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Home My WebLink About1-37-13, , L J '; _ � . y, � �.��' � �7: £ ti �4,�, r�`� �' % 3 -� � � ��, ` , � � `�` z `, � _ �x � ".�_ � '� �� ° ��+ p � � � ° �� ° � . , . � � ,� � �� ; .-s� � �, � 0 � 4`ti, Q�� 4 � � ; �� ie �/� . i � �Y �, . � /L , .`� �'�� f � �`"3 �� w�� j`' � � t �� : � � � � �� .� �� `I � � � �� . 5 ,�\°� ��,.q : � �. _ - , � _ ` _ � �,y : ` � � n � � � r , �q � � 5 � � 'U R�+ ` .� / 2 V A . � ' � �� .� . V �� t � �,� ��' �7 �� a � �� a�a� \� � Z� 74 2 � �4 3 I . 3i- Ci' �� Rp . � , �.�= ""� ; . ��'`�� '' .,� . �4 � � � , r��Q aw r�`� �.�� , �. � �� -r ,.. c`� CEM Index:RECORD # NEwCEM - • � - City of Sebastian, FL - C�metery Lots Last Name Diamand First Name Elfriede F. Address 1 644 Badger Street Address 2 I;lt3! Deed # Unit # Lot Number Lot Number Lot Humber Lot Number Comment Comment Sebastian 546 Date i-A Black # 13 Interred 14 Interred Interred Interred <F?wrd <B>ack < Friday, Dec 17, 2004 09:47 AM State F1 Zip 01-30-84 Amount $300 37 Constatine Diamond CUet) lete CN>ext <F>reu <R>e E 32958- Dte Interred 02-01-84 Dte Interred Dte Interred Dte Interred >abel <T>a�r CEsc> Paid by CEMETERY Receipt No. . . , , 3 6 4 . . . . . . . . Dat� . . . .1 / 3 0 / 8 4 . . . . . . . . . . . . . . . . . �. NO. �',. t; � 'C � List Price S...30D..00........ Maximum No. Purial Spaces.....-2.:..... .... EZfriede F. Diamond Net Paid $ , , 300 :00 . . . . . .. Monument permitted . . . ,F1 a t . . .. . . . . . . . . . 644 Badger Stree t Sebastian, Florida 32958 Lots 13 & 14, BZock 37, Unit 1 Additional (Data Rbove ti�1a Hne for C[ty R�ecord only) M STATE OF FLORIDA "` / � �EPARTMENT OF HEALTH & REHABILI�VE SERVICES VITAL STATISTICS APPLICATION FOR BURIAL—TRANSIT PERMIT �✓� L � � � s �6 A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased O F Constantine Diamond DEATH Jan. 30, 1984 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Brevard Melbourne � Inst. Holmes Regional Medical Center 3. Name of Medical Physician Address Certifier pale Ryon, M.D. ❑Medical Examiner 1301 S• Hickarv St. MelbouCn,e, �ld. 4. Funeral Home/ Name Address �}C��t Pottinger & Son Funeral Home 1200 S. Indian River Dr. 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 6. Funer�l Director/ Direc� Disposer C � will complete and sign the medical certification of cause of death. c� was contacted on . He/she verified that medicaJ�rti fication. Signature Medical Examiner, will complete and sign the �.�G� Fla. Lic. No./Reg. No. BURIAL—TRANSIT PERMIT gned Permit No. �s � Sa � 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 with ihe Local Registrar of the County in which death occurred. � Registrar or Sub-Registrar Signature Date AUTHORIZATION for CREMATION, DISSECTION or F�CJRIAL—!�(`T—SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorizatian 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. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery �BURIAL � STORAGE Date of Disposition �l / 1984 � CREMATION � OTHER (sPecify) Signature of Sexton ) Deborah C, Kraqes, Ci ty C1 erk or Person-in-Charge j This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Dire or/Dire Disposer wh there is no Sextonj 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 he used.) I • Rscsrpr rs esRSer on th.ti,� �day o d��cr1�Q C�t�ry Lat r 1 �J TBS SEB�l.STIAN CBt�"!'aRY City of Sebastian Sebastian, flarida OF TXE SUN O�'t . � � '�,� � �s,�,�.QQ�...�..1 19�.� for th� purchs�� o! th� fo21ow1n� t�rms and candi t�ona �s �t�t�d b�z+�.in � D�escrtption of Prcperty: Cemetery I,ot(a)N� B1ockM UnitA�� Q�Ll� D � Dr�llar$lS��'�� Purch�se Price: a — 4v .- Terms and'conditions of 8a1e: ��'G�. �� e�,C -��T"� �C � '��Qa � � . This oontract shall be binding upon both parties, the se22er rtnd the pvrch�s�tz�, w?�n approved by the awner af the property above described. T, or we, agree to purchase the above described property a� tlie t�zm� and c�pnditio� stated in the forrq�atng �n�trwient: The City of Sebsstian agrees to se11 the abova �entionsd property to the abpv+ �ard purchaser(s) on the tox�r and �nditions stat�d �n t1� I�bow lnstrusent. . � ..// . _ _� ... � _� . . , Ni tnt�+t