The URL can be used to link to this page

Home My WebLink About2-43-06a� � �� THE SEBASTZAN CEMETERY City of Sebastian Sebastian, Florida , RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: FROM: � � C% C� Dellars ($ T� v �l ) /.� �� ;�-�. ��L�� , , ��? %3�,� ��-5� - , , �� - -�'1�� /.,L-� 1 % `_ �/;: �� . � � on this �/�� da of /�� 198 for the y , = purchase of the fol2owing described Cemetery Lot(s) upon the terms and conditions as stated herein: Description of Property: // � Cemetery Lot (s) # �r,I Block# "]` �J Unit# :� ��G� Purchase Price: ��'j�(i', QCJ ' Dr�llars ($ ) , T rms and'conditions of sa1e: v� C��.u.��, �'r�c�� ' � � i � �.� �`i�o �� ir-.�-�� . �2�z-. ,,��'�z��r,��y1��2 �� x-e_ . . � This contract sha11 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 Cit� of Sebastian agrees to se11 the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. � ° �� ty of Sebastian Witness 0 z ti w m x � � � a , «�' �� Q! �' ��, , '�� i o �� G'� � � �' � �: �..j � �'. � . ,�;' et; � � �� '� i r ---. .�� , j � � �� " �� -- �� - -_- . __ ___ _ _____ ___ � � �. � ____ , ; � , . �. , .___ . ; i �J I _ _ �- � i � - -___--- � � � - � I 3 � �-�. w ' ' U � � � ��' �� ; �.. � '�.` � � ! �j-� --�- --- -- --- `� -.-- �'_ _�\,� � � � _� � ' �. , I i __ � ' __----- . _ _----- �_ _�.___ ___ I _. ; i '� i- - --------------- ---- --- - - -�- ', � � •J ------_—_ � ` ,, �" � � - � _ `��_.^!:� . ._ � _ ��d-, f __ /°�ry �� ..�-� , .._ �` �`aC / y' � �� , __.'__"_._ __.___._".,_- � "'.'___ .. -: ,� _ _..____ _ . � � , _. .. _ . .. . � " � _ ; �� r y� I � - � � . _ :y� �, � /�, � ___ � s FY �T� � c�: �`� �` '�� /1• �j cY I � ' ': ' � ': ' ' ; , ; j ', w , , , , , ,' F , , ' ' ' i ' ' I � �� _ _. �w__w .� __ a__ . � : '� ^ J , � � ,:; ,. , , ., , �:�, � , . , _ . . ,.. , . . ...r.' , . . ..-.. + ., .. �� .�4 �'� '�� e. '. . . ,.�r. ^ : . . , ,- ; . . .. � .,, � i '_.,. . .. � � � � ; � . , - . . . �.� �� . � . . . .. � � � � � � �. ��e � �- � i� �' �� r� -� � �'� �, C � � C� ti'� untt �� ,� ,� ., 81oCk Lot � � � � ....� �j� �Dt�e of Marlc-out ' `�-�' " ` -� — � � - c� r--`��aPs �� i e . , Date of Burial , � � '`-�` Time � �✓ ��'`~�� Name af Fur�ersf Wo�n �� ..%`�`�� , Authariz�d b �'��`�'�`��' Y � , � 0 ,., : � .�. .. ,,. � : � : .. y., , : , : „.. ,�:.zn.,�....��::�: �... -.� ... „:xe Obituaries j Death Notices � Newspaper Obituaries � Online Obituaries � Newspaper D... Page 1 of 1 MELBA E. GREEN Melba E. Green, 91, died Dec. 30, 2008, at her home. She was born in Cuba and lived in Sebastian for 37 years, coming from Hawaii. She worked at the Fox's Den Restaurant in Sebastian for 12 years. She attended St. Sebastian Catholic Church, Sebastian. Survivors include her son, Juan Loreto of Sebastian; and two grandchildren. She was preceded in death by her husband, Gilbert E. Green. Memorial contributions may be made to VNA & Hospice Foundation, 1110 35th Lane, Vero Beach, FL 32960. SERVICES: A memorial service wiii be 4 p.m. lan. 6 at Strunk Funeral Home, Sebastian. Published in the TC Palm on 1/2/2009 Toda�TC Palm obituaries and death notices Questfons about obituaries and death notices or Guest Books? Contact_Leqac}�.com • Terms of use �ower�d ey Le�gacy.carn.� obituaries nationwide Back �ZA �f3 Co 5�%V(C�° Nir��C�Ck�� a pM ��-�� http:l/www.legacy.com/tcpalm/Obituaries.asp?Page=LifeStoryPrint&PersonID=I22091... 1 /5/2009 CITY OF SEBASTIAN 4 219 CITY CLERK'S OFFICE . RECEIPT Name � t I i�'Y1 ". F�('�l Q.irCl'� ❑ Cash Date � � ` � � �� heck#�.�. Rmount Paid No. 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 CopieslBid Specs. 001501341910 LDCICode of Ordinances 001501 341930 Election Qualitying Fees � Ye � 601010 343800 Cemetery Lots LoUNiche �, Block �.s,�. Unit � 001501343805 Cemetery Fees 15p oU � • �y� Total Paid �! �, � Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY �� , � � HOME OF PELICAN ISLAND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8294 Fax: (772) 589-5570 FUNERAL HOME: ��SOC Fl�l��A�. Ci::°°` .. �.. ADDRESS: SEBASTlAN,, FL 32958 PHONE #: (Check One) �OPEN BURIAL LOT Lot Block Unit OPEN CREMAINS LOT Lot 6 Block 43 Unit 2 Addition OPEN COLUMBARIUM NICHE Niche Block Unit � N S E W BURIAL DATE AND SERVICE TIME: �i�it� f,2 ,��l,' ., ��/jl FOR DECEASED: Mefba E. Green Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownershi ��1A�J.10 +� �t.-, � ` .�/ a ✓ Name Signature Date I certify that I have determined the ownership of the above described site, that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGN TURE OF LICENSED FUNER DIRE OR: ��v.� /i,v��o,� /a�.� � Name � Sign ture Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: ' ' � og Cem ery xton � - Date � This form to be provided to Clerk's Office by Sexton for permanent record upon completion. � ^�REEN, MELBA 129th Street, P.O. Box 714 Sebastian, Florida 32958 D�Eb #509 Receipt # 323 LOT # 6, BLOCK # 43, Unit #2 Addition Gilbert Green, Interred, Lot # 6, � 10-16-82 Paid by CEMETERY Receipt No. . 3.23 . . . . . . . . . . . Dated . . . .10 :2 7 :$ 2, , , , , , , , , , , , , , , , List Price $ � 150: 00. . . . . . . . . NetPaid$ .,,,,, $150;00.. Maacimum No. Purial Spaces . . . . . . :l .—. . . . . . . Monument permitted . . . . . . , F 1 a t . , . , . . • • a '� e 3 � " N� �� <._.' � i.: Mrs. Melba Green 129th Street P.O. Box 714 Sebastian, Florida 32958 Deed # 509 Receipt #323 R. & R. I s s ue d (Data above t�is line for City itecord only) Lot 6, Block 43 _ ilni r#�� o�� STATE OF FLORIDA j �PARTMENT OF HV TAL STAT ST CS�TA� SERVICES �` � �� y_� Gj,� �� I APPLICATION FOR BURIAI—TRANSIT PERMIT A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased Gilbert Ernest Green D ATH Oct. 14, 1982 2. Place of Death City, Town or Location Name of (If neither, give street address) County . Hosp. or Indian River Vero Beach Inst. Indian River Memorial Hospital 3. Name of Medical � Physician Address Certifier J�es Gordon, M.D. ❑ Medical Examiner 2300 5th Avenue Vero Beach Florida 4. Funerai Home/ Name Address �� Pottinger & Son Funeral Home S. Indian River Drive Sebastian Florida 32958 5. Check a� The medical certification has been compieted and signed. A completed certificate of death accompanies Appro- this application. priate b� was contacted on . He/she verified that Box this death was from natural causes, that there was no accident nor other external cause of death, and that will complete and sign the medical certification of cause of death. 6. Funeral Director/ �CpmSKpCX � C c � i , � medi�l�c�e`tification. ,� -f--- �.11_ f � {I� ,! ��_ ,� +- � 5ignatu� �� .was contacted on . He/she verified that _ Medical Examiner, will complete and sign the '�� 2368 October 14, 1982 Date Signed Fla. Lic. No./Reg. No. BURIAL—TRANSIT PERMIT �-� - Permit No. �' �� — ��" '� 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. 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 occurred. Registrar or - � " (f � / � �� '� • Date i . � - Sub-Registrar Signature�. ,�lr' ' •�=�. '� �� l� � � � � `_��'�"� ��* r _ Issued � �- � ' AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA Signature , Medical Examiner Date or Medical Examiner, , gave authorization by telepho�e to Funeral Director/Direct Disposer. Date The Medical Examiner's approvai 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 ot Disposition: � BURIAL � STORAGE � CRE141ATION � OTHER (Specify) Signature of Sexton � �� ! , or Person in-Charye )_ , "--'- t- f-�'_� ^�_ _ J � / '� '% .. 'i�' ; . Piace of Disposition Sebastian Cemeter}� Date of Disposition October 16 � 1982 � �l-. . ��- a_ kv This permit must be endorsed by the Sexton pf`person in-charge (or by the Funeral DirectoriDirect 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, APR. 81 (replaces previous editions wh(ch may be used.)