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Home My WebLink About4-04-29Page I of 1 Donald "Dan" Rakowski Mr. Donald "Dan" Rakowski, 84, died May 18, 2011 at Kindred Hospital - Melbourne, Melbourne, FL. He was born on October 17, 1926 in Milwaukee, Wisconsin and lived in Vero Beach for 14 years coming from Kenosha, Wisconsin. Mr. Rakowski was the owner of Rakowski Distributing, Kenosha, WI, prior to his retirement. He served in the US Navy during the World War II, was a member of Sebastian Area Veterans Honor Guard, VFW Post #10210, Sebastian, FL, former member of the Lions Club of Kenosha, WI. He was also a member and past president of the Polish American Social Club, Vero Beach, FL. Survivors include his beloved wife of 63 Years Dorothy Rakowski of Vero Beach, daughters, Doreen FitzGerald (Dennis), Debbie Petroski (Neal), grandson, Eric Hummer, granddaughters, Carl Campagna -Davidson (Nikki), Amanda Primavera (Sean), Kasey Dixon, great-granddaughters, Marissa Grace Primavera, Danielle Marie Primavera, all of Sebastian and sisters, Delores Kodrich and Evelyn Pradarelli, of Wisconsin. He was preceded in death by his sisters Margaret Barnier and Mildred Marshall. http://stnmkfuneralhome.conVsitemakerlmemsol_data/1283/387670/387670_profile_pi... 5/23/2011 CITY OF HOME OF PELICAN ISLAND CITY OF SEB STIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Dorothy Rakowski 4340 12 Street SW Vero Beach, FL 32968 Certificate No. 2299 In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4, Block 4, Lots 29 30 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 26 day of May, 2011. CITY OF SEBASTIAN, FLORIDA ATTEST: Al Minner City Manager s Sally Maio, MMC City Clerk Name 2A/`}I1) Unit Block Lot „T9 Date of Mark -out '5 a/`t Date of Burial Oil Name of Funeral Home Authorized by 1,; /1o,) 5 /,,,T 3 wes. j e )44 CD O A Co 0) n Time G` 'DDA (57.-e,e3) (.0 W 0 o w N 0 0: 0 0 N O O CO CD CA) 1. Name of First Middle Last Deceased Donald Rakowski Date Month Day Year of May 18, 2011 Death 2. Place of Death City, Town or Location County Brevard Melbourne Name of Hosp. or Inst. (If neither, give street address) Kindred Hospital Melbourne 3. Name of Medical Chandra S. Pingili M.D. Certifier El Medical Examiner FlPhysician Address 833 Barton Boulevard Rockledge, Florida 32955 Phone Number 4. Name of Funeral Home /Direct Disposal Establishment Strunk Funeral Home and Crematory Address 916 17th Street Vero Beach, Florida 32960 Fla. Lic. No. /Reg. No. F041804 Phone No. (Area Code) (772) 562 2325 B. C. FLORIDA DEPARTMENT OF HEALT 5. Check Appropriate Box 6. Funeral Director/ Direct Disposer Approval Number: Medical Examiner, BURIAL CREMATION Signature of Sexton or Person -in- Charge a. b. El c. DH 326, 8/97 (Obsoletes all previous editions) (Stock Number: 5740- 000 0326 -2) application. State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL TRANSIT PERMIT The medical certification has been completed and signed. A completed certificate of death accompanies this Dr. C. Pingili was contacted on 5/19/2011 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that HE will complete and sign the medical certification of cause of death within 72 hours. medical certification of cause of death within 72 hours. DOTHER (Specify) was contacted on BURIAL TRANSIT PERMIT F g0eg. No. 0130 11 243 Permission is hereby granted to dispose of this body. Permit No. A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. No extension of time for filin the death certific. peen requested. Registrar or fri Date Date CPte., 5/18/2011 5/30/2011 Subregistrar Signature Issued: Due: AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA 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. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery OSTORAGE Date of Disposition May 23, 2011 Medical Examiner, will complete and sign the 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. Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar He /she verified that Date Signed 5/19/2011 Sep 26 2008 2:45PM FJNERAL HOME ADDRESS: PHONE ti: One) OPEN nURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE 'TIME: FOR DECEASED (Must rovide r Name AND SIGNATJRE OF LOT OWNER OR REPRESENTATIVE ocumentaticn of cwnersri Na me 1 certify tat I have determined the owne ship of the above described site that all site fees and acminislrative fees have been paid and authorize opening of same A AND SIGNATJRE OF LICENSED FUNE.. DIRECTOR. Ce eter Sex on FUNERAL DIRECT R'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENI G IN SEBASTIAN MUNICIPAL CEMETERY 5EBAsTIAN giiiIMP wane HP LASERJET 3200 This form lo be provided to Clerk's Off.c hoMI G vlKµ i$WrD Fo; Informatior contact: Kip Ke /ao Cemetery Sexton Se l �ystian M;,nicipa! Cemetery 589 -2545 I Ciry Cierk's U`rice Ciry Hall, 1225 Main Street Sebastian, FL 32958 OIh (772) 388 -8215 or 3888214 STRUNK FUME L C �6REMATORY SEBASTIAN, Fl 32958 72) 589 -1000 LPI 2 Block Unit 4i _Block' Unit N the Block Unit 5123 L 20(1 w Signature ignature L° 1 2 -4 Date Date Cemetery Sexton Certification: I certify that I have ohecked the ovinersi information b? viewing the owner's deed and c:ontirrninci with Clerk's office •and that all fees have been paid Date by Sexton for permanert record upon compietton. p Indian River County, Florida Property Appraiser Property Data Data For Parcel 31391900001457000040.0 Base Data Parcel: 31391900001457000040.0 Owner: DONALD DOROTHY RAKOWSKI Site Address: City State Zip: VERO BEACH, FL 32968 Legal Description Click here for full legal description SEBASTIAN HIGHLANDS SUB UNIT 17 BLK 457 LOT 40 PBI 8 -46 TO 46P Photos Notes Notes: 117 LARCHMONT TER, SEBASTIAN, FL 32958 Mailing Address Property Information Address: 4340 12TH ST SW Tax Code: 2 Property Use: Report Discrepancy Nap this pr rky. Neighborhood: Real Appraiser BG BRUCE F. Date: GOODWYN 3/4/2009 Secondary Owners No additional owners found. Click here to view oblique imagery through Bing Maps. 0100 SINGLE FAMILY IMPROVED 140018.50 SEB HLS /S ENTRANCE SCHUMA A/L(4_ affig AXLIA_ GIS parcel shapefile last updated 5/19/2011 12:16:08 AM. CAMA database last updated 5/19/2011 12:28:04 AM. Page 1 of 1 http: /www.ircpa.org/Data.aspx ?ParcelID 31391900001457000040.0 5/19/2011 Indian River County, Florida Property Appraiser Property Data Data For Parcel 33392800004000400008.0 Base Data Parcel: 33392800004000400008.0 Owner: DONALD DOROTHY H RAKOWSKI Site Address: Mailing Address 4340 12TH ST SW, VERO BEACH, FL 32968 Address: 4340 12TH ST SW Tax Code: 7 City State Zip: VERO BEACH, FL 32968 -9601 Legal Description Click here for full legal Secondary Owners description THE GROVE BLK D LOT 8 PBI 13 -77 Photos Notes Notes: Click here to view oblique imagery through Bing Maps. Report Discrepancy Property Information Property Use: Neighborhood: No additional owners found. 0100 SINGLE FAMILY IMPROVED 010074.00 GROVENOR EST /LKEWD TER MB Real Appraiser BG BRUCE F. Date: GOODWYN 6/3/2009 GIS parcel shapefi /e last updated 5/19/2011 12:16:08 AM. LAMA database last updated 5/19/2011 12:28 :04 AM. Page 1 of 1 http:// www .ircpa.org/Data.aspx ?ParcelID= 33392800004000400008.0 5/19/2011 3 -o 0 n: 4 c k 0 m 0 0 W CD O w co _LN 3111131V/1S •11 (77Z)7 628 r Pv- ;721 .(ic 5. N y ti z943 l V r Iv 1 3 -o 0 n: 4 c k 0 m 0 0 W CD O w co _LN 3111131V/1S