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Home My WebLink About1-31-09 Name MN Ill' y N 1t1 E�, Unit 'Block 3 Lot 9 • Date of Mark-out c� /Q 6 Date of Burial ..'76/8 6 Time /f, C O Name of Funeral Home /D ?r r f ` 7 F i`= ` ` s.) ::,',� , j /l /, %/.. ( ! Authorized by - - .:71 or HOME OF PELICAN ISLAND Certificate No. 2081 < , d E JA ' . 1AA% Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: 1 Deborah M. Dillahay 1101 Turtle Run Dr., #107,Sebastian,F132958 (name) (address) in and for consideration of the sum of $450.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot/niche: Unit 1_Block_31_Lot(s)Niche(s)_8, 9 & 10*_ of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 1st day of May 2006. CITY 'i F SE:A IAN, FLORIDA ATTT:, /7/ / )44 'r /' inner SajMaio, MMC City Manager City Clerk *Replacement Deed for Deed #1077 aehaligiMi-II...MAI_Ilei7:752.Tr__11,_.11f_Zia_74-li- -----/ SHEET NO. , 3 I MS . .._ _ INC ..,, ,•'EDIT LIMIT - 1 , • ..‘• ' ---- 44.1 / ,1,....., -.0 A/ ■ 1-r ; )A k A//,;e: r-EE 0 2:1 , . 1 A-,,_.. / 4 1 4 AtA/Pie / f(...0 .14S rtiC•ay...5 pi i,„frt K- . .1...-^ . Pi k4 , eii.s-J-■•A ,I . • • Q q.,ski L.-- .\\P 4 7,/,..---,-, t 0.1-, t 0..,,, . . 0 . , c. ,‘ ., -JD- dv,c, . , /,,* ,-,/,‘ -,.r, I n ‹. •-.. , i. .':, 09,5/ \ . 1. a J.r■ .. ,,.,...:z; S a.i./1 1,a),. •". , ) '', • ? )-1 ";) -11 7 , 74).Z....--k 11,= • +,,, "IP "I° • /96 Y. le H g S, t-h, f.01.r1 • ■... '11.,., .1,.,1, C:L. ::, .), 2 J3 .- J V. / I f" 1 l./_.: , •3 i• .1? t qf I K(L.L.,. I . 11.).,4,-.--,.....- /414-1-4" 7//. . w.. f %' • 1.---- i.------ V / -.• i , iv.//14, tv1" ,z) _ '....., . 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List Price$...9QQ:.QQ Maximum No.Purial Spaces...six ' Net Paid$ 900.00 Monument permitted Fu1T •-. 1 G 7 7 Lots 8,9,10,11 ,12,13 Stanley Dillahay Block 31 , Unit 1 (Data above this line for City Record only) PO Box 1 239 - Sebastian,FL QIttg of f6rtaitian Trinett tj 13jf1 NO. f 1677 THIS INDENTURE MADE This 28th day of March A. D., 19 86 , between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Stanley Dillahay ,,, Po 2oK.12 9.,.. ebaati.all of the County of ..IRO j-.an,Riy.Qr an•] State of ...F.l car ida as Grantee, WITNESSETHs That the Grantor for and in consideration of the sum of$ 900.00 to it in hand paid, the receipt whereof is herewith ac- knowledged,does by this instrument grant,bargain, sell,release, convey and confirm unto the Grantee her heirs,legal representatives and assigns the following property situated in Sebastian,Indian River County,Florida,to-wit: 8, 9,10,11 All of Lot(s)1.2...1B,Block, 31 ,UNIT 1 ,of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St.Lucie County of Florida;said land now lying and being in Indian River County,Florida. To Have and to Hold the same-forever;provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used,kept and nfaintained at all times in accordance with the rules and regulations,ordinances and resolutions of the City of Sebastian,Florida,hereto- fore,now and hereafter adopted or provided for the government 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 deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert 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 qn its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed,the day and year first above written. CITY OF SEBASTIAN, FLO; IA Attes • ...- y`/L )...e. .i *ua-- . B7.I�. ...` —; .°ra+?r City Clerk ' Mixon.,,, Signed, Sealed and Delivered " In the Presence of: . __ ,,t a. /�, g $ __ . U , %)",---)e)--e_rt._ Rvi?,,c._el --- _ STATE OF FLORIDA •nnrTwry nR TN►1IAN P1VRR . STATE OF FLORIDA / Y - / `l �ARTMENT OF HEALTH & REHABILITA SERVICES 6 07 VITAL STATISTICS APPLICATION FOR BURIAL—TRANSIT PERMIT la / A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF Mary Agnes Learned DEATH May 2, 1986 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 • [Physician Address Certifier Noor Merchant, M.D. ❑Medical Examiner 7955 Bay Street Roseland Florida 4. Funeral Home/ Name Address 301143f IciMpotxxP ottinger & Son Funeral Home 1200 S. Indian River Dr. Sebastian Florida 32958 5. Check a 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 compete and sign the medical certification of cause of death. c ❑ was contacted on . He/she verified that , Medical Examiner, will complete and sign the medic certification. " #2558 May 3, 1986 ■ 6. Funer. Director/ Signature Fla. Lic. No./Reg. No. Date Signed i,•.0 :. .'M XXX B. BURIAL—TRANSIT PERMIT 76"9- 6,7 Permit No. 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 the Local Registrar of the County in which death occurred. • Registrar or Date � Sub-Registrar Signature / :-.0. ' Issued 9-2.74 9 6j /yJ'b i II 1 C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA Signature , Medical Examiner Date or 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. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery ES BURIAL ❑ STORAGE Date of Disposition May 6, 1986 ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) ,ij n/ & "LK ce4 / or Person-in-Charge ► ��1�,. ( y Deborah C. Krages, C' ty Clerk 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. HRS Form 326, APR. 81 (replaces previous editions which may be used.)