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Home My WebLink About1-38-13��iyu.` / Qdc��,,v - t,� . s � .Y-•�.r.�, , t /��.,� �g £ � x��'gr � � . f ,� � ,. � . - -�-_�_,.� , � , �, , , ' . q � . ^l��,c1 � �i � / r/ , r , . � � . . � h� � ��p } 6�+ � '� }.�. . . �� ' �., t \ ' �� (G� 4' ,, � � , �` �� ` � ��,� � \q� _ � °�`- ,�` - �Jt\: `�Q,� � y i �� '�'� r u 'b r�- ct� �r' 'i . � N ,y ,y � A� r �I��J�t'�Ip t � v � � � 1 � � �1 � , � . : ,,,� a �' , �.' �� o�� °�1,^� b -� al'� ✓ � , �. � 1fi?�+� �3 ��,Ro� '� � iy; , g ,� � � � �� J � L �t<f � � �� ` �i; \1a� �a �� , �` \ �� A `� �� ' �� `�� i �a 5�` � � � Z ' 2 }'�!' � 3/ �' 3i- ` � �lY�� f� � � b j" ' � , �� '��.�` �,� `J !� - , j �� " 1 ✓ SWEEZEY, Raymond Box 364 Riverview Trailer Park Lot #76 Sebastian, FZorida 32958 UNIT I ADDN. BLOCK 38, LOTS .Z3 & 14 .�-- — Dorothy Sweezey interred 6-17-81 �a�"'"�`.� r, �, � � �/ �� .. _ DEED # 455 Cemetery 6-19-81 Sweezey, Raymond Paid by ��,I�s'f Receipt No. ...260 ... Dated........... BOx 364 Riverview Trailer Park ...... . Lot #76 List Price $. 350. OQ, , .... . . Dia�cimum No. Burial spaces . .2. - . • • • • sebastian, F1oTida 32958 * * * * * * , , Total area in squsre fat . . * .*.*. .*.* *•*• *• • Discount $ .. ............. Net Paid $. . .�S.Q..QO. . . . . . . Monument permitted f1 at ; , , , , , , , , , , , , , Uni t 1 addn . � Blk . 38, IAt 13 Dorothy Sweezey interred: 6-17• (Data above this line for City Record only) (Brevard County) R Name Unit_� .� � �) � Block � � 1� � � Lot Date of Mark-out Date of Burial l�� /i� f� Time �+� G� ��.�_• Name of Funeral Home �` � � � :t'. Authorized by �'�` � : � "'�>' ,.�� ,:1 � f1 � ,3 S� �, i3n, STATE OF FLORIDA UEPARTMENT OF NEALTH & REHABILITATi�7E SERVICES VITAL STATISTICS APPLICATION FOR BURIAL—TRANSIT PERNiIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased Raymond �, Swee2ey DEATH Dec. 31, 1985 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Roseland ' Inst. Humana Hospital Sebastian 3. Name of Medical 7� physician Address CertifierFarhat Khawaia� M.D. ❑Medical Exami�er Bay Street Center Roseland Florida 4. Funeral Home/ Name ss x�r,��cPottin�er & Son Funeral Home 1200 S. Indian River �`�`�� Sebastian Florida 32958 5. Check a� The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate b� was contacted on . He/she verified that Box 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 ical certification. Medical Examiner, will complete and sign the 2358 Jan 2, 1986 6. Fune�al Oirec'tor/ �t` \\ �� Signature Fla l.ic. No./Reg. No. Date Signed B. C BURIAL--TRANSIT PERMIT Permit No. 759-635 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 fited within this time limit, a"Funeral Director/Direct Disposer Report" witl be filed with the Local Registrar of the County in which death occurred. Registrar or Sub• Registrar AUTHOR Signature or w. Date '� Issued TION for CREMATION, DISSECTION or BURIAL—AT—SEA , Medical Examiner Date �, Medical Examiner, , gave authorization by telephone to Funeral Director/Direct Disposer. Date The Medicai 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. D. Method of Disposition: [x�BURIAI [� STORAGE � CREMATION [� OTHER (Specify) Signature of Sexton ) or Person-in-Charge ) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition JBn. 3� 198� Deborah C. Krages, C�'�y C{lerk This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no SextonJ and retumed 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.)