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Backup Documents 12/13/2016 Item #16D 8 -7616ec ia-3o act ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLI TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO A b 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 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 Community and Human Services 2. County Attorney Office County Attorney Office / to(ka, t211 3 ►�o i-ecvvti,ti-�u,� j tti�o<th-lx 3. BCC Office Board of County l zkzct Commissioners J �� kke 4. Minutes and Records Clerk of Court's Office 4e7 :5411/t PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in e event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Cormac Giblin/ HS Phone Number 252-2399 Contact/ Department Agenda Date Item was 12-13-16 Agenda Item Number 16.D.8 Approved by the BCC Type of Document Release of Lien(4) Number of Original 4 Attached Documents Attached PO number or account Z s number if document is ` to be recorded � �- �'-Y�`�e � �� _�c\r"\ 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? 5 hs v..Ap 0 1.0 CG 2. Does the document need to be sent to another agency for additional signatures? If yes, NA 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 CG 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 NA 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 CG document or the final negotiated contract date whichever is applicable.- 6. pplicable-6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's CG signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip NA 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_12-13-16 and all changes made CG 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. 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 INSTR 5352073 OR 5349 PG 2216 16U8 RECORDED 12/30/2016 2:56 PM PAGES 1 Prepared by:Cormac Giblin DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT Collier County Community and Human Services COLLIER COUNTY FLORIDA 3339 E.Tamiami Trail,Building H,#211 REC$10.00 Naples,FL 34112 THIS SPACE FOR RECORDING 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 Lien Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable Housing Dwelling Units (the "Impact Fee Lien") executed by Marie Nicole Joseph to Collier County, recorded on 11/16/2010 in Official Records Book 4624, Page 1331 of the Public Records of Collier County, Florida, in consideration of $15,246.26, plus interest, receipt of which is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee Lien against the premises conveyed by said Impact Fee Lien and more particularly described as follows: LOT 70, LIBERTY LANDING, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 47,PAGES 71 THROUGH 73, OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. The undersigned is authorized to and does hereby satisfy and 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. This Release of Lien was approved by the Board of County Commissioners on - Z (3 , 2016,Agenda Item Number /6 Dg . ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA let"By: A: , , 4 , • C • By: 41114/49 11111111,kAttest as to rel , C-duty Clerk Donna Fiala, Chairman Apeireattrts prm and legality: Jenni r A. di Bel eo p � pc Assistant County Attorney ;\ INSTR 5352074 OR 5349 PG 2217 16E18 RECORDED 12/30/2016 2:56 PM PAGES 1 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC$10.00 Prepared by:Cormac Giblin Collier County Community and Human Services 3339 E.Tamiami Trail,Building H,#21 I Naples,FL 34112 THIS SPACE FOR RECORDING 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 Lien Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable Housing Dwelling Units (the "Impact Fee Lien") executed by Bristol Pines, LLC to Collier County, recorded on 05/06/2016 in Official Records Book 5270, Page 2507, of the Public Records of Collier County, Florida, in consideration of $8,735.88, with no interest, receipt of which is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee Lien against the premises conveyed by said Impact Fee Lien and more particularly described as follows: LOT 214, BRISTOL PINES, PHASE II, ACCORDING TO THE PLAT THEREOF,AS RECORDED IN PLAT BOOK 46,PAGE 67, OF THE PUBLIC RECORDS OF COLLIER COUNTY,FLORIDA. The undersigned is authorized to and does hereby satisfy and 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. This Release of Lien was approved by the Board of County Commissioners on - 1 Z— 13 , 2016, Agenda Item Number /6 3 . ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, Clerk COLLI R COUNTY, FLORIDA By: �. �� By: Atte'st as • -puty Clerk Donna Fiala, Chairman AppixignatkikKgin and legality: LO Jennifer A. Belpedic� CJ-F a\� Assistant County Attorney C INSTR 5352080 OR 5349 PG 2251 is6 08 RECORDED 12/30/2016 2:59 PM PA Prepared by:Cormac Giblin DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT Collier County Community and Human Services COLLIER COUNTY FLORIDA 3339 E.Tamiami Trail,Building H,#211 REC$10.00 Naples,FL 34112 THIS SPACE FOR RECORDING 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 Lien Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable Housing Dwelling Units (the "Impact Fee Lien") executed by Doris A. Flohr to Collier County, recorded on 05/05/2006 in Official Records Book 4032, Page 0104 of the Public Records of Collier County, Florida, in consideration of $6,970.16, plus interest, receipt of which is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee Lien against the premises conveyed by said Impact Fee Lien and more particularly described as follows: UNIT 304, BUILDING 3, BOTANICAL PLACE, A CONDOMINIUM,ACCORDING TO THE DECLARATION OF CONDOMINIUM THEREOF RECORDED IN OFFICIAL RECORDS BOOK 3933, PAGE 2655, OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. The undersigned is authorized to and does hereby satisfy and 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. This Release of Lien was approved by the Board of County Commissioners on - 1 2 — 1 3 ,2016,Agenda Item Number / D S . ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA By: aqui) .-c By: Y5 to C,„itt.: ma!" puty Clerk Do a Fiala, Chairman P. Appry i a' 'to o and legality: Jennr A. Belpedio .� Assistant County Attorney D‘� `1� �r9 INSTR 5352081 OR 5349 PG 2 2 RECORDED 12/30/2016 BROCK, P P Prepared by:Cormac Giblin DWIGHT E. BROCK, CLERK O I OURT Collier County Community and Human Services COLLIER COUNTY FLORIDA 3339 E.Tamiami Trail,Building H,#211 REC$10.00 Naples,FL 34112 THIS SPACE FOR RECORDING 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 Lien Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable Housing Dwelling Units (the "Impact Fee Lien") executed by Ralph and Patricia L. Walton to Collier County, recorded on 05/23/2006 in Official Records Book 4042, Page 1596, of the Public Records of Collier County, Florida, in consideration of $6,970.16, plus interest, receipt of which is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee Lien against the premises conveyed by said Impact Fee Lien and more particularly described as follows: UNIT 404, BUILDING 6, BOTANICAL PLACE,A CONDOMINIUM, ACCORDING TO THE DECLARATION OF CONDOMINIUM THEREOF RECORDED IN OFFICAL RECORD BOOK 3933, PAGE 2655, OF THE PUBLIC RECORDS OF COLLIER COUNTY,FLORIDA The undersigned is authorized to and does hereby satisfy and 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. This Release of Lien was approved by the Board of County Commissioners on - 2 1 3 , 2016, Agenda Item Number / ' . ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA 414,240 By: 1 - .:,Y / . -- By: Attest 0 )eputy Clerk Donna Fiala, Chairman signature Approved as to form`"and legality: Jennifer A. Belpedi037 i>t Assistant County Attorney 0