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RUE COPY <br />� <br />F�TIFICATION ON LAST PA%.57 OF opo WA�Y2 <br />�.R. SMITH, CLERK <br />FDOT <br />OGC-04122 <br />Florida Department of Transportation <br />RON DESANTtS office of Right of Way JARED W. PERDUE, P.E. <br />GONIMvOR 3400 West Commercial Boulevard SECRETARY <br />Fort Lauderdale, FL 33309-3421 <br />Donation of Property to the Florida Department of Transportation <br />Indian River County <br />Attn: Richard B. Szpyrka, P.E. <br />ITEM/SEGMENT NO.: <br />4130482 <br />Public Works Director <br />MANAGING DISTRICT: <br />4 <br />1801 27th Street <br />Vero Beach, FL 32960 <br />FA.P. NO.: <br />D417 092 B <br />STATE ROAD NO.: <br />CR 606 / Oslo Road <br />COUNTY: <br />Indian River <br />PARCEL NO.: <br />114 <br />INTEREST CONVEYED: <br />Fee Simple <br />This is to advise that the undersigned, as owner of the property or property interest referenced above and as shown on <br />Right of Way maps for referenced project, desires to make a voluntary donation of said property or property interest to the <br />State of Florida for the use and benefit of the Florida Department of Transportation. <br />The undersigned hereby acknowledges that he/she has been fully advised by a Department representative of his/her right <br />to have the referenced property or property interest appraised, to accompany the appraiser during the appraisal <br />inspection of the property, to receive full compensation for the above referenced property, and to receive reimbursement <br />for reasonable fees and costs incurred, V any. Having been fully informed of the above rights, I hereby waive those rights <br />unless otherwise noted below. �oUtiTyC . <br />owners signature <br />Peter D. O'Bryan, Chairman <br />Type or Print Property Owner's Name <br />1801 27th Street <br />Street Address <br />Vero Beach, FL 32960 <br />City, State, Zip Code <br />October 4, 2022 <br />Date <br />APPIMOVED AS TO <br />AND LEGALEDEBRAAL I <br />€3Y�VjlLt_i,4! <br />DEPUTY COUNTYKr- ORNEY <br />