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Home My WebLink About4-45-04/ Paid by CEMETERY Receipt No. . . .5.9.'./ .......... Dated .... .]:. .1. ./ .~. .5 f. .8.9. ............. Lots 3 & 4 NO. ust pri~ $....3.2..5.: .0..0. ..... 2 Blk.45 ,Un.4 Max .m No.B S = ................. 1 249 Net ?aid $ ... 6.5~ ..00. .....Mo,umam ~er~tted ....................... Thomas Farrel 1 Marie Farrell interred P.0.Box 952 Lot. 4, Blk.45, Un.4 (Da~,a~vethlslinef.,C~ty~oadon~y) Roseland, Fl. 32957 · of ebas an leme ery Beeh NO. THIS INDENTURE MADE T~ .... 15ih ......... da~ of ........... No.vamher .................... A. D. If..8.9., between the CRy of Sebastian, a municipal corporation existing under the inw~ of the State of Florida, ~s (]rantor ~nd ......................... .Th..o..m..a..s...F..a..r.r.e~ !,, (.t~.e ~. ~d.~ng. ,a.t..Lo.t_ ~ 0...?olraer..~o.ur ~ .......................... P.O.Box 952 11330 U.S. 1, Sebastian, Fl.) ........................ Rom clindo...El ...... 32.957. ......................................................................... 0~ the County of .........I.~.d.~:.o:,n...R..~:y...e.~ ................ an:l State of .~'.~-9~J-.4~ .......................................... as Grantee, WITNESSETH~ That the G~antor for and hi consideration of the sum of $ ...~.?.0. :.0..0. .............. 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 . .h..i.s.,.. heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) .3...~...~, Bio ck, ~.~. ...... UNIT .. ?. .......... 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. Lucia 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 shaft be used 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 reguhtinns, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereaHer adopted or provided for the government mad operation of said cemetery. The conditions, restrictions and requirements contained in tkis instrument shah be covenants running with the hnd. In the event of the failure of the owner of any property situated within said cemetery to ob- serve ~md comply with/uch rules, reguhtions, resolutions and ordimmces 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 Sebasthn, Florida. IN WITNESS WHEREOF, The smd party of the first part has mused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk s. nd its corporate seal to be hereto dflxed, the day and year f'~st above written. CITY OF SEBASTIAN, FLORIDA ,, ............... Mayor Signed, Sealed and Delivered In the Pr ~ · . : STATE OF FLORIDA W APPLICATION FOR RURIAL-TRA~ N$1T PERMIT A. (Type or Printl I. Name of First Middle LaSt ~ ', ' ~ ' DATE ' ~ Month Day Year Deceased OF HARIE KATIIERINE FARRELL DEATH NovEHBER Il, 1989 2. Place of Death City, Town or Location Name of (If neither, give street address) Hosp. or County INDIAN RIVER SEBASTIAN Inst. 11330 INDIAN RIVER DRIVE LOT # 3 3. Name of Medical [-I Physician Address 407-464-7378 Phone Number (3Ul~r FREDERICK ROBIN, H.D.,HE. [~liVledical Examiner 2500 S. 35TH. STREET FT. PIERCE, FLA Funeral Home/ Name Address Phone Number (Area Code) CI[~ItX~F~Ir STRUNK FUNERA~ HOHE 1623 N, CENTRAL AVE. SEBASTIAN~ FL 32958 407-589-1000 Check a Appro- priate 8ox b c ~ HELEN [-] 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 rnedi~ai cettifle~tltifl of cause Of deathi : ....... : ,: was contacted onl 1/11/89 He/she verified that hR_ R~RTM; M ~ , Medical Examiner, will complete and sign the medic~a~cer ti fication. 6. ~FF:u_n_e_r, al~.Director/ , ignature ' /~/ Fla. Lic. No./R~. Date Signed ......... ~' .... /~~ ~~ #1672.... ~ 11/11/89 B. BURIAL-TRANSi~ PERMIT I~ermit No..1228-89-506 Permission is hereby granted to dispose of this body. [] A five day extension of ti~ fol' filing the d~ath certificate (exclusive Of weekends) has been requested attd granted aS bndu~ hardship would result from filing within the normal time limit. If the certificate C~innof be fll~d within this ex~dti~n~ limit, a "Fbilei'al DirectOr/Direct Disposer Report" will be filed with the LoCal Registrar of the County in which dea(h Occurred. [] No extension ol time for filfngRhe death certificate reque[ted. Registrar or Oai~ 11/11/89 Subregistrar Signature · ' Issued: Due: c. AUTHORIZATION for CREMATION, bi'tO'lioN or 'BU~IIAL-/[.~-~EA Signature , MediCal Examiner Date or Medical Examiner, Funeral Director/Direct DisPoser. Date The Medical Examiner's approval must be obtained be{ore disposal by any o~ the above methods. A waiting period of 48 hours after death is required for all cremations. ' Method of Disposition: [] BURIAL [] STORAGE ~[ CREMATION [] OTHER (Specify) Signature of Sexton ) /~.~ (~. /~.~ or Person*in-Charge ). I / CEME'~ERY OR cRI~MATOI~Y Place of Disposition Date of Disposition FT. PIERCE CREHATORY 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 th~ County where disposition occurred. Form 326, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2)