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A TRUE COPY 575-030-12 <br />;, PTIFICATION ON LAST PAGfi1G r0FwnY <br />FDOTR. SMITH, CLERK occ-04122 <br />Florida Department of Transportation <br />RON DESANTIS Office of Right of Way JARED W. PERDUE, P.E. <br />GOVERNOR 3400 West Commercial Boulevard SECRETARY <br />Fort Uuderdale. FL 33309-3421 <br />Donation of Property to the Florida Department of Transportation <br />Indian River County ITEM/SEGMENT NO.: 4130482 <br />Attn: Richard B. Szpyrka, P.E. <br />Public Works Director MANAGING DISTRICT: 4 <br />1801 27th Street <br />Vero Beach, FL 32960 F.A.P. NO.: D417 092 B <br />STATE ROAD NO.: CR 6061 Oslo Road <br />COUNTY: Indian River <br />PARCEL NO.: 802 <br />INTEREST CONVEYED: Perpetual Easement <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 reps <br />to have the referenced property or property interest appraised, to accompany the appraiser durirt <br />inspection of the property, to receive full compensation for the above referenced property, andta <br />for reasonable fees and costs incurred, if any. Having been fully informed of the above rights;9 to <br />unless otherwise noted below. _ <br />Owner's Signature <br />Peter D. O'Bryan <br />Type or Print Property Owner's Name <br />1801 27'" Street <br />Street Address <br />Vero Beach, FL 32960 <br />City, State, Zip Code <br />October 4, 2022 <br />Date <br />APPROVED AS TO N' -)k, <br />AL j� 11 IF F I W -WC <br />BY <br />WILLiAN1 it. DES. AL <br />DEPUTY COUNTY AI "i ORNEY <br />.Fl <br />his/her right <br />