Loading...
HomeMy WebLinkAbout1-35-33 - ------------ --------- _ Name ivErr-r.E "Lien 4<ci yi G( Unit Block 35 Lot 3,3 Date of Mark-out LP((a ( Date of Burial / 0 0) Time /4.0 o' 4 . Name of Funeral Home 5 rk,(1-ilg(5 • Authorized by _ _ r r ! x �A r # - , 1 I I � � , 1 i� w I ' DT'. i st�,e� ' . It. Ai,,Q T Pow 1 , p/M a MO RE _ 4 P'. I . h ' C. , al ERY15 h i C rMMA 1.of wn, ✓ ))1 f.R£C"rt4A+ • ..r l b 2 i A`. I I i 'i47' ,9h9 ,4'11- Sncn 14'(ti 11_L� ca1,, 19`t: ' lq'`1.3: 11g8,� .r■II P,�.kr?-t, TO.r60 79R p ERIC, rrxeMe, t✓ ✓ I I `� S,8. . - : kh.� •i _ 5.° 1 e lab i v I z,�. as 23 /{ '. ar as a� sr+8 �9 Iu 30 E��6 �Iv MARC7/1 cHfl RI■E i :: nt,r Elle. , W' fo5tpN1 3,. w IN 'N4 , FREDRc;0 l 1 I. /9 7R /41;2 '.4 7.3 '`,�i:`6 i47,3 _1489_ ,e031 -r,,' ill `1j r3; 1 ,EA! -, { �" 31 I 1 dS 37 39 1 1 1 SoFU e1 n 1 s'[erE pt • ' ; o,1,s Yi i Ii1P.G1,NlA / 9•NifIl,• I I O I j / lN' i (. 1, S, ,99 201 �� ','.• 1473 ¶hE/Ft '<..,,n rl '1 / 1913 19b0_1 ,t /Pt 5. .a1' 1 5 :'r. I '' YP-.2 ' 1 -I I I lI Paid by CEMETERY Receipt No N/C..TzansferDated 8124183 NO. Deed #531 List Price SN./.C.2X•GiI1.5,fgC..— Deed#199 Maximum No.Purial Spaces —1— Receipt #353 Net Paid$ Monument permitted Flat Nettie Arlene Kolmel P.O. Box 56 Lot #33, Block #35, Unit #1 8095 Havenview Road (Data above this line for City Record only) Roseland, Florida 32957 r q� . \ • III . . .. . .-:e,(C.).°) THE SEBASTIAN CEMETERY . ,3 3 \ City of Sebastian ti ' Sebastian, Florida • RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: Dollars ($ /ei • ) FROM: ) E27L- LAC%/,C FX..2 it it ii)AP. `_rte ���_�, .rf•/ 40.4! - __-_, - I. .I L 1 .eot/Z cticz. a g5-7 • on this d..514--day of , 1981 for the purchase of the following described Cemetery Lot(s) u the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)# *g Block# .36 Unit# // Purchase Price: /1 • C. Dollars($ GV-C' . ) Terms and conditions of sale: 'J2 41 )",—d e */9 )(-( C. 4-14-6‘., 4 a4.Ja-L " This contract shall 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 sell the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. (C-;; --11111 ity of Sebastian Witness FLORIDA DEPARTMENT OF / HEALT • S !!I'PLICATION FOR BURIAL-Health TRRANSIT PERMIT'cs 3 3 A. (TYPE) 1. Name of First Middle Last Date Month Day Year Deceased of Nettie Arlene Kolmel Death June 5 2000 2. Place of Death City,Town or Location Name of (If neither,give street address) County Hosp_.or Indian River Vero Beach Inst. Hospice House of Vero Beach 3. Name of Medical Address 1460 36th Street Phone Number Certifier Michaela Scott, IC2. Vero Beach, FL 561-562-7777 nMedical ExaminerPhysician 4. Name of Funeral Home/aiseet-eisposaF- Address Fla. Lic. No./Reg.No. Phone No.(Area Code) Establishment 1623 N. Central Avenue Strunk Funeral Home Sebastian,FL 1228 561-589-1000 5. Check a. El The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. ] Megan was contacted on 6/5/00 . He/she verified that this death was from natural causes,that there was no accident nor other external cause of death, and that Dr. Scott will complete and sign the medical certification of cause of death within 72 hours. c. 0 was contacted on He/she verified that AI ,Medical Examiner,will complete and sign the medi - - ifi ' n of c se •9'eath within 72 hours. 6. Funeral Director/ :I re F.E.No./Reg. No. Date Signed/7 hlkest-Disyese*, t 1862 6/5/00 B. BURIAL-TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No.1228-00-0269 0 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 complete the medical certification of cause-of-death section of the death certificate within 72 hours. 0No extension of time for filing the death certificate has been requested. Regialrm ul - Date Date Certificate Subregistrar Signature 0 Issued: G l SI p 0 Due: L I 1 o f OD c. AUTHORIZATION for CREMATION, 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. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery If BURIAL STORAGE Date of Disposition 4c"r, 9 / or-) f CREMATION 0OTHER(Specify) Signature of Sexton 1 - or Person-in-Charge Jj ,44 , ()Pc-, 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. Distribution: White: Cemetery or Crematory DH 326,8/97(Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740-000-0326-2) Pink: Local Registrar CEM S❑ Q lIndex : RECORD # NEWCEM Record: 333 earc - ie - onten s City of Sebastian, FL - Cemetery Lots Last Name KOLMEL First Name NETTIE ARLENE Address 1 8095 HAVENVIEW RD. Address 2 P. O. BOX 56 City ROSELAND State FL Zip 32957- Deed # 531 Date 08-24-83 Amount Unit # 1- Block # 35 Lot Number 33 Interred Nettie A. Kolmel Dte Interred 06-09-00 Lot Number Interred Dte Interred Lot Number Interred Dte Interred Lot Number Interred Dte Interred Comment TRANSFER FROM DEED #199 Comment <F>wrd <B>ack <E>dit <D>elete <N>ext <P>rev <R>e-search <L>abel <T>a- <Esc> Tuesday,Nov 23,2004 09:40 AM * . 1 ll 111 II . 1 II 111 1 . I III 111 . . 1 . . . II II 1 II II 1 I - 1.. ) , t, ' -2\ . ' . t - , . ‘ ----; '1 i',- .1,4 ,,•( --,,- , !Li-1-V .--" 4/Zi -0-A-4- J.-- /P-f— , i I 1 ,.."-- ( :.1;1--e- ettia--'_?4A-- ' . ,/.....,.._ ...ire._- .6,aie.„.2. ,, 1,14-j,,..1,42--t.-/—_...-! LAY-Lti'• ./1) •_i,,64,__/____,Vc.) 201"--XCC•Z./Yu•),_ , i - t•-;- ' • ' ' )7 ii '' '''';'-et.- Li • i , -. i,' { f....0c? .p,i,,,,Lc,,erf.:1_, l',/ 1 .,1,-,). ' i , ,, 0 _ ., i 1 _,',Vi . 4 0 0 0 0 —I it © ABC — =.. — ...... _ — AE3c ----".-----.__-_,„-------- le ..„......._ ABC _. . --- = = ---- >P ET< PA03630-Y660 • ,