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Home My WebLink About4-45-36Paid by CEMETERY Receipt No... 5 3...... Dated ....9 / 15/88 *Lot 36 NO. .400.00 B1k.45,Un.4 List Price S .................. Maximum No. Burial Spaces .......... *- Net Paid$ ... Q.O..On...... Monument permitted ....................... 9320 Honeysuckle La. F. Barnes 1 � 90 Herbert H. Barnes Sebastian, F1. 32958 interred 9/17/88 (Data above this line for City Record only) TitV of 6rhastittn � PIItrtrr It 19P,Q�1 No. 1190 THIS INDENTURE MADE 7%k ....15th..........., day of ..... September ........................ A. D., 10.88.., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and James F.e..Barnes ........................................ I.............................. 9320 Honeysuckle La., Sebastian, Fl. 32958 ...................................................................................................... ............................... of the County of ....Indian River Florida ....... ............................... an'I State of ........ .......... ............................... as Grantee, WITNESSETHs 400.00 That the Grantor for and in consideration of the sum of $ .......................... 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 , , tl l s, , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) 3 6,.. , , Block 4 5 , UNIT . 4.......... , 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 maintained 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 on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and yew first above written. City Clerk Signed, Scaled and Delivered in the Preyence of CITY OF SEBASTIAN, FLORIDA P .......... Mayor ......... I..... (0tg Seal) ......................... STATE 21,111,0111DA COUNTY OF INDIAN RIVER I HEREBY CERTIFY, That an this ....... 15.th .......... day of .... Sept.ember... ....... _...._ before me personally appeared .... Richard B. Votapka and Kathryn M. O.'Halloran . . . . . ... ................ .. ..... ........... respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florid, to me known to be the individuals and officers described In and who executed the foregoing conveyance to James F. Barnes ......................................................... ............................... .. ............................... I .................... .. and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance is the 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 and year last aforesaid. - Notary Pub Oq ate o} FlorWa at Large. My commission expiress NOTARY PUBLIC STATE OF FLORIDA NY COMMISSION EaP DEC 10,1988 BONDED TNRU GENERAL INS. UND. UNIT 4 DEED NO. 1190 BLOCK 45 LOT 36 James F. Barnes 9320 Honeysuckle La. Sebastian, F1. 32958 Herbert Hoover Barnes interred 9/17/88 a } Name Unit-- x`/ Block Lot - Date of Mark -out 1 i Date of Burial f f ` '` Time Name of Funeral Home Authorized by It I _ � J 0 , q5t City of Sebastian POST OFFICE BOX 780127 o SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589 -5330 September 26, 1988 Mr. James F. Barnes 9320 Honeysuckle Lane Sebastian, Florida 32958 Dear Mr. Barnes: Enclosed is Cemetery Deed No. 1190 for Lot No. 36, Block 45, Unit 4. 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. 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. We are enclosing two copies of Receipt No. 537 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, Elizabeth Reid Administrative Secretary LR Enc. .. .. ....... . S37 THE SEBASTJAH CEI►ETERY City of Sebastian Sebastian, Florida RECEIPT JS DEREDY ACXHowrgDCED OF THE SOX Opt Dollars (S Y/00.c, , FROM: 3x ga on this ( day ots2prn ,50 29BSIfor the described Cemetery Lo[(a= fL^� =-i urn �e terms and Purchase of the following oondittona as atatod herein! lkiscripelOn at A.•......__.. Cemetery Lot(sj# f Purchase Pricar�R� Terms and / .�ml2ars conditions of salon {BERT• �au�R $+9RNEs This contract shall be binding u when aPProved by 'Pon both parties the owner of t he Property above described. the seller and the purchaser, J' or We, agree to purchase the above described conditions stated in the foregoing intruaent: Property on the terms and .• rho City of Sebastian agrees to sell the above mentioned above named purchaser(&) on the terms and cnMe mo ne instrument. Property to the stated In the abovn AcitySabastian STATE OF FLORIDA rd lfrJ� EPARTMENT OF HEALTH & REHABILITA E SERVICES VITAL STATISTICS U y� APPLICATION FOR BURIAL — TRANSIT PERMIT / A. (Type or Print) I . Name of First Middle Last DATE Month Day Year Deceased HERBERT HOOVER BARNES DEATH SEPTEMBER 14, 198E 2. Place of Death City, Town or Location Name of (If neither, give street address) County BREVARD MICCO Hosp. or 9320 HONEYSUCKLE LANE Inst. 3. Name of Medical physician Address 725 -4500 Phone Number Certifier KENNETH S. GRAFF, M.D. p Medical Examiner 200 E. SHERIDAN ROAD MELBOURNE FLA 4. Funeral Home/ Name Address Phone Number (Area Code) QMK1IQXXM STRUNK FUNERAL HOME 1623 N. CENTRAL AVE: SEBASTIAN, FLA 407 -589 -1000 5. Check a ❑ The medical certification has been completed and signed. A completed certificate of death accompanies Appro- this application. priate VIOLET Box b was contacted on 9/14/88 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 DR. GRAFF will complete and sign the medical certification of cause of death. M ■1 medical certification. was contacted on He /she verified that Medical Examiner, will complete and sign the 6. Funeral Director / `1l/ / S%i jnature . Fla. Lic. No. /Reg. No, Date Signed A .. _ _ 41672 9/14/88 B. BURIAL— TRANSIT PERMIT Permit No. 1228 -88 -419 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 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 Report' will be filed with the Local Registrar of the County in which death occurred. ❑ No extension of time for filing theAeath certificate req }' ested. Registrar or p� ° Date Date Certificate Subregistrar Signature g�Issued: 9/14/88 Due.: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA , Medical Examiner Date or Medical Examiner, , gave authorization by telephone to Funeral Director /Direct Disooser. 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: Rk BURIAL ❑ STORAGE ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton or PeKQa. a.Q. erge Place of Disposition SEBASTIAN CEMETERY Date of Disposition 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, Oct B7 (Replaces May 86edition which may be used) (Stock Number: 5740 - 000 - 0326.2) S 04/13/2010 10:08 7725892583 110 10 14 :43 Star "'ra•rnte & �r ix IF. ��0[ OACLV9 I 1 xx, 241 7a4r -06 :33 7ri1:! 7 \'V 'o SEBASTIAN C ^AP =I. DAVIn HIN -ZEMAN 1023 NORTH CEEN7RAL FIVE SEAAS ?SAN FL ?2953 Pt!one Isar `.ih 0/la Y, 4rtxi "gang 772-569-1000 -RUCK Ship Gate NET 30 DA "S PREPAY STRUNK FUNERAL HOME PAGE 03 (FAX) P.001 1001 Order Acknowledgement Acknowledgerr.ent No. 72614 Sales Order pate. 03/09;10 Pape: 1 Sh!p To STRUN<F;;PJERALHOME. jUANI rA. 916 17TH ST, VE'RO BEACH, FL 32960 Phone 77. 466.1955 r ax: Customer ID 41y9 Saes Quote No. P.G. Nurnty P.O. Date 03109/10 SalesPefeor TERRI REEL uanttt Item NJ Color OeMrlption 1 MRKBRP STAR BLUE 2.0 X 1.0 X 0.4 PFT BRIM ?Pv L ETt•' R PER U•705). LET T ER IN FROSTED PANEL., 51,k�CK LI'rraC REF BARNES SENtN'D ;,WING FCR APDROVAL -;� W r\ es �0 r „/�i � � / s✓ ail/ O � %Ll�� `a4T� 1H 5 IAL T� T 7'g 4/ �'(AJ