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Home My WebLink About4-44-38 "',~~, ll;;'I.,,~~'C";S'i.':~'~ "~,','"/'--':"~. ~",~:_..1.<,!}";-;i",:i-:Y',:V{::-\:r');'~:"" --'6t>t:~JI...".,_~ ... _~~.::\,ft:~;"t1'::Ill~'i.~'!~i'Jtit'Yt:'-~~_ "::,' .'.'."J!l';~~'".',;';'7.!;i' ... 6 r~i~ by CEMETERY Receipt No.... ~~..... . Dated .... .~?~ ~?/~.?........... .LOt 38 't .' . 200.00 .. 1 B1k.44,Un.4 Ust Pnce $ . . . . . . . . . . . . . . . . . . Maxunum No. Burial Spaces. . . . . . . . . . . . . . . . . . Virginia Butts 1151 Monument permitted.... .~;J.~.t;............ 115 S. W. Coconut St. Sebastian, Fl. 32958 NO. Net Paid $ ........... ..200.. 00 Jack Butts interred 12/22/87 L t 38 B1k 38 Un 44 (Data above thl. line tor Clt, Record only) o , . , . (!titl! of &ebulItiun C!!rmrtrry Irrll 1151 NO. THIS INDENTURE MADB TIaII .... ..19 t.h....... day of oD.eG~omb.eJ:.......... 0 0.................. A. D.. It.. ~ 7.. between the City of Sebastian, a municipal corporation exlatln, under the laws of the State ot Florida, aa Grantor and ....0..... 0....00....................... .V:j..:r;:g;i,n:j..~o. ~~.. .l}:q.~ t.~........ 0 0..00. 00' 0...0.0.0... o. o. 0 0....................... 115 SW Coconut St., Sebastian, Florida of the County of .... 0 0 .+pq.;i;?~.. R:j.'y'~~................. an:l State ot ..,.. ..~o~~~.~4~ 0................. .................. aM Grantee. WITNESSETHI That the Grantor for and in consideration of the sum of $ . ?9~: .Q9.. ... .... . . . . . . . to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument arant, bargam, IOU. re1ea., convey and confirm unto the Grantee ..he r. .. heirs, legal representativCl8 and uafanl the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s) . . ~.~ .. ,Block,.. ~.4 . .. ,UNIT . ~ . . . . . . . . .. ,of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 65 of the public records in the ofOce 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 aha1l 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 lIlId 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 thci,WMl 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 aha1l revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has caused this inatrument to be executed in ita name and on its behalf by itl Mayor and attested by its City Clerk and ita corporate .al to be hereto affixed, the day and year fust above written. Atl..~ ,P:..,Oddk""-........ o' .0. {} .'-. City Clerk .... B1 .. .~.....o........... MllJor ... (GIit" ~~al) ,....--.. STATE OF FLORIDA COLTNTY OF INDIAN RIVER I HEREBY CERTIFY, That on thia .. 0 .l9t:~......... 0... .day ot . .De.cemb.er..... 0 ........ ......0.. . . .. 0' 18..87 bdore me personally appeared....... 0.. J.i~.. .G~n~.. JJ~+'+o:i.E? 0" . . . . . . . . . . 0 . . . .. and Ka.tnr.y:n.. M,.. .0. '. Hal.llU:a.t:l.. respectively Mayor and City Clerk of the City ot Sebastian, II municipal corporation under the lllws of the State of Florida to me known to be the individuala and officetll described in lIDd who executed the for('guin, co.veYllnee to .., 0...0.. 0... ........ ....y.~.~~~.~.~.~..~~.. .~~~.~.~o 0" 0....0.... ........... .... 0... ........0......0... 0 0.... ..... ........... ...... . . . 0 0 . . . . . . . . 0 . . 0 . . . . . 0 . . . 0 . .. .. .. . .. .. . .. .. .. . .. . 0 0 .... and severally' a~knowledgffi the execution thereot to be theJr tree act IInd deed as such officers thereunto duly lIuthor1&ed; aod that the Officilll s"a'. of .i1dcorpocatioll Is duly IIffixed thereto, and the SlIld conveyance is the IIct and deed of said corporaUoD. WITNESS Iny signature and official .eal at Sebastian, in the &unty of India., River and State ot Florida. the day and lear IlIst IIforeaatd. ' o~ .....f.)........................... Notary Publk tate o( Plorlda at La,.. ~f COIDID\liion explreal IOTARY PIlBLlC STATE OF FLORIDA "Y COMMISSION fXP Dfe 10.1~8i lJOalfO 111IIII fiUUW. 115. UIIl. ... h 0\ If'\ r-I r-I .1 . 0 z I Q I f;I;l f;I;l I Q Q) e ...... .i= ("I") ;tI:l E-I f;;I 0 ..~ ...:l ~ ..:t ....:t ..:t ~~ rn Q) E-I U e I-l .3~ 0 z - J: P ~.~ ::J e 0 ~ "i Q) ~ ... 't: C III ::J 2 ::J LI.. "C III Gl Q) ~ 'Q '0 '0 N e :!:: ..~ Q) 0;:: III Q) Q) 0 c - - e 2; :J 0 2: - r. ..lO" .:;.;1 III III - ..... "",,~-.. C Z .::J c( . lO.&oJ .&oJtr.l .&oJ =='.&oJ . ~==,r-I ~~ · 0 ...:l tJ .. o ~ as u as .,-l .,-l ~:3 .&oJ .,-l tr.l to bO as ~If'\.c .,-l r-I Q.) l>r-Itr.l 00 ("I") .&oJ o ...:l ~ ...... 00 - ('.) ('.) - ('.) r-I "d Q.) ~ ~ Q.) .&.J ~ .,-l to .&oJ .&oJ ==' ~ . f;I;l ,.Il:: tJ as I-) -- Paid by CEMETERY Receipt No.... ;.~.~....... . Dated 12./19/87 . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . Lo t 38 NO. u.t_ $.......... ...~~~..OO .......... N..Ilurio1S..... ........ .~....... B1k. 44 ,Un. 4 NclPaid$ .............200..00 ..__. f". Virginia. Butts 1151 .... n'r".'r............ 115 S. w. Coconut st. Jack Butts interred 12/22/87. Sebastian, Fl. 32958 Lot 38, Blk ..., Un. 4# (Data above till. line tor at7 Record 0111)') , . . . .;.~~,;<,~" ";'_'il__""_1"'''~~',~iK~)'f~-'''' .... . . . tf 1(1 ..- THE SEBASTIAN CEIIETBRY City of Sebastian Sebastian, Florida RECBIPT IS .BBRBBr ACICNOfiLBDGED 0' THE SUN OF: Two hundred and no/100 Dollars ($ 200.09 FROM: Virginia L. Butts 11&:; c:tJ r.ru"'onnt St. Sebastian, Florida 32958 on chJ.s 19thfall of Decembef 1987. for the purch.se of the foJ J o ""i. ng described Ce..terll Lot(s) upon the ter... and condi.tJ.ons .. stated hereJ.nl Description of Property: Cemetery Lot(s)' 38 . Block' 44 Unit" 4 Purchiule Price: Two hundred Dollars ($ 200.00 ) Terms and conditions of sale: This contract shall be binding upon both parties, the selJer and tho purchaser, ""hen approved bll the owner of the property above descr.tbed. " I, or we, agree to purchase the above described property on the terms and cond.ttions stated in the foregoing lntru.nt I . I &it- The City of Sebastian agrees to sell the above mentioned property to the above lWlII8d PfU'ch.ser(s) on the ter... and condltiollll stated in the above instrWDflnt. ~~i4l: ~. Ci tll of bastian ~/NYI( IkJy Wt~nn~4 . ~-~------ ----~---_._-- .. :X',\~. "J,~"_i~~.,~~~",, ~~ _."".......,t.~';#i;:;.\ .. . . ,-tV 0 " ~ \. IJ\ ,::J ~ ~' ~ +Q~4 S",~,,<> i o~ Pille..... \\... . ;J City of Sebastian L. Gene H.rrII Mayor POST OFFICE BOX 780127 0 SEBASTIAN. FLORIDA 32978-0127 TELEPHONE (305) 589-5330 Kathryn M. O'Halloran City Clerk January 5, 1988 Mrs. Virginia Butts 115 SW Coconut Street Sebastian, Florida 32958 Dear~lrs . Butts: Enclosed is Cemetery Deed No. 1151 for Lot No. 38, Block 44, 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. 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 understand that you expressed an interest in purchasing Lot No. 37. If you wish, arrangements may be made to purchase on a time payment plan - $50.00 down' and $50.,00 per month for a total of $200. We would appreciate your advising us as to your decision. Very truly yours, ~~rRd Elizabeth Reid Administrative Secretary LR Enc. .. . . . .; . VIR'GC'INIA" L BUTTS '. . ,.....SWCOCONUT':',' 115 N .... "i, S EBASTlA\ "., -...... · .... ..... ... '; JCP:fl1farI{. ~""""'DE'_ .. . ~A.a...r::... bo r3 f 44. ""'f1ltt.H ~~01]'id~"3 2':';' Il.. ~ ~ ~..2 13....!;.. ~ "----, ......... 101 62-43 311 IIJdt- ~ 3. Name of Medical Certifier FARHAT KHAWJA, M.D. 4. Funeral Home/ Name Direct Disposer STRUNK FUNERAL HOME-SEBASTIAN Permission is hereby granted to dispose of this body. o 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 oc- curred. o No extension of time for filing Registrar or Sub-Registrar Signature om OU'.'\IHME" T OF HL'\UJI .....,..D hUI....UU.IT"ll'l(l: ~E"VK.;t,.~ A. 1. Name of Deceased (Type or Print) First 2. Place of Death County INDIAN RIVER. 5. Check Appro~ priate Box 6. Funeral Director/ Gtreet ei'138&er B. C. Signature or Medical Examiner, .;,~'"':-:,7~,~""'_'i!iN',',:'~:'~~:'i",~. ~"",}~b,(""",_ ,,"'>;l:~~~:~'-:"""'0"~:o/~'7i'-'< STATE OF FLORIDA .DEPARTMENT OF HEALTH & REHABILle. VE SERVICES VITAL STATISTICS APPLICATION FOR BURIAL-TRANSIT PERMIT /-..3 ~~i tli Middle Last DATE Month Day Year OF DEATH DECEMBER 18, 1987 JACK EDWARD BUTTS City, Town or Location ROSELAND Name of (If neither, give street address) Hosp. or Inst. HUMANA HOSPITAL-SEBASTIAN ca Physician 7754 BAY STRE_dress Phone Number o Medical Examiner SEBASTIAN, FLORIDA 589-3000 Address Phone Number (Area Code) 1623 N. CENTRAL AVEN. SEBASTIN,FL 305-589-1000 a 0 The medical certification has been completed and signed. A completed certificate of death accompanies this application. b [!J. PAT was co1ltacted on 12/18/87 within 48 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. KHAWJA will complete andsjgn the medic~1 certification of cause of death. c 0 was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. Fla. Lie. No./R"!f. Nu. Date Signed -# /G-.7..2- /J'~,97 BURIAL-TRANSIT PERMIT 1228 87 475 Permit No. -- Date Issued: 1;Z -19-47 Data Certificate Due: . AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA , Medical Examiner Date , 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. Method of Disposition: O! BURIAL 0 STORAGE o CREMATION 0 OTHER (Specify) Signature of Sexton ) y / /P r- 0' eo.... i. C.."" I ,. 'i' /'. ,9-~"I <;7'- D. CEMETERY OR CREMATORY Place of Disposition ~'&~bT?/;9;e) / ~. ;2;1 .;:"'7 ~tk. 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, May 86 (Replaces Apr 81 edition which may be used) (Stock Number: 5740'000-0326-2) J. .J