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THIS INDENTURE MADE T�1s ......Z.�tll......... day of .........AUgllSt .......................... A. D.;��8..2��1
beti�•een il�e CIty of Sebastian, a municlpal corporation exieting undcr the laws of the 3tate of Florfde, es Grantor and
CINDY SWAIN
. . . . . . . . . . . . . . . . .. . . . . ... . ........ .. . ..... .. . .1.3.�.. �AP�� "Av�1�tf�.. . . ... . . . . . . .. . . . . . . . . . ... . . . . .. . . . .. ..... . ........ . ......
............................................. ..SEBASTIAN�.. FI,ORIDA„3,2958............................................
oi the County oi ....INDIAN..RIVER FLORIDA
......................... an] 5tnte of ......... .......................................
ae Grantee, WITNES3ETHe
That the Grantor for and in consideration of the sum of S,; 5 � �; � 0, ,,,,,,,,,,,,,, to it in hand paid, the receipt whereof is herewith ao-
knowledged, does by this instcument grant, bargain, sell, release, convey and confum unto the Grantee ,,,,,,,,, heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, tawit:
All of Lot(s) , 22, ,,, Block, ,,.? �.,, UNIT 1-A�D I T� O,�f Sebastian muniapal cemetery as per Plat Number 1 thereof recorded 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 Floiida; said land now lying and being
in Indian River County, Florida.
To Have and to Hold the same forever; ptovided that said property shall be.use� solely 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 resolutiona of the City of Sebastian, Florida, hereto-
fore, now and hereafter adopted or provided for the goveinment and operation of said cemetery. The conditions, restrictions and requirements 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, regulations, resolutions and ordinances and the conditions of the dded of conveyance thereof then the title of such owner
in and to said property sttall terminate and the same shall tevert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of the first 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 corporate seal to be hereto afiixed, the day and year first above written.
. �-.� ��.- . . . . . . . . . . . . . . . . . .
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STATE OF FLORIDA
COONTY OF INDIAN R1VER
CITY OF SEI3r1STIAN, FLORIDA
B, �,�>�..��,..�.. .�'.s..o�:.�„� ..........:.....
Ms�or
��I[t� �YMI�
I HEIiEBY CERTIFY, That on thia .... 27tYi .............day of ......... �lUgUS.t..............................., �..?j0�1
before me personally appeared .....Wc,l,lter'..W.•...Ba.r?�Q.$ ...............:.......... and ....Sa�.a..y..A.....�r�a.0.............
respectively Mayor and City Clerk of the Cfty of Sebastien, a municipal corporution under the laws of the Stete of Florida to me known
to be the ind3viduuls und officers descrlbed in �nd who executed the toregoing copveyunce to
. . . . . . . . . . .. .. . ... ... . .. . .. ...... .......... ... . . . . . . . . . .. . .L,�111C�.X. . �,.S,Wc,`llll...... . . . .... . . . . . . . . . . . . . . . . . . . ........ .... ... ... ... . . . .
........................................................ and severally acknowledged the exeeuUon thereof to be their free act and deed
as such office�s tl�ereunto duly authoriaed; and t6at the Officisl seal of said corporation ia duty affixed thereto, and the said conveyance
is the ect and deed of said corporation.
WITNESS my signature and officlal eeal at Sebaetian, in the County of Indlan Itiver and 3tate of Florida, the day and �ear
�NRt Nf[IP1!NAI(�_ �
��id�
=�ti�!s: rr;� : H. JOANt� SAI�lDBERG
<: ,� Mv coMMissio►a � cc �a5ea2
�� , EXPIRES: AprN 30, �002
�,�����,�' 9onded Thru Notery Pubic Undenvritaro
. � . ......�.. .... ...................
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Nota ubllc, 3tate of Florida at Large
My mmiesion expires r
G't CEM I
Index:RECORD # NEWCEM Record:1715
Last Name
Address 1
Address 2
City
Deed #
Unit #
Lot Number
Lot Humber
Lot Humber
Lat Number
Comment
Comment
City of Sebastian, FL - Cemetery Lats
Swain First Name Cindy
130 capri A�e.
Sebastian State
1815 Date 08-27-01
i-A Block # 37
22 Interred Mae E. Parrish
Interred
Interred
Interred
See Reeder far lot 22
F1
pmount
Zip
$500
32958-
Dte Interred 08-28-01
Dte Interred
Dte Interred
Dte Interred
<F>wrd CB�ack CE>dit CD}elete CN>ext {P?re� CR?e-search tL>abel CT
Friday, Dec 17, 2004 11:54 AM
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Name
Unit � � � � "-�
Block
Lot
� t9 _
Date of Mark-out
Date of Burial
Name of Funeral Ho.me_
Authorized by
.
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Time � ' ���
0
F1AR[DA DEPARTMENT OF
HEALT
A.
1. Name of
Deceased
First
°� / ��'�' - � .� 7 -
State of Fiorida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
Middle
Mae Ellen
2. Place of Death City, Town or Location
Counry
I ndian River Vero Beach
3. Name of Medical
Certifier Freedland Williams, M. [
� �Medical Examiner �
4. Name of Funeral HomelDi�t@ispvsal
Establishment
Strunk Funeral Home
Last Date
of
Pa r ri s h Death
Name of (If neither, give street address)
Hosp. or
inst. VNA HOSPICE House
1360 U.S. #1
Vero Beach, FL
Address
1623 N. Central Ave.
Sebastian, FL
� az
Month Day Year
ust 24 2001
Number
561-567-4500
Lic. No./Reg. No. Phone No. (Area Code)
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 8/27/O1
b, � JesiCCB was contacted on
He/she verified that this death was from natural causes, that there was no accident nor other extemal cause of death,
and that Dr. W11118�1'1S will complete and sign the medical
certification of cause of death within 72 hours.
6: Funeral Director/
B.
��I
was contacted on
death within 72 hours.
F.E. No./Reg. No.
� �.—�- - ��,2
BURIAL - TRANSIT PERMIT
He/she verified that
, Medical Examiner, wi�l complete and sign the
Date Signed
8/27/O1
Permission is hereby granted to dispose of this body. Permit No. � 228-01-0421
� 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 cornplete 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.
�}y��--* Date Date Cert� ate
Subregistrar Signature ��y,.p�,�.,. /l� ��.�.��Q Issued: � l.� �` O � Due: $�.'Z�( � O)
T __
�
C. AUTHORIZATION for CREMATIOId, DISSECTION, or BURIAL-AT-SEA
Approval Number: Date
Medical Examiner, , gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is
required for all cremations.
p. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemtery
�BURIAL �STORAGE Date of Disposition � �,� S /p /
�CREMATION
Signature of Sexton
or Person-in-Charge
�OTHER (Specify)
�
This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned
within 10 days to the local County Health Department in the county where disposition occurred.
Distribulion: V1fide: Cemetery a Cremetory
DH 326, &97 (Obsoletes all previous editions) Yellow: Funeral Diredor a Direct Disposer
(Stodc Number. 5740-000-0326-2) Pink: Local Registrar
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August 28, 2001
Cindy Swain
130 Capri Avenue
Sebastian, Florida 32958
Deaz Ms. Swain:
Enclosed is City of Sebastian Cemetery Deed No. 01815 for Cemetery Lot 22, Block 37, Unit 1-
Addition.
Also enclosed is a copy of your receipt.
If you have any questions, please contact our o�ce.
Si y,
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. ' ', CMC
City Gle -
SAM:js
�i'he 5���.s�a�: �e�n���-y
Ci�y af 5e�a.s�.�., �1o��a
Receipt is acicnowledged in the sum of:
0
From:
I ?� � �� A�� � C�.11�
T
.. , � �r- 1 � � /'i/ ('i
Dollars ($ �DD - D � )
on this o2 7� da.y of , 200 / for the purchase of the following
described Cemetery Lot(s)/Nich s) upon the terms and conclitions as sta.ted herein:
Description of Praperiy:
�
Cemeiery Lot(s)/Niche(s) �� Blocic � 7 Unit /- fd�A�Tid�
Purchase I'rice: T,J,� (l�i�i� .�p �_ Dollars .($ SD�> D�� )
Ternis and Condition of Sale:
1'his contract shall be binding upon both parties, the se]ler and the purchases, when approved
�by �the owner of the property above described:
I, or we, agree to purchase the above described property on the terxns. and condiiions sta.ted in
the foregoing instnament '
` r c�J �.��
purchaser si ture
Purchaser signatwre
The City of �Sebastian agrees to sell the above mentioned property to the above narned
purchaser(s) on the terms and conditions sta,ted in the above instrument.
ity of Sebasiian Witness
,. . ,.aL+ ".�� .,., . „ _ - f: � e� ,.�
'�
CITY OF SEBASTUN
CITY CLERK'$ OFFICE.
RECEIPT `
Name �.�`:�.��4� r.•.�' � �� Cash "
�.
p� ,� ' � ,��– t_'� / ❑ Check *
No. jG.f �V AmountPald �':
r ' �
001001 208001 Sales Tax
001501322900 Garage Sales
001501 341920 CopieslBid Specs:
001501 341910
001501 362100
001501 062100
. 001501 362150
001501 343800
601010 343800
001501 369400
001501 369400
680800 220681
680900 720682
680800 710683
LDClCode of Ordnances —
Community Center Reni
Yacht Club Rent
Non Taxable Rent
Cemetery Lots ��"���
Cemetery Lots `�t �r, ;r rY; ;'
LotMiche . �: �' , Biock �."f �� , Unit ! '3)
Interment Fee
Weekend Service
Yacht Club Securiiy Deposii
Community Center Securiiy Deposif
Riverview Park Secuoiy Deposit
t`�' :,�` � ��7/� r;,
� 1 Toai a�d .,<<.� ����
Initlals
� ` � Whip - D�pt. of;Oriqin • ��Iow , Fin�nc� ; • Piek • ApPIic�M - ` ;
PaidbyCEMETERYReceiptNo...,1008, ,,,,,Dated....8�27�2001,,,,, ,,, ..
List Price $ . 5 � � • � � , , , , , , Maximum No. Buriat S�ces . . . . . . . . . . . . . . . . .
Net Paid $ , 5 0 � • � � . . . . . Monument permitted . . . . . . . . . . . . . . . . . . . . . . .
(Data above this line tor City Record only)
BLOCK 37 LOT #22
LEO AND /OR NAOMI REEDER
8Z0 DEMPSEY AVENUE
SEBASTIAN, FLORIDA
32958
DEED #518
Receipt #009
�_
SWAIl�, CINDY
130 CAPRI AVENUE
SEBASTIAN, FLORIDA 32958
UNI T #f 1 ADDTN .
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DEED ��1815
LOT 22, BLOCK 37,
UNIT 1-ADDITION
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i���Gt-� C= • � � C� "02 c� 'il �
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CINDY SWAIN
NO.
��i�v
LOT 22, BLOCK 37,
UNIT 1-ADDITION
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