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PART//; INSTRUCTIONS AND INFORMATION REQUIRED TO APPLY FOR A RELEASE OF RIGHT -OF -
<br />ENTRY AND EXPLORATION FOR AN OIL AND MINERAL RESERVATION
<br />DO NOT SUBMIT AN APPLICATION TO THE BOARD OF TRUSTEES WHEN REQUESTING THE RELEASE OF
<br />RICHT-OF-ENTRY AND EXPLORATION FOR AN OIL AND MINERAL RESERVATION ON PARCELS ANDER
<br />TWENTY ACRES (20) IN SIZE, THE RIGHT -OF -ENTRY AND EXPLORATION FOR OIL AND MINERAL
<br />RESERVATIONS ON PARCELS j ,NDF.R TWENTY ACRES (20) IN SIZE HAS BEEN RELEASED PURSUANT TO
<br />SECTION 270.11, FLORIDA STATUTES,
<br />IN ORDER TO QUALIFY FOR A RELEASE OF THE RIGHT -OF -ENTRY AND EXPLORATION FOR AN OIL AND
<br />MINERAL RESERVATION ON PARCELS TWENTY ACRES (20) OR GREATER 1N SIZE, THE DEVELOPER MUST
<br />SUBMIT AN AFFIDAVIT CERTIFYING THAT EACH PARCEL WILL BE A PERMANENT BUILDING SITE, WHAT
<br />WILL BE BUILT, DATE OF CONSTRUCTION PROPOSED AND THE LAND USE WILL NOT INVOLVE PHOSPHATE
<br />MINERAL, METAL OR PETROLEUM EXTRACTION, AS SET FORTH IN PARAGRAPH 18-2.018(3)(E)(2), FLORIDA
<br />ADMINISTRATION CODE.
<br />PART/11. INSTRUCTIONS TO APPLY FOR THE RELEASE OF A ROAD RESERVATION
<br />Submit the completed application along with all exhibits pertaining to the road right-of-way reservation, Including a plat,
<br />sketch, or survey of the land proposed for release and a copy of Murphy Act deed containing road reservation directly to the
<br />Appropriate district office of the Florida Department of Transportation (FDOT) listed below. DODO NOT send $300 check to
<br />FDOT. The district office will determine whether the subject road right-of-way reservation is valid and make its
<br />recommendation as to whether the road right-of-way reservation or any part thereof should be released. The application will
<br />not be considered without a recommendation from the Department of Transportation.
<br />D • ARTil fENTOFT ANSPORTATID;\'D/,STRICTS
<br />FIRST DISTRICT - Post Office Box 1249, Bartow, Florida 33830
<br />Ann: Right -of -Way 1.800-292.3368 Charlotte, Collier, Desoto, Glades, Hardee, Hendry, Highlands, IAe, Manalm OkeechobeA Polk, and Sarasota Counties
<br />SECOND. DISTRICT - 1109 South Marion Avenues Mail Station 1020. Lake City, Florida 32025-5874
<br />Atm: Rfght-of-Wev 1386) 961-7476 OR 1-800.749-2967 Alachua, Baker, Bradford, Clay, Columbia, Diaie, Duval, Gilchrist, Hamilton, Lafayette. Levy,
<br />Madison, Nassau, Putnam, S(. Johns, Suwannee, Taylor, and Union Counties
<br />THIRD DISTRICT - Post Officell- 607, Chiole,', Florida 32428
<br />Attn: Right -9f -Way 050) 638-0250 Day, Calhuuu, Ewannbia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Okalooss, Santa Rosa,
<br />Wakulls, Walton,and Washington Counties
<br />FOURTH DISTRICT - 3400 West Commercial Iloulevard, Ft. Lauderdale, Florid, 33309
<br />Attn; Manning l-866-336-8435,19541777.4550 Broward, Indian River,Martin, Palm Beach, and St. Lucie Counties
<br />FIFTII DISTRICT - 719 South Woadlend Boul"ited. Deland, Florida 32720
<br />Attn: Rieht-of-WRY (3861943.5000 Brevard, Citrus, Flagler, Lake, Marion, Orange, Osceola, Seminole,Surnur, and Volusia Counties
<br />SIXTH DISTRICT - IDN Northwest 11 lth Avenue, Miami, Florida 33172
<br />Atin: Right -of -WRY (305) 470.5185 Dade and Monroe Counties
<br />SEVENTH DISTRICT - 11201 North Malcolm McKinley Drive, Tampa, Florida 33612
<br />Attn! Property M1lannerment(8131975fi020 Hernando,Hillsborough,Pasco,and Pinellas Counties
<br />FDOT DISTRICT OFFICE: Please refer to ALL roads adjacent to property and complete either a or b:
<br />a. ( )" The District Office of the Florida Department of Transportation certifies that State Road N also
<br />known as , DID exist on the date of the deed ( / / ) in which the reservation was made and it
<br />recommends to the Board of Trustees one of the following:
<br />(1) ( ) Retain ALL of the reservation, since It Is presently a State Road and we will need 100 feet from the
<br />centerline of S.R. _ for road improvement; or
<br />(2) ( ) Retain ,! feet from the centerline of S.R. also known as ,
<br />since it is presently a State Road; or
<br />(3) ( ) That this request is being forwarded to the applicable county or city for their recommendation, since
<br />former S.R. is now under their jurisdiction.
<br />Is. ( )" The District Office or the Florida Department of Transportation certifies that its records reflect
<br />that a state road DID NOT exist on the date of the old deed affecting the subject property and that a full release of reservation
<br />should be given. However, this application will be forwarded to the applicable county public works department for a final
<br />determination as to the validity of the reservation.
<br />By: Title: Dale:
<br />Signature (FDOT official)
<br />4
<br />Revised 08/21/12
<br />122
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