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Home My WebLink About1-40-32. . • (�itg nf �rGtt.�#ittn ��Vi.0 ��l1tPfPx1„� �PP�1 • N�. 19th September 97 TH1S INDENTURE MADE T11� ...................... day ot ............................................. A. DH 19......� hetween lhe Gty of 8ebast3an, a munfcipal wrpont(on e:ieting undcr the laws ot the 3tete af Florida, ue drnntor and Deborah Shivers . . . . . . . . ..... . .... .................... .P:O: ' Box' i'092. .. ......... ... .. .. .. . ... . . . . . . . . . . .. .. . . . .. . . .. ..................... Roseland, Florida 32957 ......................................... ............................................ ............................................ of the County or . . .Indian , Ri,v,er , , , , , , , , , , , , , , , , , , , ,, , , , .,,.� Stete ot Florida ....................................................... �e Gnnteq WITNES9ETH� That the Grantor Cor and in consideratlon of the sum oC S......, 5�: �� ..,, to it in hand paid, the raceipt whereof ia herewith ac- knowkdged, does by this instrument grant, bargain, aell, telease, convey and confirm unto the Grantee ,, heT heira, legal representatives and assigns the following property situated in Sebastian, Indlan River County, Plorida, to-wlt: All of Lot(s) ,., 32, , Block, ,. 40... , UNIT ,,(�, ,), ,Y�, ,,,, af Sebastian municipal cemetery as per Plat Number 1 thereof recotded in Plat Book 2, at page 65 of the public records in the ofSce of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the aame fotever; providad that aaid property shall be used solely and exclusively for the intecmant oC tha human dead and shall be used, kept and maintained at sll Umes ln accordance with tha culea and regulations, ordinancea and iesolutlons o[ the City of Sebaetfan, Florida, haroto- fore, now and heratter adopted or proWded tor trie government md operadon of aaid comete:y. The conditiom, restrlctlone and requlrementr conUined in thls instrument shall be covenants tunning with the Iand. [n the event of the failure of the owner of any propeity situated withln sald cemetery to ob- xrve and comply with such rules, :egulallona, :eaoluUons and ordlnances and the conditions of the de'ed of convayance thereof then the title of such owner in and to sald property shall tecminate and the aame ahall revett to the City of Sebastlan, Florida. IN WITNESS WHEREOF, The said party of the Pust pazt has iaused this instrument to be executed in its name and on its behalf by its Mayor and atteated by its City Clerk and Its corporate seal to be hereto affixed, the day and year fust above written. Attestl . . .�,..�� %L< . . . !�•� /• . . ��p— � city ci��k CITY OF SEI3ASTIAN, FLORIDA B, .. V�l�. �.:�.c�v�rr1�........ Ma�or Rignc Sc led und Dclivered ln t P�ence of: .... .. . _ '\.. ... . ��Q.,�........... ((Qit� �eal) . . L�. . ............. ,�u .. ... ........... .... ✓ BTATE OF FIARIDA CUUNTY OF INDiAN R1VER I HEIiEBY CERTII+Y. Tbat on ffile ...........19t�'1.......deY or ..............SeRt�ar►kaex......................., lY.��. befoee me peraone)ly .np�8«a .,.Walyer W. Barnes KSttlij�T1 M. 0�'jS110Z'Ail t .................................................. end ....................................... roepectively Mayor and Ciry Clerk nt the City ot 9ebastten, e muniripol mrporntion under thc lee•s of the State of Florlda to me known to bc the ludividuule und officrra descdbed ln nnd who eaecuted tl�r foreguing cupveyance ta Deborah Shivers ....................................................................................................................................... ........................................................ and severally scknowledged the ezecutlon thereot to be thelr free act end deed as sucti otticers tl�ereunto duly authorized; and that the Officiel seul of said corpuration le duly eftixed/// lend the eeid conveyance is the nct anJ deed ot sald eorporatlon. WITNESS roy eigneture end offlclsl oesl at Hebaetien, in the last nturrsaid. _ _ _ _ _ �— LINDA M. �ALLEY MY COMh71SSI0N 1 CC 975M4 IXPIF�S: June 18.1998 BaMed Thm tb1�Y PubYC lpidxwribn unty of nd v e ot F orida the ey and �es; . .. .. . ........ .. ... . .. .. ................ N ary ubtic, 3tste ot e at I.�rge. My commleslon explr linda M. Gallev \ ; ' �� , , .�, /, F� � Name 4 1 Unit O � f�c: ��:� t.� Block Lot - � Date of Mark-out i� a:�� ;( '_ Time %' i 1.% `% � i"7 Date of Burial %� � ; � `} i � �I Name °of Funer�l Hom� �° -� �; i h: �. .: ,, i , ��_..��. � , ;' � '�,-r= .�. i! .. �./� .'] � � .fi , , �� /' Authorized . _ -- _ � `� V �.rS� �-�'��_�' l � � �i��X ��t� �f� ��, I--1- �'�� / c !/� � � `�� .> ��1�� ,, � I r� , ,.� � o`�� ro�� 3 a- g- a3-9% �� .� +� a2 �� State of Florida, Depa t of Health and Rehabilitative Services, Vi�atistics /✓ �%� APPLIC�ON FOR BURIAL — TRANSIT PERMIT �/'�� A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Ovid M. Shivers, Sr. DEATH $�19�97 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Vero Beach �nst. Indian River Memorial Hospital 3. Name of Medical Certifier Frederick P. Hobin, M. D. , M. E. 4. Name of Funeral Home/ Direct Disposer 5. Check Appro- priate Box . ■ c ❑ C� Medical Examiner � Physician �00 ,,,$ 35th ` t. r�erce, F1 Address 1623 N. Central Ave. Sebastian, Florida 32958 Address Fla. Lic. No./Reg. 1228 Nhone Number (561) 464-7378 Phone Number (Area Code) 561-589-1000 The medical certification has been completed and signed. A completed certificate of death accompanies this application. was contacted on 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 will complete and sign the medical certification of cause of death. was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. 6• Place of Seb85tlan In state cemetery/ Removal Final Disposition: Cemeter X crematory - name/county: 1 ndian River from state Donation �• Funeral Director/ gnature � �. No.�e�. No. Date Signed D'+reei Bislmsef G'0 �� ` — g. BURIAL — TRANSIT PERMIT �22g—g7-0356 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 resuR from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a"Funeral Director/Direct Disposer ReporY' will be filed with the Local Registrar of the Counry in which death occurred. ❑ No extension of time for filing the death certificate requested. C. � Subre�gist�ra Signature Date �+ � Date Certificate Issued: —� ` / Due: AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT—SEA Signature , MediCal. Examiner. ._ . Date or Medical Examiner, , gave authoriza#ion by telephone to — Funeral DirectorJDirect 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. Methods of Disposition: � BURIAL ❑ CREMATION ❑ STORAGE ❑ OTHER (Specify) Signature of Sexton ) or Person-in-Charge ) _� -�µ , . �'-�� CEMETERY OR CREMATORY . Place of Disposition��l�"JGJ 1�� '�[ . Date of Disposition . '��• g � 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 HRS County Public Health Unit in the County where disposition occurred. HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-2) �`� CEM Index:RECORD # City of Sebastian, FL - Cemetery Lots t Name Shi�ers First Name Debarah ress 1 P.O. Bax 10'�2 ress Z Cit,y Deed # Unit # Lot Number Lot Number Lot Number Lot Number Camment Comment Roseland 1603 Date 1-A Block # 32 Interred Interred Interred Interred State 09-19-97 40 O�id Shi�ers F1 Amount CB?ack CE>dit <D7elete CH>ext CP�re� <R>e Wednesday, Dec 29, 2004 10:29 AM � ip $500 e 32957- Dte Interred 08-23-97 Dte Interred Dte Interred Dte Interred .. . �' . � THE SEBAST�AN CEMETERY Cl7'Y OF SEBASTIAN, FLORIDA ACICNOWLEDGED OF THE SUM OF: . �� FROM: on this �y�day o�� foZZowing described Cemet ry conditions as stated herein: Description of Propert�+: Cemetery Lot gl . w Purchase Price Terms and Condition of sa1e: 19 � �� ($�� Dollars � for the purchase of the upon the terms and �) , Unit Do11 ars ( �� This contract sha11 be�binding upon both parties, the seZler 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 foreqoing instrument: The City of Sebastian agrees to se11 the above mentioned property to the above named purchaser (s) on ti�e te �s �d co�ions stated in the above�instrument. I / � 1 an d • City of Sebastian � 1225 MAIN STREET � SEBASTIAN, FLORIDA 32958 TELEPHONE (561) 589-5330 o FAX (561) 589-5570 October 13, 1997 � Deborah Shivers P.O. Box 1092 Roseland, FL 32957 Dear Ms. Shivers: Enclosed is Cemetery Deed No.1603 for Lot 32, Block 40, Unit lA. Also enclosed is a form - Retum for Transfers of lnterest in Real Property - which must be filled out by you and completed by the office of the Clerk of the Circuit Court when and if you have the deed recorded. If you wish to have this deed recorded, you may do so at the otiice of the Clerk of the Circuit Court, P. O. Box 1028, Vero Beach, Florida 32960. � We are enclosing two copies of Receipt No. 958 and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. A stamped, self-addressed envelope is provided for yoar convenience. � Sincerely, � • ' � �t�L�. Kathryn M. O'Halloran, CMC/AAE City Clerk KOH:Img Enclosures CEM iex:' Last Name Address 1 Address � City Deed # Unit # Lot Humber Lot Number Lat Humber Lat Number Gomment Comment � City of Sebastian, FL - Cemetery Lots BEMTLEY First Name MILT4N W. & EDITH H. 1362 SW. DpMASH LANE SEBASTIAN State 1041 Date 03-07-85 i-A Black # 40 31 Interred 32 Interred Interred Interre These lots were sold as per Linda Galley� 0 <F>wrd �B>ack <E>dit <D>elete CN?ext C Wednesday, Dec 29, 2004 10:28 AM FL Amount V C _� Zip $300 32958- Dte Interred Dte Interred Dte Interred � Dte Interred 11/3/94 J � c � �it� nf �r�tt��n �PIItP�P�'l� �PPi1 N�. �. 1 u 41 THis INDENTURE 1�ADE 111s ......7�h............ d�y of ......M�3rGh ................................ A. D.. lY.$5.... 6etM•een the Clty ot 8ebastl�a. � muaiclpat oorporwtloa exbtlns under the lawr ai the St�te ot Flaeld�. �� aruitor �ed .. . . . . . ..... .. Milton W. & ,Edith..H•.. $��1X�:�Y................................... . . ... . ................... . . �1362 SW Damasic Lane � �� . . . .......... . Sehastian,. Elr�rida...32958........ .......................... . ... . . . . . . .. ... ................................. ot tn� co�ty or ...Indian..Ri.ver ......................... .o� sr.t� ot .....Elorida....................................... u Cirrntee, WITNE88ETH� That the Grantor foi and in consideration of the sum of S. 3QQ: Q�, ,,,,,,,,,,,,,,,, to it in hand paid, the recoipt whereof is herewith ao- know�dged, dces by this instrument grant, bargain, aell, release, convey and conCum unto the Grantee .�heir, , heirs, legal repreaentativae and asaigna the following property eituatad in Sebastlan, Indian River County, Florida. tawit: All of Lot(a) 3�r�? , Block, ..�yQ ... , UNIT �.. .adsi�t,. .. , of Sebaatian municipal ametery ae por Plat Number 1 thareof reoorded in Plat Book 2, at page 65 of the public recorde in the of9co of the Cbrk of the Circuit Court of St. Lucie County of F1orWa; wid Ltnd now IyinQ and bein� in Indian River County, Flodda To Have and to Hold the �r►e forever; ptovideA that wld pioperty dull be u�ad wlely and excluwvely for the interment of the humrn de�d and rhrll be u�ed, kept and maintained at ali time� in acxordance wlth the rule� and re�ulation�. ordinance� and realutioni of the Clty of 8ebattian, Fbtida, h�reto- fore, now and heseafter adopted or provided for the Qovernment and operatbn of �eid cemetery. Tt�e oonditioni, re�tticUon� and requirement� oontalned in thL inatrument ehall be covenants running with the land. In the event of the failure of the owner of any pzoperty �ituated within wW cemetery to ob- aerve and �mply with auch rulee, reguladona, reeolutions and ordirwnces and the conditions of the dded of conveysnoe thereof then the titb of suct� owror in and to raid property ahall terminate and the iame ahall revert to the City of Sebaatian, filorida. IN WITNESS WHEREOF, The said party of the fust part has cauaed this instrument to be executed in its name and on it� behalf by IU Mayor and attested by Its City Ckrk and its oorporate seal to be hereto affixed, the day and year fust above written. � Attest: ....... ... . ..........�""'"" ............. Clty Qerk Rigned, 3ealed und Delivered in the Prerence oh . . .�i.%. . . . �,�r . . . . ... . . . . . _ __ l�TAT� O�+' FIABIDA COUNTY OF INDIAN R1VER CITY OF SEBABTIAN, RIDA B� .. ........ ....... . .............. M (�� _�) � . , ... I HEIiEBY CERTIFY. Tiu�t � thL .. �t�l .................dry or .......Mar,ch..................................... lY.BJ`�• before me pereonally sp�and ..Jim Gallagher .............................. ....... ana ��T��..G�..��$�5.............. respectively Mayor and Clty Clerk ot the City of 9ebutlan, a municlprl corporation under the lawr of thc 9tate ot F1orldR to me knowrn to be the fndividualr and otticers deacrlbed fu and who executed tbe toregoln� co�veysncs ta . . . . . . . . . . .. .M��.tP�. W,..& .Edi�. .�I.. . �entl.ey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . ...........:� ............................................ and reverally �cicaowledged the e:ecutlon Weeeot to be thetr tree act �nd deed �s euch ditoers therrunto du�y ruthoriaedi and tb�t t4e Otticisl aerl ot qid corpontion io duly attixed theeetq and the said conveyancc is thc ict `abd de� ot wld oorpontbn. �VITNESS my dgniture and otflcW teal at Sebutlsn� W the County of Indi�n Rlver �nd 9tate ol F1orldR. the dq and �ear I�at �forrasld. Not� Publlc, 8tate u �rW� a r . . . . . . . . . . . . . . . . . . �Y �� p1ra� Ndt�ry Public, State of flaida My Co�„mission Expues Auq. 22, 148$ wna.� ihry TroY Fain-lmur�nc�, Ino. �• . � � �1 O �l_ THE SEBASTIAN CEXETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: � � � � ��(--c.�c- ��-7 ��i � � o Do2lera ($��;,� U•G O ) FROM: 'Y� � i �:.�. . /, � _L '�_/. '�-�r � / ,�. __ i e � 3'G �- � GcJ �� z�� L � � � � ,�, ,,� L�.3� �� Y on this 7� day of�Y��l--� 198�for the purchase of the following described Cemetery Lot(s) upon the terms and conditions as stated herein: Description of Property: Ceme ter y Lo t ( s ) � ,> / .d �� Bl ock �1 �./(�_Uni t �l / �d,./. /_�� Purchase Price �� Apllars ($ �pD• n b i Terms and conditions of sa1e: �r. �.,G�..�,�.,�,� - � - � -y�s- This contract sha11 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 i��%" 7j � G - The City of Sebastian agrees to se11 the above mentioned property to the a ve named purchaser(s) on the terms and conditions stated in the above instrument. ., � /� � �i1_ � � City of Se a t an $ENTLEY, MILTON W. & EDITH H. 1362 SW DAMASK LANE SEBASTIAN, FLORIDA 32958 DEEL #1041 RECEPT #402 LOTS 31 & 32, BLOCK 40, UNIT 1 ADDITIONAL �/ �. -I i , � � '�►` s � � ► l % J