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HomeMy WebLinkAbout2516519U81 ~ t Re: Lot 8, Block 1622~ PORT ST, LUCIE SECTION 23, a subidivision according t~ the plat thereof recorded in Plat Book 13~ paRe 29 of the public records of St. Lucie Co~anty. Florida. Lot 7~ Block 53. SOUTH PORT ST. LUCIE UNIT S~ a subdivision according to the plat thereof recorded in Plat Book 14~ paRe 12 of the public records of St. Lucie County~ Florida. • ' 41 ~ N~'1 ..~r It~~ad ~ : t i t ir:ilc ~ '.~~,~i:~~ty r ~ •„ of in- ,,:~ ~~iuutd be , ~ i ~,plicci . ~. •i~~~utd bc ~ ~. rittrn ;.1,•~i in per- ~. ;~, black • ~ . t `.ratc he- . . :, , ~~rinonent • , ~,.•~3 when ~ '~, ~~~rruted. ,~ t~~ ,ubmit a ~ ~ ,~~~• of Death . I). parLnent ~ !;, ~~i.~n Re- '; , ~+;tiiin 48 ; ~ ..it~ r death ~ .:~~!„tiUD Of ~ ; tt~~ [~it- { .•~ ~~~~~UAlhla. i!! It K ` ~,: ~)[ T-~ ( .,. ~ tils I ~ ~ E~~ r at.••. , ~~ ~.t t~1c5C , .n~~haU~e ~ , :mprison- , ~ ;~~. j~ ~ 1. i. ~~~. ~ ui.l 1 ~i I~~~.t ~.~ ~ . .'' , ' ' .. ` nt~~r~z~c~~r ~N r.ot.u~~~ii~n ~~f ~!'~. t-- 3~~ ~ ~ ~ DEPt\ttT\ll•:1T Uh' Ilil~ttll 1~1?SOURCI~:S 1~'~~'.~;~`~;iJ,,t~i~~;~ c~:~z•riF•ict~~rr: ot~• »h.~~T~i 79-006292 ~~LF. uar~ ~ Ilr \n. I.:~A\1k OP UEl'F..\SF.U /'irc~ 1ju/.!6• /.a</ 2a. DA7'E llnrrlh Unv Y~•ur ~lA. Huu~ oi Uea~1l (T)'pe ur Ptu~~/ lIF ~ _ _ (l`-~~?OFIi t',~•:06 j~:IPi7,I:R nF:»~Ek:P'Ti:*1EER ~ 1 ' i1:30_ FM 979-_-,.-- i. SEX 1. Cq1AR OR R:\('F: 5. \ev~r \1a~ueJ. -~ta~eicd. ~G. I)ATE 1)F' I:71t'fll 7. ~GE rAr ~.•~rs i L'nder 1 Yr. H Uudcr 24 llrs. ~"--" «It~UN'PIi~ DI\YI~CP1~: 1(1fP1I)' f I,~rftiduy> >l~~~ifi~s 1-~ys lb~urs ~lin. r~ .cncTc~+.sl~rr ~ ~ -- 7 s - ~-- - ----- ~---- _~-- _ J'~9I.RIED_ __ 1LZY 2 Z 03 6 R. 1'Lr\CF:OF DEATII IX ~~':~.hington. D.C. 9. 1'Sl'A1. NI'~IUE\CE rUi;~v~ drrrusi•Jli~.'d. /(rr+sfilu~i..rt. irsiJente \A\iF, OF 1lOtiPIT:\1.. ~IiNSI\G ItU\fE (1R OTIIER I~tiTITt'TI~)X a. STATF. b.COV~:TY ~'l~re aJrnrvion~ ~l( r.t :n nssht:.tr.~^. ;;~i: sfr.. t cJdr, ;.r V?r.Gl'riIA ~ II~SlDE CITY I.I~tITS hA.I,sER R~ED AI~.I~lt I~~~I~IC L CL.?~' . e. CITY T~f , I n e. lSPECIFY YES OR NO) ~ ~ER -- ~ ll,i:I PIA ( ~.2~~4 ) Yes d. STRF.ET AI)pREtiS N; rr.~al. ~ir~ l,.tr.ti~,nl ~Vsshington, D C ~t 612 S i YAT~? BLAI~TE PL lOa. I:cl'.\1. OCCGPATI!)\ (Gi~.• i:~n~,+.~/ r. n-k IOb. F~t\U QF Bl:ti1Xk.SS Uk i l l. RIR i IIPL ~CE 1_. CITI"LE\OF'\~'HAT C4liNTRY'' ~or-: ?:n.•r.: rr~..,:f ..i '>i~:drta• li/:. r:. n tj •~f~r~~[i IXI)1'ST!{ l~ruf: e~r fon !kn r.~ur,fn~l _r~ ~IRF.D i;S AI2t~i OrrICu'R ~/A ~~ .ta=T,IL~l~C ' ' - : _ - - USA--- - 13a. FATHF:H'S \A\1F - - - 13b. ~t07'IIFR'S 1(.~IDt:\ \A~1F. i l f. \A\1F OF St'!:l'!~'IXG SPOI~SE G'~C'S 8 !iINZER . £LLL?~1 ~ !~~x~F!i : r n_bFR'i'~`. ~' •'r_I:i2F'F -- - - - - - - -- - - - - - - - - -- _ -- - - -- 1.-~. F:~r~ m t'.S.~iG.~U~'f-~1.tiEfl'NITYXO. 17a. 1\Fnlt\L~XT 7{fJ..177l1\'~///i' !~~ l~/'C'1..1 ~F'/~ 17b. ADIIRtSS Strc~t Gt> ----Statt irmPa! t'utc~s. 1~S ~~50-10-O~t31 LA~P.EF.'I'A 1~i. YZi~tZ£R,/~'IFE/~EE ITf7•i ~9 1R. CAI'tik OF DF ~7~H: I(.nter ~~nly ~.rto a'aus.• pa•r line j.., ~c i. tl.l. w7d fel. / ~ Int~•rral Retw~r~n PAHl' L DE:ATII \YAS t:Al,'SF.U Bl': ! Umrt and Ueath: I~f~t6ui_~'re c-at;se t~) S:•i~~I,?, CELL i:i-I1IFFtiFtI~i~'IAZ'IOIr' C.~_F.Cy1:02~~ _OF LLiJ~ -- CortJittuns, tf cny, ' i u~h~ch Ro~'a ~isF to ~ aAo~c causr ic). ctaF i)UE TO (63 ---- - - -- - -• '- -- - - - - ~ (np fhe unde.i~inQ causr - - -- - -- -- - -~- - - ~ 4uL . ' --- - 't -- DUE TO (~1 _ _- - - - - - - - ~ ~ PAItT IL ~)TIiEIt S(GXIFICA\T COtiqIT10KS' ~nr.:~~buti:~r. :~. d.-ath b~t n~~1 ' 19a. AU"fOPCY'1196.ItYe,.~Yere Fmdir.KSConsidcred rel~trA tu the terrninal di.~a.r ~-nndition gi~en in Da~t 1(a) YFS ~)R AU ~n 1)~-terminin~ tF.e Cause of Dealh? ~ ~ . .. - ~ ~~-- F IF OPEXATlOX ~l'A5 PE}tFOR\1F.1) '~Oa. DATE OF OPERA'11t-\ 20G_ CnX1)!TIO\ FOR 11lIICII OPE}2ATIOJI a CO\1PLETE ITE\15 20a and 2A6 R'.~S PF.RF'OIt~fEU v a 21a.Spec~[) ~( ariidrnt.suicid~.homi- 21b. HUVK A`:U UATF' OF 1\Jt~KI": 11~fi~h.Day.Yearf2lc. !)E.SGHIRE HM'v I~iJliRY UCCI:RREU V c~de, or mann~r undele~mined i ~E ~~f~•~ nal~.r~ n~ /njun in pQrt / ar Fart /)- ~t ~ - - - -- - - - - 1-- -- W 22d_ IKJCi{Y AT 1\'ONIi: 21t. Pi.ACE OF INJI'ItY: /.If /In:.~.• F'urm_ 21f. 1.OCATIOti C(TY COl:Y7'Y --- -STATE iS~'t~f> )'~s or ~nl F~act~r:. titrrrf or O(licr J1:.ddinR. f-ta ~ T 22.1 certif~ lhat ~~ (this hu~p~1 1) at~~. d the Q~~racr~l t~•~rr~~._k~7;~,~~F,;F?. ,.,.39.. t~ e~--~~ L~.~.R . 19_~~ _. that ~(K~~) la~t csw the deceased aLce on ~~ yx,~~fj'y,~~,.A., ~g ___t~_,a~id :?:et dr.th unurrrd frum th: e~cus and o:~ the ~'.~.t ar.d hnur stattd ahovt_ - -r--- - --, '12a_ SIGXATVRE . - - ---- - -` - - - - --- 22b. nATE S!G\EU ~ ~I Ir~i~'-__ _~~ I."~.,./ (~+ ~.Y~~ .a~` F IYS\lll.~ DIttPCTOR STAFF ~= p ;~~.. lG ~ ~ FFlYS. ~1 s~ 1'r.....FR _; 22t. PH7 SIC11N'S ` ~ 12d. ADUNF SS 3 \A\1F_ 1T~~pc) ~ `~`',~• :s~ ` JO'iES '•'D CP^t i•fC FS25 lEth S^' ':*d << '- ''.~- ~(;ni? 23a. BIiRL\L X~3b. D:\TE °_3c.\A\tEf)'rCt:~1f:7ENYOR('kE\1ATOR1'23d. I.OCAZ'If)v rCily,t..un.urcounh/ ISt.:fe~ - r_RE~twT~~Y ~ KF.,~,vn~. Arlington I~ational Cemetery Arlington, Vir ia '3a. F[T\FRAI. HO\tE I't.l•~t~: ~1~1F:F~%iL ~!~2;~, -- ---- - 2:rw. l'.'D6RTA ~E1C'~S CII: ;ATIiRE Y,.h_ UVUF.RTAKFR'S y~ ~w REGiSTRAT Ai)llItE~Sj2O PiGUTIS F:/.Fi:,,~Lt:?J~1~I:F'II! ,. ~r1 F~C7.'JI~~. 1.Yi ~ ~ -Y1 ~cuxex ~~ 257 KEMARkti: ~i.~ " :.-~",~ ~A[_ I . Authurily ic granted for crrmation by ~•• • - `„ c•~+, • ~ . . ,~ -- .c. • ~: 519U~1 . -: ~ ~ ~ . '~ -------------------- - ------- • -------~+-•--'-' --' -».G..---v ~~ y ;~tedical Exumin~f br~tep~nlaGv! , ;: ~~ . ' - - ± ----- AR "S--~M_Jji~~--- ~~ ~* ~ ,:;',~ ~.~nat~:-------- - AM - ----- - , ,, , , -. .,~ ... ,.., . -- ---- - - -- - - - ~ . . - - _ s ~ ~~ C cfOUJf ~t1;jTA ~ --__ - ~ :~. 2c .. ~.•'; • ] ' , _ . ~'- GER POITRA5 P ~ ~~ i~" '~~ J' ~ CtERK ~ . .-_.r -"' ,. ; ,~ " . --- CIRCUIT COt1Ri ~~'~ Ss~ - . • ~+, ",; ` ~ : .~: I CERT 1 FY '~~~~rt~te above ~ s a true arid corre~,' certificate filed in order with the Vit~l Reco~ Co I umb i a De~+artment of' pub I i c He ~ I th. ' . . ac~o~~ 3, iy79 ~ ; ~. (Date Issued) hOT 1~r;~ID WITHQUT R41SED SEAL ~~~ ~-- _ _-.. _. _ _ - - - . - - ---__~-~. _ f ~ ~~ a _ _~_ .. t~iA~Ag~ ~ on of t he or i g i na I ~BtV,~,o i on, 0 i~.~r i ct of ohn H. Cranda { 1, Cli i ef ital Recurds Division - -- ~_ .___._ . ._ .-.....:_.,~,; ~s-~-_ ~ .. .• ,~~'~349 Q~~2515 , - - ~~_ __ _ ._..