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• <br />6 a PROPERTY OWNER'S NAME: <br />16, PROPERTY OWNER'S MAILING ADDRESS: <br />PROPERTY CONTROL NUMBER: <br />PROPERTY LOCATION: (Unincorporated area or Sebastian) <br />NUMBER OF ERUs RESERVED: <br />SPECIAL ASSESSMENT AMOUNT: S <br />LEGAL DESCRIPTION OF THE PROPERTY: <br />WASTEWATER CAPACITY RESERVATION <br />AND <br />CONSENT TO SPECIAL ASSESSMENT <br />Reference is made to the Information at the top of this page. The <br />Undersigned, the owner of the Property defined below, hereby irrevocably consents <br />to the imposition by the County of a special assessment in lieu of impact fee■ in <br />the amount set forth above (the "Special Assessment"). The payment of the <br />Special Assessment together with the interest thereon and the charges in <br />connection therewith will be secured by a lien against the Property. The Special <br />Assessment is imposed in connection with the reservation for the Property by the <br />County of the number of equivalent residential units ("ERUs") set forth above of <br />wastewater treatment plant and transmission capacity. <br />SECTION "A" of the Master Capacity Reservation and Consent to Special <br />Assessment recorded in Official Record Book _, Page _ of the Public <br />Records of Indian River County, Florida is incorporated herein by reference and <br />made a part hereof. <br />IN WITNESS WHEREOF, the County has caused this Instrument to be <br />executed as of the day of , 1987. <br />INDIAN RIVER COUNTY, FLORIDA <br />Terrance G. Pinto, Director <br />Department of Utility Services <br />Bv! <br />Charles P. Balczun <br />County Administrator <br />ACKNOWLEDGED this _ day of <br />, 1987. <br />Notary Public <br />My Commission Expires: <br />(SEAL) <br />