HomeMy WebLinkAbout2-13-15SHEET NO.
SAWYER, GEORGE AND KATE
Route 4, Box 258A DEED #390
Honeysuckle Lane
Sebastian, Fl
BLK 13 LOTS 15 & 16 - 74,,4:,4 2,
(4�0 G_t4�( ' ``K4wre6t 4,,6
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Paid by General Receipt No. .. fr -? ..... Dated... z "Y
.... .... /�� ............... .
List Price �. ,5. Q _ . _ . . Maximum No. Burial spaces ......2.
Discount $....... .......... Total area in square feet .........
Net Paid $..5 - Monument permitted flat
R &R Attached (Data above this line for City Record only)
DEED #390
Mrs. George Sawyer (Kate)
Rt 4, Box 258A Honeysuckle D1
Sebastian, Fl 32958
George Sawyer interred 31111
BLK 1.,3. -LOTS 15 & 16
UNIT #2
a • .
Artistry in C
Memorials
Merritt Monument Company, Inc.
4820 South U. S. Highway 1
Fort Pierce, Florida 33450
Phone: 464 -5547 or 464 -3755
FOR APPROVAL
SEBASTIAN CEMETERY
June 9, 1980
SIZE, 54" x 14" x 6"
GEORGE L.
1907 - 1980
Unit 2
Block 13
Lot 15 and 16
5411
SAWYER
KATE_ W.
1909 - 1411
Granite - Marble
Bronze
6" thick /concrete to be placed under
grass marker which will be installed
flush with the ground.
APPROVED :,
DATE i
'THEY HAVE NOT BEEN FORGOTTEN"
of
• v / r
� r
Artistry in
Memorials
Merritt Monument Company, Inc.
4820 South U. S. Highway 1
Fort Pierce, Florida 33450
Phone: 464 -5547 or 464 -3755
June 9, 1980
Mrs. Florence L. Phelan,
City Clerk
City of Sebastian
Post Office Box 127
Sebastian, FL 32958
Dear Mrs. Phelant
Granite - Marble
Bronze
Enclosed is an original and one copy of an approval
for a double grass marker for the SawvQr family to be
installed in Sebastian Cemetery. -A en
If this meets with your approval, please sign my
copy and return it to me.
Encbsures
Sincerely,
MERRITT MONUMENT COMPANY, INC.
,&"/� f Z-u�
Ms. Debra S. Sorensen
'THEY HAVE NOT BEEN FORGOTTEN"
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
A Is "'3/3 VITAL STATISTICS
APPLICATION FOR BURIAL -TR., SIT PERMIT
NAME OF
DECEASED
(Type or print)
First
George
Middle Lest
Lawrence Sax er
DATE Month Day Year
Y
DEATH March 8, 1980
PLACE OF DEATH
COUNTY Indian River
CITY, TOWN, OR LOCATION
RO$elarA
NAME OF (If not in hospital, give street address)
HOSPITAL OR
INSTITUTION Sebastian River Med. Cent
Attending Physician
Medical Examiners o
(Name of Medical Certifier)
Farhat Khaxaja, M.D. P.O. BOX 436
(Address)
Sebastian Florida 32958
rF u neral INsma)
ome Colonial Funeral
Address)
Home S. Indian River Drive Sebastian Florida 32958
Check A : ] A completed certificate of death accompanies this application.
One
8 ❑ Dr. was contacted on 1 g
He has assured me that this death was from natural causes and that he will complete and sign the medical
certification of cause of death.
C ❑ The attending physician was unavailable or this death comes within the Medical Examiners jurisdiction.
The body was released to me by
,19
March 9, 1980
(Signature) (Fla. Lic. No.) (Date Signed)
Funeral
Director
BURIAL TRANSIT PERMIT No %�11—,,z5 —j7'
Permission is hereby granted to dispose of this body by burial, transportation out of state, storage or cremation. For cremation a
waiting period of 48 hours after death must be observed and the Medical Examiner's approval must also be obtained.
❑ A five day extension of time for filing the death certificate has been requested and granted.
Signaturp of
Method of Disposition
l� BURIAL
❑ CREMATION
F] STORAGE
[] OTHER(Specify)
Signature of Sexton
or Person in Charge
CEMETERY OR CREMATORY
Date of
Disposition March 11, 1980
Place of
Disposition Sebastian Cemetery
This permit must be endorsed by the sexton or person in charge (or by the funeral director when there is no sexton) and returned
within 10 days to the local county health department.
HAS Form 326 (1/77)
!.