Backup Documents 07/08/2014 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLID"A D
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3 .
O ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO j
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 Te--Whe �Com plete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If ocument is already co plet wit
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Office.
P B g g � P tY Y
Route to Addressee(s) (List in routing order) Office Initials Date
1. Jennifer A. Belpedio, ACA County Attorney Office h 0(c114--
2. BCC Office Board of County
Commissioners / itZ\1�A
3. Minutes and Records Clerk of Court's Office
0 9 (1y 1l:2.rlo.01
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 Elly Soto Mc uen,HHVS Phone Number (239)252- 664
Contact/ Department
Agenda Date Item was 7/8/2014 Agenda Item Number 16D3
Approved by the BCC
Type of Document Release of Agreement Authorizing Number of Original 1
Attached Affordable Housing Density Bonus and Documents Attached
Imposing Restrictions on Real Property
PO number or account N/A
number if document is 5 e_e .t.+uc1,„e e
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? esm f
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 esm
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 esw— 0.ja•
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 esm
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 esm ✓
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip (Nair ,/
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 'V 6
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 7/8/14 and all changes made during esm `-/
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.
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
1603 '
INSTR 5010177 OR 5060 PG 655
RECORDED 7/23/2014 8:37 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC$10.00
RELEASE OF AGREEMENT AUTHORIZING AFFORDABLE
HOUSING DENSITY BONUS AND IMPOSING
RESTRICTIONS ON REAL PROPERTY
KNOWN ALL MEN BY THESE PRESENTS That COLLIER COUNTY, whose post office
address is 3299 Tamiami Trail East, Naples, Florida, 34112, the owner(s) and holder(s) of a
certain Agreement Authorizing Affordable Housing Density Bonus and Imposing Restrictions on
Real Property executed by Rockwell T. Gust and Joan R. Walsh, d/b/a J.R. Properties
(Ospreys Landing Ltd.) to Collier County, recorded on October 30, 1992, in Official Records
Book 1766, Page 887, of the Public Records of Collier County, Florida has terminated and is
hereby released, remised, quitclaimed, exonerated and discharged from said agreement, that certain
portion of the premises conveyed by said agreement, more particularly described as follows:
The East Half of the Southwest Quarter of the Southeast Quarter less the Southerly 75 feet
thereof for State Road Right-of-Way, in Section 6, Township 50 South, Range 26 East, Collier
County, Florida.
The undersigned is authorized to and does hereby release the agreement with respect to the above named
property and consents to the agreement being forever discharged of record with respect to said property.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
1 /
, De e uty TOM H' , CHAIRMAN
Attest as to Cftaiirhan' ,� 1�1�`�-
signature only,
Approved as to form
and legality:
Jennifer A. Belpedi
Assistant County Attorney a