Backup Documents 07/11/2017 Item #16D 5 16D 5
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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 re o rctih.� '11x3
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. Susan Golden Community& Human
,-�1 'Ct/
Services (
2. Jennifer Belpedio County Attorney Office
�cf,f
3. BCC Office Board of County '7' '-
Commissioners \('tom/S/ •
4. Minutes and Records Clerk of Court's Office
1\")
a!S5P4A,
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 Susan Golden Phone Number
Contact/ Department CHS 252-2336OZ_2 33
Agenda Date Item was 7/11/2017 16.D.5. l �. 31
Approved by the BCC V
Type of Document Release of Lien Number of Original "('G` /�
Attached Documents Attached
PO number or account
tonumbeber if recorded document is i1 1, 1337?. 6960030
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? ^9�K Stamp OK if
(� P(4' Original is
11�' NOT required
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
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 �}h
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 6/28/16 and all changes 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.
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
160 5
INSTR 5429814 OR 5415 PG 3201
RECORDED 7/14/2017 3:31 PM PAGES 1
Prepared by: Susan Golden DWIGHT E. BROOK, 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 Rebecca D. Christopher to Collier
County, recorded on 7/28/2006 in Official Records Book 4079, Page 1763, 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 7, 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 -
i,AV t , 2017, Agenda Item Number (L'.�• .
(73
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIE' C• TY, FLORIDA
arr
BY ./ I::a �®moi• BY: /1L✓_
Attest as t0.Chairman's U• epu ,� Penny Tayloor airman /
signature only.
Approved as to form and legality:
Jennifer A. Belped' o—
Assistant County Attorney
CS,
16D 5
INSTR 5429815 OR 5415 PG 3202
RECORDED 7/14/2017 3:31 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Prepared by: Susan Golden
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 Jennifer Taylor to Collier County,
recorded on 6/30/2011 in Official Records Book 4696, Page 3189, of the Public Records of
Collier County, Florida, in consideration of$13,981.67 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 14, REGAL ACRES, ACCORDING TO THE PLAT THEROF, AS RECORDED IN PLAT BOOK 49,
PAGES 87 THROUGH 90, INCLUSIVE,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 Boarder of County Commissioners on -
l ' , 2017, Agenda Item Number (0. ,5 .
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E.BROCK, Clerk COLLIEC TY, FLORIDA
zAlir
BY ���L�::.�� j��,= By:
'1- 'ut G Penny Tayl•i' hairman
Attest as to Chairman's
signature only,.•• ,=
Approved as to form and legality:
Jenm er A. Belpedio O
Assistant County Attorney CR-
1 6 0 5
INSTR 5429816 OR 5415 PG 3203
RECORDED 7/14/2017 3:31 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Prepared by: Susan Golden REC$10.00
Collier County Community and Human Services
3339 E.Tamiami Trail,Building H,#211
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 Mark T. Korzen to Collier County,
recorded on 7/25/2006 in Official Records Book 4077, Page 3289, 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 204, BUILDING 8, 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 -
, 2017, Agenda Item Number 1 la j .
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIE' CO" TY, FLORIDA
Ey: /tor
v� By:
;14ty '; Penny Taylo Of airman dr
Attest as to Cham s r
ianettre only,
Approved as to form and legality:
Jenm er A. Belpedi
Assistant County Attorney n
160 5
INSTR 5429817 OR 5415 PG 3204
RECORDED 7/14/2017 3:31 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Prepared by: Susan Golden COLLIER COUNTY FLORIDA
Collier County Community and Human Services REC$10 00
3339 E.Tamiami Trail,Building H,#211
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 Mariela Pena to Collier County,
recorded on 7/24/2008 in Official Records Book 4381, Page 0359, of the Public Records of
Collier County, Florida, in consideration of $12,442.46 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 97, LIBERTY LANDING, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 47,
PAGES 71 THROUGH 73, INCLUSIVE, 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 -
, 2017, Agenda Item Number 1 6,-.►J. ..
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIE' C TY, FLORIDA
G
By: VW. - • �( By: //
- _i_ ,Llt
Penny Tayloir hairman
Attest els to Chou*s
signature only.
Approved as to form and legality:
' - I
Jennifer A. Belpedio 0'� o'N\
Assistant County Attorney 2
Ca��
1 6 0 5
INSTR 5429818 OR 5415 PG 3205
RECORDED 7/14/2017 3:31 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Prepared by: Susan Golden REC$10 00
Collier County Community and Human Services
3339 E.Tamiami Trail,Building H,#211
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 Diego Perez Garcia & Berta O. de
Perez to Collier County, recorded on 10/05/2006 in Official Records Book 4117, Page 0104, of
the Public Records of Collier County, Florida, in consideration of $8,158.66 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 112, INDEPENDENCE PHASE II, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT
BOOK 43, PAGES 64 THROUGH 66, INCLUSIVE, 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 -
--J 1 k , 2017,Agenda Item Number 1 l(7.'"h.,.c5 .
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK,•Clerk COLLIE'JO
TY, FLORIDA
By: By' /P/fri ,._ Q--#—A--•"
Dip tydi,
i Penny Taylaairman
an't
Attest as to Chairm
signature only.
Approved as to form and legality:
Jennifer A. Belpedio 037 o.
Assistant County Attorney �- (RN',
1 6-0 5
INSTR 5429819 OR 5415 PG 3206
RECORDED 7/14/2017 3:31 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Prepared by: Susan Golden COLLIER COUNTY FLORIDA
Collier County Community and Human Services REC$10.00
3339 E.Tamiami Trail,Building H,#211
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 Habitat for Humanity of Collier
County to Collier County, recorded on 5/09/2016 in Official Records Book 52701 Page 35021 of
the Public Records of Collier County, Florida, in consideration of $16,430.16_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:
LOT 48, LEGACY LAKES, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 59,
PAGES 69, OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA(1815 FREY COURT,NAPLES)
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 -
--Q--;\ \. , 201' Agenda Item Number '1Q.-. rJ. .
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHTE. BROCK :ClerkCOLLIER •jpTY, FLORIDA
. , 410)
B �� �j '`� By:
•
//
Y
Attest as to Chaim ,-�.. 4 ep Y ' -p£NNy T"LC Q , C Si pe mil n)
signature only. -...•' '
Approved as to form`and 1 gall :
, _
sc) )\ —,'
Jennifer A. Belpedi
Assistant County Attorneyc�� \��\C
C¢