Backup Documents 06/24/2014 Item #16D 7 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP A 1\A At ha`)41414"6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
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 7
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already compl wiMfh�
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. Jennifer A. Belpedio, ACA County Attorney Office o (o A W i -
2. BCC Office Board of County \P‘--\
Commissioners /5/
3. Minutes and Records Clerk of Court's Office �C 61aT eCI
PRIMARY CONTACT INFORMATION
• 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 Mandy Moody `a�5�vV0. Phone Number 239-252-233
Contact/ Department
Agenda Date Item was June 24,2014 Agenda Item Number 16.D.7
Approved by the BCC
Type of Document Satisfactions and Release of Mortgage Number of Original 1
Attached Documents Attached
PO number or account Recording Fee paid by check from the title
number if document is company.
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) pplicable)
1. Does the document require the chairman's original signature? MM
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A ✓
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 MM
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
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 MM
document or the final negotiated contract date whichever is applicable. N�
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MM ✓
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 aware of your deadlines!
8. The document was approved by the BCC on (o(01 and all changes made during MM ✓
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 7'
BCC,all changes directed by the BCC have been made,and the document is ready for the g:).0j30
Chairman's signature.
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
16D7
INSTR 5001352 OR 5052 PG 3412
RECORDED 6/30/2014 8:27 AM PAGES 1
Prepared by:Mandy Moody DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Collier County COLLIER COUNTY FLORIDA
REC$10 00
Housing, Human&Veteran Services
3339 E. Tamiami Trail, Building H,#211
Naples, FL 34112
THIS SPACE FOR RECORDING
SATISFACTION AND RELEASE OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3299 E.
Tamiami Trail, Naples, Florida 34112, the owner(s) and holder(s) of a certain Agreement for Waiver of
Collier County Impact Fees executed by Remercile Isme and Samuel Alzime to Collier County, recorded
on September 5, 2000 in Official Records Book 2717, Page 2170, of the Public Records of Collier County,
Florida, in consideration of$8,194.34, receipt of which is hereby acknowledged does remise,release, quitclaim,
exonerate and discharge from the lien and operation of the said agreement, that certain portion of the premises
conveyed by said lien, more particularly described as follows:
Lot 2, Block 5,Avalon Estates, Unit 1, according to the plat thereof, as recorded in Plat Book 3, Pages 62,
of the Public Records of Collier County, Florida.
The undersigned is authorized to and does hereby release this Lien with respect to the above-named property
and consents to this Lien being forever discharged of record with respect to said property.
ATTEST: BOARD OF COUNTY COMMISSIONERS OF COLLIER
DWIGHT E.,BROCK, CLERK COUNTY, FLORIDA
Attes a , p � Tom Henning, C airman
eputy Clerk
signature'Only.
Dated: to 1 H Approved as to form and legality:
(SEAL)
Jenni r A. Belped
Assistance County Attorney 0. V2 \II--