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$7}030-f2 <br />FDOT <br />R1GHr WAY <br />OGC - 04!22 <br />Florida Department of7ransportation <br />RONDFSANTIS Ofcc,,fRightofWay JARED W. PERDUE, P.E. <br />GOVERNOR 3400 Nest Cormwrcial Boulevard SECRETARY <br />Fort lauderxi.'tl¢, Ft. 33309-3421 <br />Donation of Property to the Florida Department of Transportation <br />Indian River County <br />Attn: Richard B. Szpyrka, P.E <br />Public Works Director <br />1801 27111 Street <br />Vero Beach. FL 32960 <br />ITENVSEGNIENT NO.: <br />MANAGING DISTRICT: <br />F.A.P. NO <br />STATE ROAD NO: <br />COUNTY: <br />PARCEL NO.: <br />INTEREST CONVEYED: <br />4130482 <br />4 <br />D417 092 B <br />CR 606 / Oslo Road <br />Indian River <br />809 <br />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 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. if any. Having been fully informed of the above rights, I hereby waive those rights <br />unless otherwise noted below <br />Owner's Signature <br />Type or Print Property Owner's Name <br />1801 2711 Street <br />Street Address <br />Vero Beach, FL 32960 <br />City, State, Zip Code <br />Date <br />APPROVED AST <br />AN Z_jAM; <br />MDFWAAL <br />DEPUTY COUNTY Ari :)Rt4=_Y <br />179 <br />