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HomeMy WebLinkAbout0219 - _ -~3'7431 µ _ _ ou_u ~JGr.• . , .~w~ d lle~h~ u~ ReA~Mlu~~ne Sc~1n~ J ~Ot-JJ srwTi s~~c No. - - nrvmoa oF ~Ew~.n~ ` ~~If, O~ ?liNi IN F L O R i u A wEd~~pAR'i NO. ~0 J~ - H~MAN[NT IN[ ~_H~ rrst ~ru i~si SIE YyWOf HI SE1t DATE Oi OEATM M~. nu ~ AUGUST h~1I BATZ ~ a• ~ ~ UCE .~au. wwo. ~.ewr. ww.. wGf-uu w.w. ~.e.~ uw~~ . o.• O~tE Oi M[tH ~.orw. w~. COIMaTr Of OEAiM • nc. ~wc ~ M~r~~~~w~~ .os. rn wws .~a w~ ~ ~hite a 81 ~~ac. la 18~3 Clir. TOYM, W l i10N Of Of/1iN wsra ta~ arm NOSniAI W OMEI KST~i1RAN- ~r rw ~w t~ee~. a~ s~Yn u~ wuuu~ vecr~ nf u «o ' • ~ Stuart Yes :~~arti:~ `:e~^.orial I-:osDital ST~iE Of YlM ~r wo~ « v.w... wr~ piKfH Oi 1N11Ai COVNTLLY MwRi1F0. P:E~:~t w.;:.ED. ISUtvNiHG S10USE ~r ~re. ow~ ~wr ww~ ~ Gown~ 1 WiDOwED. OivJ:CE D~ snc+n C~ e T ~.,,,~„~,,,.,K, Pennsylvania USA . - - :~1.ice Sn SpCIAI SECYOi1f NUWER VSUAL OCGWwTKiN ~a.~ a..~ or .o.. oo+~~ ow.~: -~:~a. o. i~~. r eur Kw0 Of WSNESS O~ N+WISriY p~ewps M .orw we. m« .e...ea ~ i ,r 154-07-7421 ~y General Ccr.;,rac ~cr Construction n.».wc..vo.~ ~s~owc~-sun cawm utr.roww.o.?our~oN s,efcs ~u+o mw.E`"2iver Dr. ~IY~CJ11~1 O~ ND - ~y Florida ~N St. Lucie iW : ort Pierce \0 14 11203 S. Indiar. i~iNF~~N~MF ~Mp +AM~ uar ~ ~'AOTMEi-IU~JEM N~ME ~rY ~w~ ~ uW ~s [iD~AV~Q~I QPT i ~ 11;..:i1fA~T ARf . . I Wp~AMNT-NAMf ' MAyWG ApGipSS ~smn M~.~.~. w0.. c.n W w.... N~4, tr~ F la . 33450 AZice ~ Batz ~,n 212G3 S. ~~dian River Dr. Ft. Pierce - ?wn i. oEwn~ wws Gus[o ar: ;[nT[e av?r aa cwust ?[e _nvt roe (~l Ir~, a+o (~p ~u~.ii~ o.~a~? ~i.~w µ ~p M4~/~I~~~~~~(~~V ~ f j ^ ~ ~ ,G'~.GKad i . ' ~~e bff q G~ v?~-~ ~c n~ ~ ~r~-?-e~ ~ Gv?~? , i ~ ~.¦~M.r~ c~rs~ ~a. w~ w, a u~ ca+xoa.rca at . lnwp C~~N U~t .~i ~ r C ...,~.o C~i/~,61•~-- . L{~t ~'S~L-~ ~ ("~IQ~T ~ ~ ~Ati Y. OTMFi S~CsMJKANT " ca+on.o~f (o: .~_:.~,r _~.r. c.us~ Gn1. r~f . w~ ~AYiO~SY H rES vt~l ~~ws~wOf CWr ~ ~ f',.T ;-v~~ ~~%'%l.~ N r ~?YJ ,N'1~ ~ns a wo~ oaii~ w Nu~..wwo cww If~ 111 w!oY~1 ACC~OfNi. SUh,;Df C~ A YUURV .~o•.+•, p....,.~ n,:_i HOW INIU~r OCCYIREG ~~'m~ e I~n ~ ut w,~u 1~1 h~~3pOY~1CMWfs Ot {1MfifWlh(D ~ M tM M'hL ~ ~NIIM~ wT WOBt nwCE OI IHJIA1f »w. ~r•en. r.ao.., ~.OU7.G+ ~ wen a~.r.w .a.. an a rw~r. u~w ~ 1lMOA A~ W MO~ OAK! MM.,~K. ~vK.n~ ~ . 7M' 7M »S CERf1ilGTpn- ror.r ~.r nu ra+s. w. .~u I u.e us~ ~.r .~../M~ um a. I 00/M?~O~ ~r11 M Ol4TN OCCVI~~Y w~ n.ee. w+ w ~M13KI~M: rJy MI ~l~~ ~OO~ ~Iq~ N~1M_ 1~W~~ ~~A. ~M, q M N?t ~ ~~m»o~s rwt /y T~ /J / /L] ~ 7 w w r~ ~.o.uou. M . tN wa•seo r~cr ' Y ~!q D 3 r!~ ~ l:e ~ ~ 71~. !N /C ~ M t0 ~ 4wHn~ tnre~. Cf~tYKATqea-i.~EDK~~ EiwwwER OR COROr+E~. o. ~•>,s rm .ou. o. a.~. .~•t Nua~». w.s ~owo~w.tee Ny ~u~w~Mh p~Mt q~~ ~!W/o~ rw~ Mtis~~Wr~W.. w rr Ww~O~.. .O.~~w Mt AY n011~ ~ N~M 0CC1NYS O~+ M~~n ~M FI~ q M 4vfIH~ s~~nO' ' 77~ M. J7? M. . ~ CEiTY~E~- ~~!m w~wn ( n • SiGn~T ' Ncw~~/p~~ nr w E SK.nED ~~o-~., w•,.w~ . ~ fI~ ~.7 • ~ C Y'f' ~ ' .7L ' I v~ c ~ , ?k . MJ1?M1G AODtESS-CEfff~Ef s~r ii~~. o~ .o o I Cm ~oyw.~ ir.• iu ~ tl~ ~r / I/ ~/+~/~''il ~J~L~r.t~~ Xi J~/~ ~ ~ . •utuL. CREMATqN. REr~OVwl 1CEMttEa+We CiE iGWY-~.a~r. :O ' ON a~r a q.n. s~.re ~ . ~~ntrr~ ( ~ ta i2@IT10Vdi ,to .°~C?..S~:t-` i , __i.C:~r"___~+~~;••'-- '-nrt _Tnrce~~_ ~ - DAiE ~r0~~. Mr, .t~~~ fUNE~AI n.^.w~E-n~va ~r.:, .:i:55 _'^o. t.r. O~ ~O.r. f~•r~. l~r~ 7 . tyAt;r. 9~ 1972 ,wYa;.cs ::c:-~ .::~-;c. ~G3ox 777 r^,.. ~ ~ ? ~ Pierc~ F~7 z 334 ~ Y.$~~Sj,2 ~WE Oi-SG.v aE ,'~LG~+.~A~-S'..• J~E ~ Ontt 1ty~ ID ~f ~(/.ia 1lG:i"~•J ~ . ~ R.s.:Qro ~y ~ ~./i~ ~ O~ir~.c~~ ~ //.t~.e,%~ f ~ i ~ ~ - - . • / ~ - - - - - ~ ~ N ~ ~ : . , • ~ !///~J;. ~ ' r -1 ~ ~ ' :`~"i,•~`^ ` ~^'~orr„ ~ t hereby certify this ro be a true and corred topY of Me Loca~ tn '-D o c o . • Registrar's record on 4ile in the Martin Cou~ty Htalth D~p~~t- . ~ ,~c. ~ • ment at Stuart, Florida. 1\= ._,-,~;o ~ - . .~cc.~m (1r/arn;ng: Not valid unless raised seal of the Martin ~ ~ ' - . - County Health Department is affixed.) ~ ~'~A N ~ . ~V.~ ~ ~ _ ~ r~ ~ ~ ~ N. D. A'~1Ll.R, M. D. -.s ~ ~v ~ County Nealth Officer b Lotal Re~istra~ D~~_ ~ . . . i?s~~t-~C/ ~ . . .~L~ Y ~ ~ /~QA st~ Dev~Y ~I Rwistrar n-~R~ 206 ~~~t ~18 - - _..M - - ~