 Barber Sebastian, NO. ti�� Lyons St. F1. 32958 �ir�� uf �Pbtt�xt�tri ��an�e��x�� .e.�� No. ��~�� THIS INDENTURE MADE Thl� ..........2.4.Cr1..... duy or .......Ma.y ................................. �. D., 18��...� hCt\1'NC[I tl,e City uf Sebustian, n munlcipal corporutlon exiet[ng under the luwa uf the 3tate of Floridu, na Gra�lor aud . . . . . . . . .. . . . . . . . . .. . . .. .. . . .. AQ�.o.tk�y...�... .I�y.oz�s . . . .. ... .. .... ......... .. . . .. . .. . . . . . . . . . . .. . . . . . ... . . . .... . .. . .. ..... ...... ..............................853. Barber..St. , Sebastiln�.. F1..... 3295.a....................................... ot cnr ca�ncy oi . . .Inciian, , Ri;ver .... ...... . .......... �oa scace �t .... .. Fl.orida.............. .... . ....... ....... .... ue Grantee, WI`LNES3L+Tiie That the Grantor foz and in consideration of the sum of a...,4 �� • � � . ............ to it in hand paid, the recxipt whereof is hetewith ac- knowled�ed, does by tlus instrument grant, bar�ain, sell, rele�asa, convey and conficm unto the Grantee ,,,, h e r h�;us� legal repreu;ntatives and assigns the following pruperty situated in Sebastian, Indian River County, Florida, tawit: All of Lot(s) 5, ,&, , U,]31ock, �' 0,,,,,, UNIT ,,�; , Aa a., ,, of Sebastian municipal cemetery us per Plat Number 1 theieof rccorded in Plat IIook 2, at Pabe 65 of the puUlic records in the of6ce of the Clerk of the Circuit Court of St, Lucie Cuunty of rlorida; said land nuw lying and being ui Indi,u► 12iver County, r'lorida. To Have and to Hold the same forever; providad that said ptoperty shall be.used soiely and exclusively for the uiterment of the human dead and shall be used, kept and rnaintained at all times in accordanca with the rules and rzgulationa, ordinances and resolutions of the City of Sebastian, Plorida, hereco- fore, now and hereafter adopted or provided for tha government and operation of said cemetery. The conditions, restrictions and requirements cor►tainr.d in this instruznent slialt be covenants running with the ]and. In the event of the failtuc of the ownar of any property situated within said cemetery to ob- serve and cumply with such rules, regulation�, rewlutions and ordinances und the conditions of the deed of conveyance thereof then the title uf such owner in uid to said property shall terminate and the same shall revart to the City of Sebastian, Florida. IN WITN�SS WIiEREOF, The saici party of the &st pazt has caused this instrument to be executed in its name and on its behalf by its klayor and attcsted by its City Clerk arid its cor�wrate seal to be heteto afPixed, the day and year fust above written. Attcst: . /. ! 1ni..L. .1. ![ ` . .C/. .'.�11.G,��"5,...r ./. . . . . . . . �� City Clerk l/ 9igne�, Senled uncl Tsclivered ln the P esrnce oPs . . . . . . �.pa..0�. . . . t✓`, ; c!L/-eo� . . . . . . . . . . . . . . . . . . . . .�-:�' ..�...�� ......:............ � s�rn�ri; or i�•�.OitIAA CITY OF SEI3A&TIAN, FLORIDA IIr . . . . !. . . . .L��. .�. . ��'.......... Maror ((Qit� �e�l) CEM iex:RECORD # Last Name Address i Address 2 City Deed # Un it # Lot Number Lot Number Lot Number Lot Number Comment Comment <F>wrd <B City of Sebastian, FL - Cemetery Lots LYONS First Name DOROTHY E. 853 BARBER ST. SEBASTIAN 1174 Date i-p Block � 5 Interred 6 Interred Interred Interred Tuesday, Dec 28, 2004 12:24 PM Stata 05-24-88 40 MCDEDE,EDWARD <N>ext <P FL Z ip Amount $400 Record:5 32958- Dte Interred Dte Interred 05-24-88 Dte Interred Dte Interred h <L>abel <T i STATE OF FLORIDA • � � �EPARTMENT OF HEALTH & REHABILITATIVE SERVICE �� S � VITAL STATISTICS � �,� 1 NJ•AX�1 MI.I� I 1 N� 111-.11.111 .1.VI) """"""""'"'"'","" APPLICATION FOR BURIAL—TRANSIT PERMIT A• (Type or Print) 1. Name of First Middle Last Deceased DATE Month Day Year �W� MCDEDE D ATH MAY 23, 1988 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp, or BREVARD BAREFOOT BAY Inst. 410 EAGLE DRIVE 3. Name of Medical � Physician Address Certifier DR. MICHAEL ZIMMER M.D. Phone Number , ❑ Medical Examiner 2300 — 5TH AVE, VERO BEACH, F'L 567-7111 4. Funeral Home/ Name Address �� STRUNK FUNERAL HOME 1623 N. CENTRAL AVE. SEBASTIAN F� Phone Number IArea Code) � 407-569-1000 5. Check a❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro• this application. priate Box b� MAUREEN was contacted on 5_/2�/88 within 72 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. MICHAEL ZIMMER M D. will complete and sign the medical certification of cause of death. 6. Funeral Director/ Dife�'.i-D+cPacer �� was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. re Fla. Lic. No./Reg. No. Date Signed 4� 1672 5/23/88 °� BURIAL—TRANSIT PERMIT 1228-88-250 Permission is hereby granted to dispose of this body. Permit No. ❑ 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"Funerai Director/Direct Disposer ReporY' will be filed with the Local Registrar of the County in whic death occurred. ❑ No extension of time for filing t death certificate equeste Registrar or ' Date Date Certificate Subregistrar Signature Issued: 5�23/88 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 musi be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is required for all cremations. Method of Disposition: (� BURIAL ❑ STORAGE ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or P�e�e ) CEMETERY OR CREMATORY Place of Disposition��'0'�'r�� +'�—�'fk.. Date of Disposition J ' ��r'!t � . This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when thete is no Sexton) and returned within 10 days to the local County Health Department in the County where disposition occurred. HRS Form 326, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2)