HomeMy WebLinkAbout1-40-17� d by CEMETERY Receipt No. . . �. . . . . . . . . Dated . . . Q G � Rb � �. . �.� a. . �. � .
?.i.c: Price S .. .� �:� Q r �Q.. . . . Maximum No. Euiial Spaces ... 3 . ..... .. . .. .
.
Net Paid S , , �F 5 �: . � � / Monument permitted . . . .F 1 a � • • • • • • • • • - • • •
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(Data above mL line tor C1ty Recoed only)
�tf� itf �P.�MBft�2t
�PI1�P�P�1�' �PP�
��
Margie 0'Brien
P.O.Box 780411
Sebastian, I'1.
,�.:�.
C;�;�1
32978
Lots 17, 19, 20,
B1k.�40, Un. 1 Add.
NO.
cs��
THIS INDENTUAE l[ADE 'ltils . .2� th . . . . . . . . . . . . . d�y ot . . MaY. . . . . . . . . ........ . ... . . . . . . A. , lY. .. .. �
............... D $ %
betNeen the Clty ot 3ebartiaa. a munlclpal oorpor�tJoa �istin� undcr the lswa of the 9tate oi Floridy u Graator and
Margie 0'Brien
.......................................................................................................................................
...................................P. 0.. Box 780411.�...Sebas.tian:..F?: ....3?.978-0411......................
or tn� cow►r� or .........znd.ian.��..v.e.x ............... .�a sac� or .....F.loxi.da......................................
u Grantee� WITNE89ETH�
That the Grantor for and in consderation of the sum of s...� 4 5 0..� Q. ,,,,..,,,, to it in hand paid, the ceceipt whereof is herewith ao-
. .....
knowledged� does by this instrument grant, bargain, scll, release, oonvey and conf'um nnto the Grantee ,,he r., heirs, legal representatives and assigns
the following property situated in Sebastian� Indian River County. Florida, tawit:
All of Lot(s)19.� �,(,� � B1ock, 4 �,,,,, UI�iIT , 1. Aaa ;,,, of Sebastian muniapal cemetery as per Plat Number 1 thereof recorded in Plat
Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of S� Lucie County of Florida; sai�d land now lying and being
in Indian River County, Florida.
To Have and to Hold the same forever; provided that said property shall be used aolely 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 regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto-
fore, now and hereafter adopted or provided for tha government and operation of said cemetery. The conditions, restrictions and requirementa 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� reguladons, resolutions and ordinances and the conditions of the dded 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, Fiorida.
IN WITNESS WHEREOF, The said party of the fust part has caused this instrument to be executed in its name and on its behalf by its Mayor and
attested by its City Clerk and its oorporate seal to be hereto affixed, the day and year fust above written.
Attest: . _ . . .`�./. . . . . . . .1'C!5�!! Y . . .�,�.�.,,� . .
Clty Qerk
Rtgned, Sealed and Delivered
�e Precence of� �
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..........................................................
STATE OF FLORIDA
COUNTY OF INDIAN ftIVEYt
GITY OF SEHABTIAN�
B .... '��1�/ .................
Mn,�or
���p ���
1 HEtt�TiY CP:ft'rIFY. Tin�t oa thlr .....�:..! .�. �......dsy ot ...........�../.�'..� ......................... '%
, 3t���,
�rfar� m.a , ar�ng:l3' aPPcsred . . . �. . . �:�. . . � � �° . . . . �� �.'t J�.. f� . %. � . . . . . . . . . . . . . . and � .�: .1-''�;"/��%.C,� •rl . • . � . � �,.E�
respect[vely Mayor enci Clty Clerk of the pty of 8ebeati�n. � a�uniclpwl eorpoeatton under the lawr ot thc 3tate ot Nlorida to me known
to be the ladividualr urwl ollicerr deccrlbod Iq sad who pceeuted tbe toccgoing co�veyance to
. . . . . . . . . . . . . . . . . . . . ./.l!.l .fr. .!i G,/ �=:.. . . . . . . .o. �. . . .��. . .1. .! .!-=.!.✓. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.......................................:................ �nd �ersrally �ckoowled�al the eze.cution f.heeeot to be thelr free act snd deed
as ruch otflcery. therrunto duly �uthor4edi aod t6at t6� Otfieiat real of uld corporstiun Ir duly atflxed theroto� and the w!d conveyance
Ir thc wet and deed of sald �rpor�tJon,
WITNLS5 m� sfsnajun �nd oflicW �al st 8ebwtlrn� la t6e Couaty of Iadlan ftlrer uid 8tate ol Florlda� the dy and �ear
loet afosewld.
- ' ...,LJ.... . ................
No ry Pub etate ot F1o*�ote y u c, State•of florida
NY oomobalon ex�lrar
My Commission Expi►es Aug. 2T, 19$8
Bund�d ih�u Troy Fam • In�u��nc�, ���,
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FLORIDA DEPARTMENT OF
HEALT
A. (TYPE)
1. Name of
Deceased
2. Place of Death
County
Brevard
First
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
Middle
Margie Ru
City, Town or Location
Melbourne
Last
O'Brien
Date
of
Death
Month Day Year
Dec. 19 2001
Name of (If neither, give street address)
Hosp. or
inst. Mariner Health of Atlantic Shores
3. Name of Medical Atltlress rnone Numoer
Certifier Rajiv Chandra, M. D. 20 East Melbourne Avenue
Medical Examiner Physician Melbourne, FL 321-951-7404
4. Name of Funeral Home/Di�et�.Dtcpasal Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 1623 N. Central Avenue
Strunk Funeral Home Sebastian, FL 1228 561-589-1000
5. Check a. � The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. � Susan wascontactedon 12/20/O1
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Chandra will complete and sign the medical
certification of cause of death within 72 hours.
6. Funeral Director/
B
c
�
was contacted on
of cause of death within 72 hours.
F.E. No./Reg. No.
��, � J 1862
BURIAL - TRANSIT PERMIT
He/she verified that
, Medical Examiner, will complete and sign the
Date Signed
12/20/O1
Permission is hereby granted to dispose of this body. Permit No. 1228-01-0599
� A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within
72 hours.
�No extension of time for filing the death certificate has been requested.
Re�5tT�6'r'' • Date Date Certific e
Subregistrar Signature �. . n, ��(,,� �'�/..�..( Issued: f Z, / � Due: � 1�Z�/� !
Approval Number:
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Date
Medical Examiner, , gave authorization by telephone to
Funeral DirectodDirect 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.
�. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemetery
�j BURIAL �STORAGE Date of Disposition j i•1�`��b�jC�,
r�`�
�CREMATION
Signature of Sexton
or Person-in-Charge
�OTHER (Specify)
} ��. �
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.
Distribution: 1Nhite: Cemetery or Crematory
DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer
(Stock Number: 5740-000-0326-2) Pink: Local Registrar
PAY
TO THE
ORDER
STRUNK FUNERAL HOMES, P.A.
CASH ADVANCE ACCOUNT-SEBASTIAN
916 17TH ST.
VERO BEACH, FL 32960
PH. 567-562-2325 .
�. o fi Se _� e�l.t a�..
l.-.�, c�JLG.� ( u.J 4/Y.xM P 1 V C
. . ...��� 95B 201h Plaw � . � .. . ' .
. ss �� � p� Vxo Beach, FI 32%0
Indian River National Bank �"�""�aRNe.`°�°
FOR �� � ` S V C -+
�i■00 20 i:7u' i:0670 L 2057�:.
2017
l 2 � 2 a 4 C� ' 63-1205/600
DATE
� � a �'. oc�
t �' DOLLARS � �"°��
nR
__ .. _, ______ .._.._-- ------.__ __.___.�------
�20 252ii'0L .
`�LO�K 40 LOT 18 UNIT 1 A17DIT16N DE�D #1053
Margie 0'Brien
P.O. Box 411
Sebastian, FL 32958
William (husband) interred 6/18/85
Un. 1 Add., Blk. 40, Lots 17, 19, 20 Deed 4�0551
Margie 0'Brien
P.O.Box 780411
Sebastian, Fl. 32978
� � - -
� ~ .
•
City of Sebastian
L. Gene Harris POST OFFICE BOX 780127 O SEBASTIAN, FLORIDA 32978-0127 Kathryn M. Benjamin
Mayor TELEPHONE (305) 589-5330 City C�erk
May 26, 1987
Mrs. Margie 0'Brien
P. 0. Box 780411
Sebastian, Florida 32978
Dear Mrs. 0'Brien:
We are enelosing Cemetery Deed No. 0551 for Lots No. 17, 19, 20,
Block 40, Unit 1 Addition. We are also enclosing Check No. 1C73
in the amount of $25.00. You were inadvertently charged too much
when you,made your final payment as you can see from the enclosed
teceipt.
If you wish to have this deed recorded, you may do so at the
office of the Clerk of the Circuit Court, 2145 14th Avenue,
Vero Beach.
We are also enclosing a form - Return for Transfers of Interest
in Florida Real Property - which must be filled out by you and
completed by the Clerk of the Circuit Court's office.
Ver truly yours,
G ��
Elizabeth Reid
Deputy City Clerk
LR
Enc.
'. � � •
T0: FINANCE DEPARTMENT
FROM: KATHRYN BENJAMIN,�-�n'
F�--�
•
May 26, 19$7
Please issue a check in the amount of $25.00, payable to:
Margie 0'Brien
P. O..Bax 780411
Sebastian, Florida 32978-0411
Reimbursement for over-payment on cemetery lots 17, 19, 20,
Block 40, Unit 1 Addition.
� . � � ' aso
THE SEAJI.STIAN CENETBJtY
Ci ty of Spbest�an
S�ba�rtian, Florid�
R�C��PT �$ �RI��Y JiCXNGidl��7:� OJ' TNi �NN O��
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� � n pol.��r�r iS��.�l
7 �
F�oH:_ �,.,�.,,��� n� �o �r .�►
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°� «�� �' daY ot' i� 1°C�. 19@�' �for th� puroh��� ot Chr �a2low.tny
d��r.tb�d Ceu�t4.ry �at (s1 upon th� tarroQ a�d cnnd.iC�o�nr aa atated 1�r�iq�
AQaotlptio� oF PropQrtyr
C@aie�ary I.ot(e1 N/�rl f., �� B1ockM__�!C) unitN�l
.......,._
J a
Purc�e Price�,.,�,� ���,.,►,�,���Y�S`.T _� llarsl�_ 4J �• Of� 1
Te�lus �nd co�ditionr� of sal�s
�SC�.o� �i. �wv — d�.o� �ra. �outa uv�.l. �i��o �v �.�.l..l�.
Thts contract aba11 be binding upo� both part�es, the seller ,�nd tha ppr�b�µipr,
when aBPrc�tn�ci Ay the owner oF th� property �ov�e da�cr.lbed.
I, or we, agree to purchase the above descriDed p�opetty o,� Ch� term� aqd
c�onditior� �rt�t�d �n th� Foreqoinq iptr�w�er�ts
.
�.//_ ��'L ' � _i�ir '
/
`he City oF S�bastiao agrees to se12 the above mer�ttoned property to the
above naa�d �uahar�r(s) on t1�r terw� and c�nd�tio�n� �teted �n the a�iovp
instruu�nt.
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Purchaae pri �:e S�-S"G� . U t;
Pa1d . ��!S"a_��n Dwte Ba2anceS y()(��
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��i o9�' Paid�oaice a'- �- ' ealance�,�,�n�
`� �3 Paid c,?��+D�alt�►���j�ces�t,r
Paid 50.00 dated 5-1-86
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G�f�s331 PC� �.�-0 `� B�LY��``� Balance 225.00
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