Backup Documents 04/08/2014 Item #16C2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP ire( - J
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO �r
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATUR�
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the Co A r O
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office p, A
4. BCC Office Board of County 'T \
Commissioners 7 zAzsV4
5. Minutes and Records Clerk of Court's Office I(-I-
f+lis PRIMARY CONTACT INFORMATION ? (J J Y e 'Z J I if
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Pam C 's Phone Number 239-252-2359
Contact/ Department
Agenda Date Item wa 4/8/2014 Agenda Item Number Cl6C2__)
Approved by the BC
Type of Document Satisfactions of Notice of Claim of Lien Number of Original 2 04- P kt,
Attached Documents Attached
PO number or account 408-210152-649030
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? SS
2. Does the document need to be sent to another agency for additional signatures? If yes, SS
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed SS
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's SS
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the SS
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's SS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip SS
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be. a e f your deadlines!
8. The document was approved by the BCC on � enter date)and all changes SS
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes,if applicable. �--�
9. Initials of attorney verifying that the attached document is the version approved by the /
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature. dQ'�'
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
ra ,:
This instrument prepared by: 1 6 I
Jennifer A. Belpedio
Assistant County Attorney INSTR 4975217 OR 5031 PG 2727
Office of the County Attorney RECORDED 4/30/2014 8:31 AM PAGES 2
3299 East Tamiami Trail, Suite 800 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Naples, Florida 34112
COLLIER COUNTY FLORIDA
REC$18.50
(239)252-8400
SATISFACTION OF NOTICE OF CLAIM OF LIEN
FOR WATER SYSTEM IMPACT FEES, WATER TAPPING FEES,
AND SANITARY SEWER SYSTEM IMPACT FEES
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS
EX-OFFICIO THE GOVERNING BOARD OF THE COLLIER COUNTY WATER-SEWER DISTRICT, was the
owner and holder of a certain Lien against:
JENNIFER KILE COLVIN
191 Islamorada Lane
Naples, FL 34114
The Lien was recorded on the 10th day of February 2005, in Official Record Book 3731, Page 3987, in
the Office of the Clerk of the Circuit Court of Collier County, State of Florida. The Lien secures the principal sum
of One Thousand Fifty Five Dollars and No Cents ($1,055.00), plus accrued interest and penalties, if any, and
imposes certain obligations against real property situated in Collier County, Florida, described as follows:
UNIT NO. 10, WEST WIND MOBILE HOME ESTATES, A CONDOMINIUM AS MORE FULLY
SHOWN IN OFFICIAL RECORD BOOK 630, PAGES 1883 THROUGH 1932, PUBLIC RECORDS
OF COLLIER COUNTY, FLORIDA, AS AMENDED; TOGETHER WITH ALL UNDIVIDED
INTERESTS IN THE COMMON ELEMENTS OR SURPLUSES ACCRUING TO SAID PROPERTY.
INCLUDING A 1984 CLAREMONT MOBILE HOME, IDENTIFICATION NUMBER
FLFL1AD397004793, TITLE NUMBER 40488746 WITH ALL ATTACHMENTS AND
IMPROVEMENTS THEREON.
SUBJECT TO THE TERMS AND CONDITIONS OF THE AFOREMENTIONED DECLARATION
OF CONDOMINIUM, AS AMENDED, EASEMENTS, RESTRICTIONS AND RESERVATIONS OF
RECORD.
SUBJECT TO TAXES FOR THE YEAR 1996 AND SUBSEQUENT YEARS.
FOLIO NUMBER: 81620400009
Collier County, a political subdivision of the State of Florida, and the Collier County Water-Sewer
District, a political subdivision of the State of Florida, hereby acknowledges receipt of payment in full Satisfaction
of the Lien and hereby cancels the Lien.
16C2
The Clerk of the Circuit Court is hereby directed to record this Satisfaction of Lien in the Official
Records of Collier County, Florida, to acknowledge that the Lien ceases to exist.
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County, Florida, and as
Ex-Officio the Governing Board of the Collier County Water-Sewer District, acting through its Chairman, directs
execution and recording of this Satisfaction of Lien, by action of the Board this day \- T.,1--.\ , 2014.
ATTEST:'"' BOARD OF COUNTY COM1M4ISSIOERS
DWIGHT E."B1.;OC , CLERK COLLIER COUNTY, FLORIDA, ASII-IE
GOVERNING BODY OF COLLIER';
By �L• ,C . COUNTY AND AS EX-OFFICIO�`I HE
qop to tx,Clerk GOVERNING BOARD OF THE.COLLIER
Attest as`tp,Cha matt$ COUNTY WATER-SEWER DIST, 1CT
Appr®i {erfAniym and legality: °:1 ' '
/
c _. � _ L
Jennifer A. Belped •M HENNING, C, AIRMAN
Assistant County A orney 3 1 3 19 U
nt prepared ` �` 6 C 2
This instrument
e
Jennifer A. Belpedio INSTR 4975218 OR 5031 PG 2729
Assistant County Attorney RECORDED 4/30/2014 8:31 AM PAGES 2
Office of the County Attorney DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
3299 East Tamiami Trail, Suite 800 COLLIER COUNTY FLORIDA
Naples,Florida 34112 REC$18.50
(239)252-8400
SATISFACTION OF NOTICE OF CLAIM OF LIEN
FOR WATER SYSTEM IMPACT FEES, WATER TAPPING FEES,
AND SANITARY SEWER SYSTEM IMPACT FEES
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS
EX-OFFICIO THE GOVERNING BOARD OF THE COLLIER COUNTY WATER-SEWER DISTRICT, was the
owner and holder of a certain Lien against:
GLENN QUESENBERRY
2360 Shadowlawn Drive
Naples, FL 34112-4836
The Lien was recorded on the 13th day of May 1994, in Official Record Book 1947, Page(s) 680-681, in
the Office of the Clerk of the Circuit Court of Collier County, State of Florida. The Lien secures the principal sum
of Seven Thousand Eight Hundred Forty Dollars and No Cents ($7,840.00), plus accrued interest and penalties, if
any, and imposes certain obligations against real property situated in Collier County, Florida, described as follows:
THE SOUTH 110.00 FEET OF THE NORTH 1222.70 FEET OF LOT 36,NAPLES GROVE &
TRUCK CO'S LITTLE FARMS NO. 2 RECORDED IN PLAT BOOK 1, PAGE 27, PUBLIC
RECORDS OF COLLIER COUNTY, FLORIDA; LESS THE EAST 5 FEET AND LESS THE FILLET
CURVE DESCRIBED IN OFFICIAL RECORDS BOOK 772, PAGE 469, PUBLIC-RECORDS OF
COLLIER COUNTY, FLORIDA.
SUBJECT TO EASEMENTS, RESERVATIONS AND RESTRICTIONS OF RECORD AND TAXES
FOR THE YEAR 1984 AND SUBSEQUENT YEARS.
THIS IS A NON-HOMESTEAD PROPERTY.
FOLIO NUMBER: 61834800004
Collier County, a political subdivision of the State of Florida, and the Collier County Water-Sewer
District, a political subdivision of the State of Florida, hereby acknowledges receipt of payment in full Satisfaction
of the Lien and hereby cancels the Lien.
The Clerk of the Circuit Court is hereby directed to record this Satisfaction of Lien in the Official
Records of Collier County, Florida, to acknowledge that the Lien ceases to exist.
16C2
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County, Florida, and as
Ex-Officio the Governing Board of the Collier County Water-Sewer District, acting through its Chairman, directs
execution and recording of this Satisfaction of Lien, by action of the Board thisc8k4-. day ' \ r\\ 2014.
iilfr{lg.
ATTEST: ' BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA,AS THE
GOVERNING BODY OF C II
By:- OL.,l �' _4 A COUNTY AND AS EX-OFFIC1O.THE
Attest as to ;; Clerk GOVERNING BOARD OF THE COLLIER
signature oak, COUNTY WATER-SEWER DISTRICT•
Approved es to form and legality:
pP 11
Jennifer A. Bel P edit "tom HE IN., CHAIRMAN
Assistant County Attorney 3/3)ILi