4.
This declaration shall run with the land and shall be binding on the heirs, personal
representatives, grantees, successors and assigns of Owner.
5.
In further consideration of one dollar ($1.00), together with the acceptance of this permit
and the mutual considerations hereinabove stated, Owner agrees to indemnify, defend
and save County harmless against any and all claims, demands, actions, suits,
proceedings, judgments, liabilities and losses, of whatever nature, including reasonable
attorney’s fees, arising out of or from the issuance of this permit to Owner.
IN WITNESS WHEREOF, the said grantor has signed and sealed these presents on
, 20 .
Signed, sealed and delivered in the presence of:
(Signature of two witnesses required by Florida law)
WITNESS Signature (required)
SIGNATURE OF GRANTOR
TYPED OR PRINTED NAME OF WITNESS TYPED OR PRINTED NAME OF GRANTOR
MAILING ADDRESS OF GRANTOR
WITNESS Signature (required)
SIGNATURE OF GRANTOR
TYPED OR PRINTED NAME OF WITNESS TYPED OR PRINTED NAME OF GRANTOR
MAILING ADDRESS OF GRANTOR
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me by means of ☐ physical presence or ☐
online notarization, this _____ day of __________, 20____, by
____________________________ who is ☐ personally know to me or who has produced
_______________ (type of identification) as identification.
Witness my hand and official seal this day of , 20 .
Signed:
Notary Public in and for the County and State aforementioned
RECEIVED FOR FILING BY PALM BEACH COUNTY, LAND DEVELOPMENT
DIVISION by:
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