INDIVIDUAL RECORD AND RETURN TO: Development Review Division Marion County Transportation Department 412 SE 25th Avenue Ocala, FL 34471 THIS INSTRUMENT PREPARED BY: __________________________________ __________________________________ __________________________________ PID No: Name of Project: Project Number: PUBLIC INGRESS AND EGRESS EASEMENT THIS EASEMENT, Made this ______ day of ________, 20 _____, by __________________ ______________________________________ whose mailing address is ________________________ ______________________________________, grantor(s), to MARION COUNTY, a political subdivision of the State of Florida, whose mailing address is 601 SE 25th Avenue, Ocala, Florida 34471-2626, its successors and assigns, grantee: (Wherever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of organizations). WITNESSETH: That the grantor for and in consideration of the sum of Ten dollars ($10.00) and other valuable considerations paid, the receipt and sufficiency of which is hereby acknowledged, hereby grants unto the grantee, its successors and assigns, a perpetual public easement and right of way for vehicular and pedestrian access upon, over and across the following described land in Marion County, Florida, to wit: See Exhibit "A" Attached hereto and by this reference made a part hereof. TO HAVE AND TO HOLD the same unto said grantee, its successors and assigns forever, and the grantor will defend the title to said lands against all persons claiming by, through or under said grantor. American LegalNet, Inc. www.FormsWorkflow.com IN WITNESS WHEREOF, the said grantor has signed and sealed these presents the day and year first above written. Signed, sealed and delivered in the presence of: (Two witnesses required by Florida Law) (Witness No. 1 - Signature) (Witness No. 1 - Printed) (Signature of Grantor) (Name of grantor - Printed) (Witness No. 2 - Signature) (Witness No. 2 - Printed) (Signature of Grantor) (Name of grantor - Printed) (Address of Grantor) (City, State, Zip of Grantor) STATE OF COUNTY OF __________________ The foregoing instrument was acknowledged before me this ________day of ________, 20_____, by _________________________ who is personally known to me or who has produced ________________ _________________________as identification; and who acknowledged that he/she executed this easement freely and voluntarily for the purposes therein expressed. ________________________________ Print/Type Name:__________________ Notary Public in and for the County and State last aforesaid. My Commission Expires: ___________ Serial No., if any: _________________ American LegalNet, Inc. www.FormsWorkflow.com STATE OF ____________________ COUNTY OF __________________ The foregoing instrument was acknowledged before me this ________day of ________, 20_____, by _________________________ who is personally known to me or who has produced ________________ _________________________as identification; and who acknowledged that he/she executed this easement freely and voluntarily for the purposes therein expressed. ________________________________ Print/Type Name:__________________ Notary Public in and for the County and State last aforesaid. My Commission Expires: ___________ Serial No., if any: _________________ Revised 04/06/04 American LegalNet, Inc. www.FormsWorkflow.com