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Paid by CEMETERY Receipt No. .. �� 8. . Dated .... S� 8� 9 Z L O t i$
BIOCIC �
List Price S.. ... ./{OO.•OO •• Maximum No. Butisl Spaae ............. ... . Un i t j
NetPaSdf ,,,,..400.��
....... Monumentpermitted .......................
David John DeGraeve Sr. interred 5/9/92
(Dets sbove thle Ilne tor Gty Record ooly)
f�it� nf �rb�siittrc
�PI1tP#��1� ��P�
NO.
NO.
1 � V V
'�1360
TH18 INDENTURE MADE 7iL .....$.kll.... .. ... dsy or ....Ma.y .................................... e. n., 19..9.�.,
bet�cren Ihe City of 3ebaetlan, ■ munklpsl corporatton e:ixtins undcr the laws of the 9tete o1 Florld�, es Gnntor snd
Terry DeGraeve
............................�.4.0. Pe�riwin•k•�e Drive.........................................................
Sebastian, FL 32958
.................................... ............................................ . ... ......................................
o� �h� coo�cy ar ..,Indian River Florida
.................................... •nl 9fate ot .......................................................
�e Grsntee, WITNE89ETH�
That the Grantor [oi and in consideraUon oC the sum of S....Q�O . QQ• •••••••••••• to it in hand paid, the roceipt wheroot is herewith ac-
knowkdged, does by this instrument grant, bargain, xll, releax, convey and confirm unto the Grantee ,.};e,�r, ., heirs, legal representatives and assigns
the following propeKy sltuated in Sebaatian, Indian River County, Flodda, to-wit
All of Lot(s) , l 8... . Bbck, . 36. ... , UNIT ,,..1, ,,,,,,,, of SebasHan municipal ametery as per Ptat Number 1 thereo[ recorded in Plat
Book 2, at page 65 of the pubdc records In the offlce of the Ckrk of the Ctrcuit Court of St. Lucie County of Fbrida; �aid land now lying and bei�
in Indian River County, Florida.
To Flave and to Hold the same [orever, provided that sald property shall be used aokly and exclusivety for the interment of the human dead and shall
be used, kept and maintained at aIl times in accordana with the rules and regulatlone, ordlnancee and resolutiona of the City of Sebastian, Florida, hereto-
Core, now and hereaRer adopted or provlded [or the government and operatlon o( seld cemetery, The conditione, roatddions and requiromenta contained
in this instrument shall be eovenants tunning with the Isnd. In the evrnt of the failute of the owner of any property situated within said cemetery to ob-
serve and mmply with iuch rulea, roguletlons, �esolutiona and otdinanaa end the conditione of the debd of conveyena thereof then the titk of such owner
in and to aaid property ehatl terminate and the same shall revert to the City oC SebasHan, Florida.
IN WI►NESS WHEREOF, The said party of the first pazt has caused th{s inatrument to be executed in its name and on its behal( by its Mayor and
attested by its Clty Clerk end its corporate aeal to be hereto effixed, the day and year first above written.
j CiTY �OF S B IAN, FLORIDA
_- �`�it,+�t � ��a�� � `'
eu�st. . . ..'...... ... .......
.............................. B�
Clty Clerk s�or
tiignrd, Sexled und DeHvered
. Irr-F e Prosence oR� ,
; " � �/�
. �....!.� .... ................... .....
� ...��.......
(Qlit� �eal)
S7'A'fE OF Fi,ORInA
COl'N'fY OF INDfAN RIVER
I fIF.IlE6Y CF.RTIFY, Thst on thte ... $th ................adv �r .......May ...................., �e..9.�
..................
brfure nu pereonelly a���a��a �oc�nie..R.,..8owe11 .............................. s�aKathry.n..M,...O•'�Hal.lor.a.n...
resp�•ctively Meyor and City Cl�rk of the City nf 9ebestian, a municipnl corporrttiun unde� the lewa of the 9tate ot Floride to me known
to br lbe indi�•idui�le nnJ officcra descrlbed ln und who execulcd the furrguiug cunveynnce to
................................ Te,rrY...DeGraeve...................... ............................................
..... .................................................. snd Fevernlly acknowledgrd the executfon thereof to be thr.ir free nct nnd dred
es surh otficers lhereunto duly eufhorized; end thet the Oftfcixl seai ot eeid corpornlion is July effixed thrreto, nnd the setd ennvayancr
is fhc nct unJ decd of ee{d rnrpordion.
�1'lTNE39 my elgneture end otficlel �enl at 3eAaetfan, In the Coµnty ot Indlen R�ver ond 3t e o( Floride, the day end �ee-
Inst xforresid.
_ �L � r
UNDA M LOHSI . ...... ... .. . ...................
Nopry FubBeState ot Florld� Note Publle, 3tste o Florld st Lr�e.
My Comrnissbn EwphN JUN /�.1001 My mmieeton expir r
����0��w Linda M. Lohsl
Paid by CEMETERY Receipt No. . .7 � 8. . . . . . . . . . Dated . . . . 5 �.$ � 9 2 , L O t 18
List Price $...... , B 1 o c k 3 6
�F��,•�� � Maximum No. Burial Spaces . .. . . . .. ... .. . .. . jJril t 1
Net Paid $ , , , , 4 � � ; � �
. . . Monument permitted . . . . . . . . . . . . . . . . . . . . . . .
David John DeGraeve Sr. interred 5/9/92
(Data above this line for City Record only)
I
� � � �
aR � s- �
Unit .,�..
Block
t
Lot i
Date of Mark-out
Date of Burial ��=T,� �.' �-� - Time /�;�� --� a�J �
Name of Funeral .Ho
�
. � .,
Authorized bv ��
�—�� �!T-' r � 1 1�--
`, .
_ ._
�e � rQ.��(e� l e�r r
7�-��e�►w�n k.le�-�v�
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� o h n o..v; c� J.�e � r�a.e.Ye �': i►� �-e.�r� �" �i�
1�1
NO.
1c�VV
_ State of Florida, Department of Health and Rehabilitative Services, Vital Statistics
A. rT„�o p
1. Name of
Deceased
or nnt)
Firsi
APPLIC�N FOR BURIAL — TRANSIT PERMIT �
Middle
Last
L / �,
� ..�;/
L/ T ,
DATE Month Day Year
OF
DAVID JD�J ��E �. DEATH
2. Place of Death City, Town or Location Y� �
County Name of (If neither, give street address)
Hosp.or
Tnr�i an i�;.�o,- .. _ . Inst.
3. Name of Medical
Certifier
Frederick P. Hobin,M.D
4. Name of Funeral Home/
Direct Disposer
Cox-Gifford Ft�neral H
5. Check a �
Appro-
priate
Box b ❑
6� Place of
Final Disposition:
�• Funeral Director/
n;��+ n��„� ..
B.
C.
�
Medical Examiner Addi
2500 S. 35th Street
M.E. Phvsician ��..,..� „_ ____ .,, . ,
Phone Number
Address Fla. Lic. No./Reg. No. Phone Number (Area Code)
1950 20th Street
asne
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.
In state cemetery/ g�stian CPSnetery Removal
crematory - name/county: from state Donation
_, Signature F.E. No./Reg. No. Date sign d
°� _ S/9��2
BURIAL — TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 14 -11 -1
❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship
would result 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 County in which death occurred.
❑ No extension of time for filing the death certificate requested.
Registrar or !'� Date / Date Certificate
Subregistrar Signature X, �A Issued: `7 Z- Due:
AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA
Signature
, Medical Examiner Date
or
Medical Examiner, , gave authorization by telephone to
The Medical Examiner's a Funeral Director/Direct Disposer. Date
pproval must be obtained before disposal by any of the above methods. A waiting period oi 48 hours after
death is required for all cremations.
Methods of Disposition:
� BURIAL
❑ CREMATION
Signature of Sexton )
or Person-in-Charge )
❑ STORAGE
❑ OTHER (Specify)
CEMETERY OR CREMATORY
Place of Disposition � 5 G 13 ��% ig ,�/ ('� = f_ i. ���o�
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)
�
.
RECEIPT IS
�
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
Y ACKNOWLEDGED OF THE SUM OF:
*%Cl �
�
FROM:
on this day o , 19�o�-for the purchase of the following
described Cemetery Lot(s) po the terms and conditions as stated herein:
Description of Property:
Cemetery Lot (s) # � B1ock# ��((J' Unit# �
Purchase Price: � Dollars( ,•� )
Terms and'conditions of sa1e:
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:
The City of Sebastian agrees to se11 the above mentioned property to the above named
purchaser(s) on the terms and conditions stated in the above instrument.
/
Ci y of Sebastia
` /
, 'w
GiJi tness
�
City of Sebastian
�
POST OFFICE BOX 780127 ❑ SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330 ❑ FAX (407) 589-5570
May 14, 1992
Terry DeGraeve
740 Periwinkle Drive
Sebastian, Florida 32958
Dear Mrs. DeGraeve
0
Enclosed is Cemetery Deed No. 1360 for Cemetery Lot 18, Block 36,
Unit 1.
Also enclosed is a form - Return for Transfers of Interest in
Florida 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 office of the Clerk of the Circuit
Court, 2145 14th Avenue, Vero Beach, Florida. •
We are enclosing two copies of Receipt No. 708 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 your convenience.
Very truly yours,
�-���.,;., _ �` �-, ,'.�-
�`�'`� G %�� , �.
Kathryn�.M. 0'Halloran
City Clerk
KMO:lml
enclosure
(\ws-form-cem.rec)
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C��ent�t�er� ��e�e�
N° . 166
23rd Apr�l ?1
THIS INDLrNTURE MADE 1�is ...................... day of ............................................. A. D., 19......,
between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida� as Grantor and
.... ....................... mrs...Roland. S•..Bu�be6............................ �Ro.Zand..S.'.. Bugbee interred Lot 17)
. .... ........ . . .... - -
, Roseland,
............................................. .........................................................................................
of the County of ..,Indian River Florida
....... ................................ and State of ............... ......................................
as Grantee, WITNESSETH:
That the Grantor for and in consideration of the sum of �. ..**�5 0•. Q.Q*� . ........... .... to it in hand paid, t}�e receipt whereof
is herewitl� ncknowledged, dces by this instrument grant, bargain, sell, release, convey, and cuufirm,unto the Gzantee...t1181T heirs, legnl
representatives and assigns the following property situated in Seba tian, Indian River County, Florida, to-wit:
Blk. 36, Unit �1
A 11 pf LotS.. .1?. . &.�i. . . . . in Section . . . . . . . . . . . . . of Sebastian municipal cemetery as per Plat Number 1 there-
of recorded in Plat Book 2, at page 66 of the publiC records in the office oY the Clerk of the Qireuit Court of St. Lucie
County oP Florida. �T 18, BLOCK 36, UNIT Z, WAS REPURHCASED BY CITY OF SEBASTIAN ON 9/24/80.
Ta Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of
the dearl and shnll be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions
of the City of Sebastian, Florida, heretofore, now and hereafter adopted or provided for the government and operation of said ceme-
tery. Tl�e conditions, restrictions and requirements contained in this instrument shall be covenants runnaa� with the land. In the event oF
Uie failure of the owner of any property situated within said ccmetery to observe and comply with such rules, regulutions, resolutions
and ordinances nnd tl�e conditions of the deed of conveyance thereof then' the titie of such owner in and to said property sl�all terminate
und the same shall revert to the City of Sebastian, Floridn.
IN WITNESS WH�REOF, The said party of the first part has caused this instrument to be exeeuted in its name and on its be-
half by its Mayor and attested by its City Clerk und its corporate seal to be hereto affixed, the day und year first ubove written.
Attest: G2�.... ......... ........................
City Clerk
Signed, Sea]ed � Delivered
in the resenc f:
.�� .�..�.......... ...• ...............
" "" �GZ�c'/�1.; ;-,.-�_..�
..............................t,/...
CITY OF SEBA6TIAN, FLORIDA
/
B� . . . . . . . . . . CL,�!�'. . .,�. .� : :d' .�i��', �'!. . . .
Me.yo
(fdi#� �etc1)
STATI's OP' FLORIDA -
COUNTY O� INDIAN ftI.VER ��
: i-:E:trrye�- �Fn7•I_r,Y, ?`h»t .... +_his ........! . �e.�......day of . .....��,.!�. /�.�-r—•J ........................... 1�..7.;
before me petsonally appeared ........,,,ChaT198 5. Zimme� A. T. Jordan
............................................ and .......................................
respectively Mayor and City C1erk of the City of Sebastian, a municipal corporation under the laws of the Stute of Florida to me known
to be the individuuls c�nd officers described in and who executed the foregoing Conveynnce to
mrs. Roland S. Bugbee
.......................................................................................................................................
........................................................ and severally acknowledged the execution thereof to be their free act and deed
as such officers thereuntp duly auttiori�ed; and that the Official seal of said corporation is duly affixed thereto, and the said conveyuncc
is thc act and deed of said corporation.
WITNESS my signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day nnd year
last aforesaid. - �
. C�L1!`.'c�c'e_' . �12� . . . c!. . : `.�'`'.`: .�:?'L� . . .
� Notary Public, Stnte of Florida at Large.
M� commission expires:
S� a4 Fbcida at L.arBe.
� NotarT R�� ��es Februa�Y �� 1972�
MY CO►^^�ission Exp p A,e„�v.
. Bonded bY Atha Insu��nc-