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57"30.12 <br />FDOT FJGHT �>�Y <br />occ - am <br />Florida Department of Transportation <br />ROIN DESA ris ofrice urRigiit of Way JARED W. PERDUE, P.E. <br />GOA LRNOR 3400 West Commercial Boulevard SECRETARY <br />Fort Lauderdale, FL 33309-3$21 <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 />PLb!ic Works Director <br />1801 27'" Street <br />Vero Beach. FL 32960 <br />MANAGING DISTRICT 4 <br />F.A.P NO <br />STATE ROAD NO.: <br />COUNTY: <br />PARCEL NO.: <br />INTEREST CONVEYED: <br />........._... <br />D417 092 B <br />CR 6061 Os:o Road <br />Incian River <br />100 <br />Fee Sim:jle <br />This is to advise that the undersigned, as owner of the property or property interest referenced above and as shown on <br />Right o` Way maps for referenced project, desires to make a voluntary donat'on of said orcperty 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 r;ght <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, if any. Having been fully informed of the above rights, I hereby wave those rights <br />unless otherwise noted below <br />Owner's Signature <br />Type or Print Property Owner's Name <br />1801 271 Street <br />Street Address <br />Vero Beach, FL 32960 <br />City, State, Zip Code <br />Date <br />APPROVED AS TO F,,'-) <br />A N ID LS F Y <br />BY ' <br />WILLIAM r'IFS. - AAL <br />DEPUTY COUNTY A i i OPINEY <br />