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HomeMy WebLinkAbout0066 ~~1538 ti ' RE : Lot 7, Hlock R, MARr?V2LL~ EBT~?T$S , aaaordinq to th~~ plat thereof . r~corded in Plat eoolc 8, pag~ 77, o! tho public records o! St. Lucie County, Florida. i lE~ ANp REC R~ ^ s~. tv~1e CJUY~r ~A. #'15~~ Th~s :n;t;ument v;as p-ep~re3 by Rcf•i •~'J~Tq~S ~ ~~cc~e~~ v: cou~ j~~' Ci~esler (3. Giiiiin ,12~-A P,o. Znd SG ~~r Fi~rCe, F~a. No~ l 4 1~ 1 H~7Z - - - - ? " ~ ' ~ CERT1FiCATE OF DEATH Urqr?~e«~ ~f tkalll ~ad Re6~6il~~~~ire S~..ues 1TATE F~~e Ho. ; ~xv~,v or- ~~r~.ui F L O R I D X 7YIf. Ot /RtNT IN ~wr~~~'~O j REGIS7NAR•S NO. 488 ~ElMANtNT INK ~E~p_NAME nn~ rwa~ ~~s~ ~x DATE 01 OEAM I~OM1M, ON, ~1~~1 ' Sti Mu0~001 /Ot ! : ~ISTlYfiW~S ADOLPH K A It ~ October 5 1972 ~ RACE rw~r~. wOM. uI~K~M uNU». AGE-V,t1 utiot~ ~ re•~ ~ua.ot~ ~ w• DATEOf NtiM ~..pw~*. ur. COIlNTTOf DEATN 6602 ~ .K~w, 4.a.... .b. a~? , ~ ~ i . White 65 ~s, i~tar. 27 Z90 Sain't Lucie f CRY, lOWN. Of IOCATION Of DEATH wf~01 e~n .r~*t MpSryTA? OR OTMEY INSTItUT10N-NAME ~w rp~ ~w ~~ny~. pnr~ s~r~~ u.o .wre~ ~ ~ f.tC.?T +!f O~ w0 n Fort Pierce Yes DOA - Fort Pierce Memorial Hosnital ~ Si~tE Of WRm nor w ~.s ..ue GTIIfN Of W11A7 COUNTRY ' MAtR~EO. NEVFR MwRlIEO, SNlvNNG SpySE owe .ueeM riw ~ ~ cawrw' ~ ( WIDOWEO. ONORCED ~ vrtn i ~ ~s~•~n+~~ ~ Wisconsin ~ USA Married Florence Storms rMlu M(1~SH irvro. n eur SOC~?t SfNRlir M1WER USUAL OCCIMATION ~G~n a~H W wqc OW~i oww0 rOSr W I(INC Oi MlSM~ESS OR 1NDUSTRt/ ' OCCYWO M rO~MG uR. l`~!M Y~tF~t01 ~ „ ~:393-OS-0444-A Mtana er „ Retail Store •p"~~• RESqENCE-SGtf C011MTr UtY, TOWN, W IOCwT10N Ms~N cwv ~r~ns STlEEi ANO NVM~E! . ~ s.~cw. .~s u w . ~wFlo ida w St. Lncie Fort Pierce Yes ~~.1010 Bermuda Avanue fATMER._NMtE re4r rwat ust NOTMEI-~urDfN NM~E ~rs~ r,~ae u IS ~NI'ORMMIT-N'w[ eMywG wOORfSS ~suer w~~.s. w, c.rr p ro.~.~. ~~.w. tr~ Florence S. Krans . ~„1010 Bercnuda Ave. Ft. Pier e F1 33450 ?ART 1. OEAiM WAS CAUSED ~Y: ;fHiER ONIY OMf GtUSE IE~ l?K iOR kl (6L APD (~l{ ~~r~ir~~w O ut ~~M Na~w ' ~Weu~R 4Y1~ (.1 l c~i DS[' ~~•:~7~ ~ /~P,~7~ S'ectJ ~ f/NOrt , .s ~ e . COMOIfIOMl, N aM, ~II~ICN G~~t ¦~1~ 70 IrrlO~~II C~Ylt /W. yy~ t0. W~f ~ CO.+seOUewC! Or: ftaflM6 ~w( YMrH• ltIMO C~YM l~lt MRi OTME! SIG?~~i1C/~NT COMOfTlOnaS: eo.~ana.s coMa~Vn.+e q ot.a ~~n aor nuno ro uru one~ e+ ru~ ~ w~ AVT~~ 1f rES re~e .~~o~..ei eo..- ~ ~ ~ ns ~ s+w~to a~e~r~ru+c uuu O/ O~~IM ~ 0 ~w l ACdOENt. OR DA ~ rpwiw, p~r, ~~MOI/A HOW IN/URY OCCU[![O ~~Ml~ N~N~ OI ~NW~f iw ?~~7 ~ O~ rut n, rttr ~ IqYKJ ~ OR {I~OEiEWIMfD M ~ M f~ 1NA/R7 AT wOtK hACf Oi INIUl7.r rore, r.e., f+un, r.pw~, ~p~ATtON ~ snet ot ~.~.o ro , un o~ ~o?r, ar.n ~ ~ ~ snan ns w.a. ar~ce ~ue., e~c. ~ sncu. i lM 7M ~h CEItT~iKwT~ON- .ortw w• nu ~ ..a.a o.~ .i.~ ~ y.o usr s~w MY~/M!~ ..~+e a. ao: ao wr +w.. n.~ ot~rN oeeu~a[o w~~ ruce. o-. er _ !lITSK!AM: TO ~ ~Ontw O~t ~!V WOS ~A~~ Dt~w. ~wOU~~ OAR. V+O. q Mt ~l3T ~ Art[w0lO M~ ~ 1 q r~ c~p~nlOGt. Ouf lia OlCI~SlD ~~Or V G 7 7~ i71~ 7~ t~l~ ~O 5 72 '}N (~].d '11~ ~ t0 n~! Gyf~ql f~~rlD CHTYIUt10N-MEp~Cwl EXNrWE~ OR COtONER: o.. n.t ~.s~s o. rw „o„~ p. a,~,, n.e wctoe.....s r.o..ou.`cro aao ~au.iw•na~ w w qot ue/a rwt ..resr~c.rwM. w.~ O~wWw, ~ ro-nr wr •u~ ww : ee.m oeeruw w~ wn ...s oa a n+r e.u~~s~ s*.reo ~ : 72~ M 7!~ ~ M. ; CfRT1f1fR-NMIF ~tm O~ nwr~ ~ SIGNwTU~E ae~e[ o~ ~OwTf D~.a.~, w~, ~tui T~. 3erna d D ~s :i u+~ oC~ .~f'!• it,. ~ 10/6/?2 r+uxWC~AD01tES5-CE~tY1fI s~ne= or o~o em w~o.. t~ • ort tit Ir •ci S!~ ~ ~-o ~ p; ar Florida ' n 0 N7RUl. CRfMAT10N_ REMpVAt fw~ETER~f pi CRFtitA70(1Y-N.u~F IIOCw ION cm or p.~. fr•*t ~ ~ srean ,N ~urial ~,~ii2lcrest Mem. Gardens~,., Fort Pierce, Florida = DATF / M~ FUN tAl HOMtE-NA/N[ ANb A~,RFSS ~ St~t~~ O~ O~+O , C~n Q~ tp~r~, 3t~it, I~~ ~ i Octo~ie"r 9,~97 ~tates Funeral Home, Box 777, Ft. Pierce FI 33450 V• S. ~61Z FIM pIt~7QR_ !(!~E REWSt SK',x~7~/ff D~iE ~ CErvED tr IOCU ~tG~S~~~¦ R•~.19~0 ~ . ,y ~ctober 6 1972 I her~by oerlify this to b~ e trw and oorrect oopy af the Locsl - ~ ~ ReQlstr~rs rooord on fib in ths St. l~ucl~ Couny Fba(th pe~ mont at Fort Plera. Flortda. "1>t:;, ; , i (Wunir~: Not vaJid unlau ratsed sesl of the St, !~?cJs ' ~ f County Fiealth DepaAme+~t is effixed.) • : ; . ~ ! ~ = ; f ~ , ~,t ~ . ; N. D. MILLER, M. D. ~ , s. . ~ f County H~sltfi OfficK dc L+oc~! Rsg(str~r . - . ~ ; , - 1 7W •~"'J, „`-~•h `~fi'• , 1 ~ ' ~ 1 { ~ 4~ cti 1 D~putY Loc~t Rsofstru ' : y•,~ : • • ~ t~t~"~:` , ,i _ r i.~i.~:~! . . . _ . . D~U!'. ~ TIiVC ~ • NEtIL ORIiFIN JEFFRIE9 S LLOYD GNAqlEpED P O BOX 1270. FORT ?IERCE. FLORIDA 33450 - T~~EPHONE i305` ~64-8200 _ F ~