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The Sebastian Cemetery
City of Sebastian, Florida
Receipt is
From:
in the sum of:
O GD/
on this ���'"day of
described Cemetery Lot�
Description of Property:
Dollars ($ � � �
0
�, 20 G�U for the purchase of the following
upon the terms and conditions as stated herein:
Cemetery Lot �� __ Block � Unit ��
.
Purchase Price: Dollars ($_�� � )
Terms and Condition of Sale:
This contract shall be binding upon both parties, the sellex 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:
Purchaser signature
Purchaser signature
The City of Sebastian agrees to sell the above mentioned property to the above named
stated in the above instrument.
Witness
6
f�ifg nf £►rh�s#ian
�;:� ,.. � �PI�tP�P�1J �PP� No. � 1'���
28th March 2000
THIS 1NDENTilRB 1[ADF 1ti4 ...................... d�y of ............................................. A. D., ]Y......,
between t6e Ctty o! Sesastian, a munlelp�l eorporstlon dottns undcr the laws ot the 3tate ot Florfda, a� Grantor and
............................................ S1�i�.�.eY...A....S4�*eXS.............................................................
865 Gilbert Street
............................................ Sehastian., ..F.L.. 329.58............ . .. ... ......................................
�r �n� conner or ..Indian. River ..................... .n� ara� or .........Florida .
......... ...............................
w Gruiter, WITNE88&TH�
That the Grantor fo: a�d in considocation of the swn af s S OO . � 0 ...�������� wheiaof ia herewith ao-
..............
Imowledged, daea by thie mstrumeat grant, bargein, aell, releaee, convey and confirm wto tiw Grantae ,,�? e r, , tbirs, lagsl xapieaentativa and aa�gns
the following propecty situatad in Sebaatian, Indlan Rivei County, Florida, to-wit:
All of Lot(a) ,1 ?. ... Blodc, ,, 4�,,, UNiT 1 A,,,,,,,,, of Sebaatian munidpal cemetary as pec Plat Numbac 1 theieot mcorded in Pht
Book 2, at page 65 of the public racorde ia the office of the Cbrk of the Cirwit Court of St Lucia County of Florida; seid land nom lying and being
in Iadian River County, Florida
To Have and to HoH the mme fomver; provlded tLat said property ahall bo.wed aobiy and excludvaly for the intarnient of tha hum�n doad and sLall
be uaed, kapt aad mainteined at all timea 3a axordance with the mlea and ngulatioae, ordinancea and reaolutiona of the Clty of Sebaatian, Florida, hemto-
Pore, now and he:eafter adoptad or provided for the govemmant end oparatbn of aeid cemetary. TLe conditions, ceatrictiona snd iequitanente contained
in this inatcument shall be covenanta running wkh the land. In the avant af tha failu:e of tha oamer of any property situatad within said cemetery to ob-
aern and �mply wlth fiuch nilea, rogulatlona, meolutiona and ordinancxs snd the conditlone of tha dded of conveyanca thereof then the ti�le of such owner
in and to aaid property ahail tem�inate and tho asme ahall revert to tha City of Sabeatian, Florida
IN 1V1TNE33 WfII3REOF, Tho aaid party of the f'�at part haa auaed this Instrvment to be executed in its name and on ita bohalf by ita Mayor and
attatnd by ita Clty Clerk aad ita corporate sesl to ba hereto afSxed, the day and year Hiat above writtea.
CITY OF SEAABTIAN, FLOAIDA
Attestt �' �•�`���- V 1/S�S!�!�! J..�!.Y.1— "� �' "`
. .. ..... . ....................... B� . . . .........................
....... . . .... .......
Clty Qeek Mqor
3t , Sealed nd Delivered
In e Preae ofi
..... . . ....:.�%•••-•• ... .�r.�...... ��tl� o�p.i��
..... .�.�.....`- .............
STATE OF LOitIDA
COUNTY OFINDIAN RIVER
I HEREIIY CERTIFY, Tdat on thb ........?St�l.........day of ....................�$�.G�3......................,$��r.Q,OO
before ����i . Wslter W. Barnes Kathryn M. 0' Halloran
YPPeared ........... ................................. and .......................................
reepuctively Mayor and City Clerk ot t6e Clty ot 9ebsetlen, e municipel corporation unJer the lews ot tde 9tate ot FlorWa to me known
to be tlu individuuis und oflicera described lp end who executed the foreguln6 ewveysnce to
..........ShirleY...A._. Sowers ................. ....................................
.................................... ......
........................................................ snd aeversily ackoowledged the e:ecutlon tixreot to be tdelr trce act end deai
ea sucd otficers thereunto duly authoritcd; wd tLat tde OfflefuJ seul ot srid rnrporation te duly atfixed t6rntq and the aeid conveyance
is the act ond deed ot e�ld corpontbn.
WITNES9 my signature and ottieW wl at &butbn, ln t6e Coun o an i6v S e ot Florids, the day and �ea;
last afure��W.
� U!W IL 9Al1EY ' . . . . . . . . . . ..
�. MYCW+tAISSIONiCC740178 ..• . .... .. .. . ..... .............
EXPIRES.,hne�a2� ary bUq 3 0! Florida �t
mnawnwrbwvaweunarr.rrs Mv aslo n �
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City of Sebastian
�
1225 MAIN STREET o SEBASTIAN, FLORIDA 32958
TELEPHONE (561) 589-5330 o FAX (561) 589-5570
March 28, 2000
Shirley A. Sowers
865 Gilbert Street
Sebastian, FL 32958
Dear Ms. Sowers:
Enclosed is Cemetery Deed No.1722 for Lot 12, Block 40, Unit 1 Addition.
Also enclosed is a form - Retum for Transfers of �nterest in Real Property - wluch must be filled
out by you and completed by the office of the Clerk of the Circuit Court when and if you ha.ve the
dced recorded. If you wish to have this deed recorded, you may do so at the office of the Clerk of
the Circuit Court, P. O. Box 1028, Vero Beach, Florida 32960 or you ma.y call or call the
Departrnent of Revenue at (904) 488-9487 for more information regarding the completion of this
form.
We aze enclosing two copies of each the receipt and ask that you sign and retum to us the copy
marked with an "X" and retain the other copy for your records. A stamped, self-addressed
envelope is provided for your convenience.
Sincerely,
� •
�• � �a,�.�.�.
Kathryn M. oran, CMC/AAE
City Clerk
KOH:Img
Enclosures
` ' � 3/25/85 •
Pai� by CEMETERY Receipt No . . . . . . . . . . . . . . . . . Datad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO.
Lirt Prico S.. 300: 00... ... .. Maucimum No. Pucial Sp�oer . -2-
................ 1 � 4 6
..
Net Paid S . . ..�. :.�. . . . . . . . . Monumant pormitted . , , F1 a t . . . . . . . . . . . . . . Odessa Ha11
Lots 11 6 12, Block 40, Unit 1 addition
678 Layport Dr.
Sebastian, Floride 32958
(D�t� �bn�e 1bD llm !ot Clty R�ord onq�)
��tj� tt� �P�1��t�Mri
�PiitP#��1,J �PP�
N°. � �G46
THl$ 1NDENTUAE 1LAD8 1Ub ..... 25,th.... ....... d�y ot ... .........M��'�h .......................... A. D., li.�,� ..�
between the Clty ot Sebost4a� r muaiclp�►l eorporstlon esbtln� uader the l�w� ot the State ot Fbrids. �� Qnntoe and
Odessa Ha11
.......................................................................................................................................
678 Layport Dr.
...,.....SekaSt.ian...Fl.oxida,..3.2958 ........................................... ............................................
o! the Co�nty of .,...Indian River ...................... wJ Ptst� ot .....Florida........................................
�a �iru►tss, WITNR9d$THi
Thrt the Grantor for and in oonrideration of tho sum of S...,300 � 00 ..............� it In hand paid, the noeipt where0f i� herowith ao-
lcnowlod�ed, doe� by this iaarument �rraat� bar�ain. iell, relasre. oonvey �nd oonfirm unto the Grsntee ,.�?? {'. ., helr�. le�nnl ropre�entativa and awi�u
tho followia� ptoporty dtuatod !n Sebartian. Indian River County� Fbrld�� to-wlt:
11 2 40 UNIT 1 add.ition
All of Lot(s) . . . . . . Bbdc, . . . . . . . . . . . . . . . . . . . . . . . of Sebaalan muniapal cemetoty ae par Plat Numbet 1 thorooP racordod in Plat
Book 2� at paga 65 f the publlc racorda in tho of8ce of the Cbrk of the Citcuit Court of St. Lucia County of F1orWa; tald land now lyiny and bain�
in Indian River Co y. Fbtids. ,.�
j Q�� �,,���r-
G `'�,�
To Have and to Hold the a�me fonver; provNed ttwt wid property �htU be wd ably and exclueively for the iaterment of the hum#n dead u�d ahrll
bo ured� kept aad nwintained ot all tlmet in a�ordaace wlth the rute� aad re�uLtioru� ocdliwnoe� and realution� of the City of Saba�tL�n, Florida. heceto-
fore, now snd heraPter sdopted or provlded for the government and operation oP wid cemetery. The conditbn�, remictlon� and cec�uir ments �ntained
in this instrument ehaA be covenanta runping with tive 4►nd. In the event of the failure of the owner of any propatty sltuatad within � cemetary to ob-
�orve and comply with auch rule�, roguladons, rawlutiona and ordinanae and the conditione of tho dded of conveyanoe thereof then the thb of such owror
in and to raid property thsll terminate and tho wma �hal! revert to the Clty of Sebartlan. Florida.
[N WITNESS WHEREOF. Tl►o wid party of tha flt�t part haa caueed this inetrument to be executed ia it� name and on it� behalf by itt blayot and
attetted by iU City Clerk and iti oorporate ieal to bo hereto affixed, tha day and yoar firet above written.
Attects . , . . '"t.�.�--�!!ti.!..�'..!^� ....
Clty Aerk
3f�ned, Sealed rnd Delivered
la tde Praetax oti
� .�• . .I �. r.T �`C � � . . � . . • . . . . . . . . . .
. . . . . .�. . . . . . L1��lI�d?�. . . . . . . . . .
STATE OF FiAItIDA
CITY OF SEB AN. FIAAI
8� ...... .. • .. ...�.... ..............
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COUNTY OF 1NDIAN R1VBR . -�
I HE1tE8Y CEBTIFY.'thst oo thU .....25th .............dsy ot ..........March.........................:........� 1i.35�
before me personally �ppe�red .....Jim Gallagher ................................... �d . Deborah. C:..Kra�es............
re�peetively Mayor rnd Cfty Cle�k o! the Clt� of 8ebastf�n� • municlpa! corporation under the lRwi ot tbe 9tate ot �Florlda to me know�n
to be the Individualr a�d otttcerr dacribed b aad who aceeuted tbe tore�oln� co�veyNnce to
Odessa Ha11
.......................................................................................................................................
........................................................ and avera!!y scicaowled�ed the exuutlon ti►ereof to be thelr free art and deed
as rucA vtf�ceEs theceuatu duly Kuthurludi and t6�t the Ottklal wl of wid corpontlon la duly xtflxed tderoto. u►d tha ald conreyar►ce
a tAc J►ut �and deal o! yW oorporstbn.
� i�iT�(�4' �y'�a�tnse �ad oftici�l re�! at Seb��tlan� lu the County of Indlan Alrer aad 8tate ot Florlds. the day and �a�
I��t �tor�ld.
- _. - .. . ...Y. 4:.. .. ..................
Not� Publir, 8 ot FbrW� at
'- Yr1D0°°�"�0' °7p�`�otar� Publu, State of flaid�
My Commiuion Expues Auq. 22, lp8ti
{�q� Tlur Tar f�in • lo�uw.n, yc. .
PLORI A DEPARTMENT OF
� HEALTI
A. ('TYPE)
1. Name of First
Deceased
S� f Florida, Department of Health, Vital tics
APPLICATION FOR BURIAL - TRANSIT PE IT
2. Place of Death City, Town or Location
County
Miami-Dade Miami
3. Name of Medical .
Certifier Jong Lee, M. D.
Medical Examiner Physician
Middle Last
�.� a
a y�
U i A�
Date Month Day Year
of
Estes � Death
Name of (If neither, give street address)
Hosp. or
inst. Jackson Memorial h
1611 NW 12th Avenue
Miami, FI 33136
March 23 2000
ital
Phone Number
305-585-2180
4. Name of Funeral Home/Diuet-BM�pes91 Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 1623 N. Central Avenue
Strunk Funera Home Sebastian,Fl 32958 1228 561-589-i000
5. Check a. The medical cert�cation has been completed and signed. A completed certificate of death accc�mpanies this
Appropriate application.
Box
b. � was contacted on
HeJshe verified that this death was fcom natural causes, that there was no accident nor other extemal cause of death,
and that will complete and sign the medicai
cert�cation of cause of death within 72 hours.
c. �
6. Funeral DirectoN
was contacted on He/she verified that
, Medical Examiner, wiil complete and sign the
of death within 72 hours.
F.E. No./Reg. No.
7 �L __� 862
Date Si�ed
3/27/DO
B. BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-00*-0151
� A five (5) day extension of time for filing ihe death ceRificate (exclusive.of weekends) has been requested and granted since the physician has
been contaeted by the funerai director and wili not be able tc complete the medical certification of cause-of-death seetion of the death certificate within
72 hours.
�No extension of time for filing the death certificate has been requested. .
Registrar or Date Date Certificate
SubregistrarSignature Isaued: ,3 �i+ 7�00 Due: ,� ,� / m,.p
�—
c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number: Date
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.
p. CEMETERY OR CREMATORY
Method of Disposition: Piace of Disposition S@be5t18t1 Cemetery
�BURIAL
�CREMATION
Signature of Sexton �
or Rerson-in-Charge
� STORAGE
�OTHER (Specify)
Date of Disposition
This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral DirectoNDirect Disposer when there is no Sexton) 8nd returned
within 10 days to the local County Health Department in the county where disposition occurred.
Distribution: White: Cemetery or Crematory
DH 326, 6/97 (ObsWetes all previous edNions) Yelbw: Funerel Directa or Direet Dispoaer
(Stock Number. 5740-000-0326-2) Pink: Locel Repfatrer