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Home My WebLink About1-37-01; ; _ !,J ' ' s, �,�. �'�P' � 37 � . £ : : .- _t. �. �4�. rP�� T -� � � . a`� �`j 3 � , �� z � _ �� v �� c^ � � ° Q ,�' ��^ � d 4 ��cl � ` I'i � �� ' - � � � � � �4 � R�� -° , � � �, �O �.� � ' � �Y � /G :�� , a� ,� � k � ' �_3 �� Y � � �;� � � �� ,�! �� .� �� ,a�� ' _ ,�s j9 ' � g �� J� ; ..� ,:� `� / r� � � , � � � ':�i ' � '\�� - � {�� _ ' � �t�'; �`� � a � �. � a�� Z>, . 7y, 2 � �-q 3/ 3%- ` � , � , O �� "�� -�' � � r,,K, , f _ , ��'`� � . � � �� . � �,�� aw �' �, : - � �.'� . .. � III I _ .r 1� �'! ��. � Paid by CEMETERY Receipt No. . . 5 7 . . . . . . . Dated . . . . ..10 ,-4 �83 ......... . �SO oo -- L,iat Pria S . . . . . . . . : . . . . . . . . . . Maximum No. Eurial Spaoea . . . . .1 . . . . . . . . . . NetPaids ,,,,350:00., flat . • • . Monnment permitted . . . . . . . . . . . . . . . . . . . . . . . Nd� 053f� JEAN SHANNON P.O. BOX 912 SEBASTIAN, FLA. 32958 (BAREFOOT BAYJ R& R ISSUED (DstR abo�e !bV lim for CYt� Iiecord only) LOT //1, BLOCK �37 , UNIT //1 ADDI ,/l./ �u,v��-7 . ti "'`'^�� -�! ry V SHANNON,; JEAN LOT #1, BLOCK 37, Unit #1 Addition A1 Shannon, Interred, Lot #1, BZock 37, Unit #1, Addnt. Auqust 19, 1983 . e� _ `', _ u � � � � � RECEIPT J on thi s��da y of described Cemetery Lot(' • 3 �'� �r TAE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida �, 19b�,for the purchase of the following the terms and conditions as stated herein: Description of Property: Cemetery Lot (s) # ,� B1ock#s�� Unit�YT Q�L�i!��i1.i'. Purchase Price: lY d��, /� (J Lbllars ($ �) Terms and'conditions of sale: /�C�,��.��- �iL`�� ` �S�- � � � This contract shall be binding upon both parties, the seller and the p�rrchaser, 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 instrwnent: The City of Sebastian agrees to se12 the above mentioned property to the above named purchaser(s) on the t�rms etnd conditions steted in the above fnatrument. Wi tne�ss � � �i ./. _� _'�� r • -.. - . LJ hlayor Pat FZood, Jr. City of Sebastian Z225 Main Street Sebastian, Florida 32958 Dear Mayor F1ood: � Auqust 17, 1983 I herewith promise to pay the sum of $350.00 for Cemetery Lot No. 1, B1ock 37, Unit 1 Addition, in the Sebastian MunicipaZ Cemetery, when insurance settlement is made. Approved by: / �` � � �1�✓ . - ... . .�� ,�-�° � Very truly yours, Q�` C G. �yc��A,ry,� Jean Shannon �/� � �3 / �� / STATE OF FLORIDA �ARTMENT OF HEALTH & REHABILITA� SERVICES VITAI STATISTICS APPLICATION FOR BURIAL—TRANSIT PERMIT �- 1 � � 7 u /�i A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased O F ALBERT ONEAL SHANNON DEATH q�9. ��, 1983 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian �"$t� Sebasti.an River Medical Center 3. Name of Medicai %�] Physician CertifierEi 1 iott Landf ield, M.D. ❑Medical Examiner 4. Funeral Home/ Name 5. Check Appro- priate Box a b X� c � Address 100 Woodlake Plaza Suite 6–B, Palm Bay Address F 1 . The medical certification has been compieted and signed. A completed certificate of death accompanies this application. Dr. Lanf i el d was contacted on $�. He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that He will complete and sign the medical certification of cause of death. medical certification. 6. Funeral Director/ % �Sgnature Direct Disposer � � ' ,� �L�c..�G-r' � B C � is contacted on . Heishe verified that Medical Examiner, wi�l complete and sign the Fla. Lic. No./Reg. No. BURIAL—TRANSlT PERMIT 1672 Date Signed August 18, 1983 . PermitNa �228-$3'2�1 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 filed within this time limit, a"Funeral Director/Direct Disposer Report" will be filed witi} the Local Registrar of the County in which death occurred. Registrar or Sub-Registrar Signatu Date Issued Q�+�ust 1�7 19.�? AUTHORIZATION for CREMATION, DISSECTiON or BURIAL—AT—SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telephone to Funerai 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. Method of Disposition: �yBURiAL � STORAGE � CREMATION � OTHER {Specify) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition Auqust Z9, 1983 Signature of Sexton j or Person-in-Charge ) City CZerk This permit must be endorsed by the Sexton or person-in-cha�ge (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. HRS Form 326, APR. 81 (replaces previous editions which may be used.)