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Home My WebLink About4-35-07 ..'. Wity of l'tbusthtu ear r m r t r r y m'r r la e 14'(3 NO. THIS INDENTURE MADE 'I1IIa 26th day of October 94 A. D~ I......., bet.....n the City of &baatlan, a lDun"'lpal eorporatlon nl.tln. und~r the law. of th~ Stat~ of Florida, a. Grantor and .................................. ... .... H:ra... EQx(!.one. .Allen................. 114 Mabry Street ................................., .........Sebas.tian,.. FLQ.dda, 329S,s.", of the County 0' . Jm~;I,~.t:l.. R~,v,~r....................,.. an'] State of ..... ..1,1.P:f:J9A.................................. u Grantee, WITNESSETH I Thet the Grantor for and in conslderatlon of the sum of S .... ~ .'. 9.Q~ : R9. . . . . . . . . . . to it in hand palcl, the receipt whereof I. herewith ao- knowledged, doe. by this instrument pnt, barptft, aeD, releaae, convey and confirm unto the Grantee .~~.~. ... heln, lepl repre_tatl". and anlp. the foDo..q propaaty situated in Sebastian, Indian River County, Florida, to-wlt: AD of Lot(s) .~..~. .8, Blode, ....~?. ,UNlT...~......... ,of Sebastian munlc:lpal cemetery a. per Plat Number 1 thereof recorded In Plat Book 2, at pap 65 of the pubHc records In the ofl1ce of the Clerk of the Circuit Court of St. Lucie County of FIorlcla; .Iclland 110.. lyins and belli(! in Indian River County, FlorldL To Hue and to Holcl the .me fore\'Or; proYlcled that salcl property ohaD be uled IDlely and ellcluslYOly for the interment of the human dead and nil be Uled' bpt and maintained at aD time. In acoordince with the rule. and ....latlons. ordinance. and resolution. of the aty of Sebastian, Florid.. hereto- fore, no.. and herOIfter adopted or provlcled for the 1l0\'Omment and operation of saIcl cemetery. The condition.. restriction. and tequlrementa contained in this Instrument .haD be co_nt. ruM1n1l with the land. In the e\'Ont of the faBure of the owner of any property situated within saIcl cemetery to oll- ae"e and comply with iuch rule.. ....latlon.. reIOlutlon. and ,ordinance. and the condition. of the deed of con\'Oyance thereof then the title of such o..ner in and to I8Id property shaD terminate and the .me .hall reYOrt to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part he. Cluaed thl. Instrument to be executed In Its name and on it. behalf by It. Mayor and attested by It. City Clerk and it. corporate _I to be hereto afI1xed, the day and year first aoo\'O ..rltten. Att~.t~l.. .r(J.!!.III~ ,7'~ City ~ By m..... ~... ""...... ~~?t';t~ (Q(itv "111) STATE OF FI.ORIDA COl'NTY OF INDIAN RIVER 26th October 94 I HEUEBY CERTIFY, That on thle ....",'..,..,'.,."... .day of .....,....".....,"',..,....".....,............,., I.."., b,fore me p~raonally appeo",d .. ~!:~.l:I,':1,~,,~:,. ~~.~,~.i~~,.,...................,... and . ~~.~~:r:Y.r:t., ~.',. ,Q,~ ~~~.~~:r:~,r:t, ...",..,II.rly Mayor and City ank of th~ Clt, of Seba.llan, a mun"'I,..1 corporation under th. la,.,. of t.... Stat. of Florida to me known to be Ihe Indl.idual. and om.... d~..,rlbed In ond who ""O('ul"" th~ 'o"'lOln. .......y.nee to . . . . . .,..,.." .".....""............... .':f,r:l!! .'. . .~.OX~:n,I)~, .A:J.l~n......,... ....,.. . ...,..".., . . '.. ...."".........."..,.." . . . . . . . . . . .. . . . . . . , . . . . , . , . . . .. . . . . . .. , , , , , , .. , . , , , , , . " and ....,a1ly ""knowled."" th. oxet'1lllon thereof to be their 'ree a'" and deed as ."cb orneer. thereunto duly authorlaed I and that the Official ,..I of ..Id mrporallon Is duly affixed th...to, and the said moorya""" I. tbe oct and deed 0' ..Id corporation. WITNESS my "lIDature and off"'lal _I at &ba'tlan, In the Co last aforeaatd. . l.INIM M.lW.I.EY 1lY~'CCsm24 EIlIWS:.....1I, 1_ .....1lIIlI..., PlIIIIe....... Name /"'J ' '-'!"- /ki) b(';r:~ i 1-, . ~~ ..". f I' ,,::: f< 1 ~ t--J E. i~ Unit L! Block ~3 c;' Lot -] Date of Mark"out , I C j 'j''' '<''-If I' I. ) I ", l I l.~ < I' (j 1;; S'., ,I -.' '1 ...~. I._.~.. , .> / I Time ''? . r f) r'\. ...- .-".. '_" 'J', , ,...11"' Date of Burial Name of Fune~1 Home :j rl:-',j;~ i~: I< '''s''i " " '--.~ '" - "~,' 1 );,,~~<~/ '\ /', -,/ /,;.<), '~,:,,:y:/. '\ Authorized by ;..-'':s:~/C? ',<~~~~.,,~ Q Alkn~xan~, 11 ~ rYlaby <-i 6i- <~Scl:)(i~ +; an, Pl- 6;2Q60' ~~ 7!L ~ C:)ccl- 65 lL1;T J.f' 'Mev~ L. 8\dnne r -Ink-raP IO/~c5 /q~ " , \. - ~ )Jb.l4l~3 -- 0c , - 10/26/94 Lots 7 & 8 ~2:> Dated.............................. Block 35 Paid by CEMETERY Receipt No. .. .. .. . . . .. . .. .. U it 4 1 000.00 Maximum No. Burial Spaces................ n List Price $ . . . . ~ . . . . . . . . . . . . . 1 ,000 .00 Monument permitted. . . .. ., . ., . ., .,. .. ... . . Net Paid $ .................. ~X~ ~ (Data above this line for City Reeord ooly) NO. 14~,3 .' . . . ~~6 THE SEBASTIAN CEME:rERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA Y ACKNOWLEDGZIJ OF :rIlE SUM OF: ~ (S ! /(0. fl/ ) FROM: on ~ day 0 :followin described Cemetery sta'ted herein: :for the purchase o:f the 'terms and condi'tions as Description of propert;y: Cemetery Lot(~) 'It Block 0,5 ~f1 ' Purchase Pric : ~ Dollars Unit -<J .' (S~&'~~ Xerms and Condition of sal.e: Xhis con'trac't shal.l be bi.n.ding upon bot:h parties, the seller and the purchaser, when approved by t:he owner of the proper"ty above described. I, or we, agree 'to purchase the above described propert:y on the terms and conditions sta'ted in. the :foregoing instru;ment: Xhe Cit:y o:f Sebastian agrees the above named purchaser ( s) above 'trument. sell the above mentioned propert;y to e terms and COnditio~ated in. the J . ,'1" (J" ,,~ \ IJI~,J ~ ~". - , y- ~o 'V" ,1 S ~ ~.,>.Q c,p \c,'- 01- PfL IC"'~ - . City of Sebastian 1225 MAIN STREET D SEBASTIAN, FLORIDA 32958 TELEPHONE (407) 589-5330 D FAX (407) 589-5570 October 27, 1994 Mrs. Roxanne Allen 114 Mabry street Sebastian, Florida 32958 Dear Mrs. Allen: Enclosed is Cemetery Deed No. 1473 for Cemetery Lots 7 & 8, Block 35, Unit 4. 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 when and if you have the deed recorded. 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. We are enclosing two copies of Receipt No. 825 and ask that you sign and return to us the copy marked with an "X" and retain the other copy for your records. The previous receipt you received had an incorrect Block number listed. A stamped, self-addressed envelope is provided for your convenience. V~:;l~ yours, ~m. Oi/~A.. Kathryn M. O'Halloran City Clerk KMO:lmg enclosure (\ws-form-cem.rec) . . '?:16 ., THE SEBASTIAN CEMETERY CITY OF SEBASTIAN SEBASTIAN, FLORIDA OF XHE SUM OF: ($!/~.fl/ ) FROM: on tbi~ day 0 . followin described Cemetery stat:ed herein: ror the purchase of the t:erms and conditions as Description of Propert:y: Cemetery Lot(~ flOck 0,5 Purchase Pric !-~ Dollars Unit ~ .. ($~&~ Xerms and Condition of sale: Xhis con 'tract: 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 propert:y on the terms and conditions stated in the roregoirJ.g instrt.l:DJent: ~~ Xhe Cit:y of Sebast:ian agrees the above named purchaser ( s ) above t:ru:ment. sell the above ment:ioned propert:y to e terms and conditio s~ated in the - ,// A, 1, Name of Deceased (Type or Print) First APPLlCW FOR BURIAL - TRANSIT PERMIT . (-3.5=-67 - State of Florida, Department of Health and Rehabilitative Services, Vital Statistics Middle Last Skinner DATE Month Day Year OF DEATH 10/22/94 Robert Lewis City, Town or Location Name of (If neither, give street address) Hosp. or Inst. 2. Place of Death County Medical Examiner 3. Name of Medical Certifier The medical certification has this application. physician Address 4. Name of Funeral Home/ Direct Disposer 5. Check Appro- priate Box aeath accompanies bP Pam was contacted on 10 '24 '~4 within 72 hours after death. He/she verified that this death was from natural causes, that ttfure "as no accident nor other external cause of death, and thatNoor Merchant, M.D. will complete and sign the medical certification of cause of death. c 0 was contacted on ' He/she verified that , Medical Examiner, will complete and sign the medical certification. 6. Place ~fSehast ian Cemet Rnal Dlspo~rron. 7. Funeral Director / D~<::t QiiP':'i9r Removal from state Donation Date Signed B. BURIAL - TRANSIT PERMIT Permit No.1 ??S-94-()4Q7 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 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. o No extension of time for filing th eath certificate requested. Registrar or / Subregistrar Signature ~~: '/ ~.4" );r g:~ Certificate 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. Methods of Disposition: . BURIAL o CREMATION Signature of Sexton ) or Person-in-Charge) o STORAGE o OTHER (Specify) K j:J?- I~~~rr~ CEMETERY OR CREMATORY Place of Disposition ~ LA ,1-<0,,4joj eLN'I'- T ~J Date of Disposition / b /'2.. S - J <7 'I , D, 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 wit!'1in 10 days to the local HRS County Public Health Unit in the County where disposition occurred. {t HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number: 5740-000-0326-2)