Backup Documents 09/26/2017 Item #16A41 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP] 6 A 41
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
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 KN 9/26/17
4. BCC Office Board of County 1 "'-\
Commissioners 04 6/ "(12..(..\�—
5. Minutes and Records Clerk of Court's Office
(kC INT-i *Avpm
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 Nancy Cardin le-Lower,Code Phone Number 252-2436
Contact/ Department Enforcement
Agenda Date Item was 9/26/17 Agenda Item Number l6-Aã(y/
Approved by the BCC y
Type of Document Release and Satisfaction— H&H Number of Original 1
Attached Documents Attached
PO number or account 111-138911-649030
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? STAMP OK KN
2. Does the document need to be sent to another agency for additional signatures? If yes, KN
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 KN
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 KN
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 KN
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 KN
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip KN
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 9/27/17 and all changes made during the KN N/A is not
meeting have been incorporated in the attached document. The County Attorney's an option for
Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by th KN \ is not
BCC,all changes directed by the BCC have been made,and the document is ready fo the an o tion for
Chairman's signature. a th' line.
[04-COA-01081/1344829/1]1: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
16 A41
INSTR 5452505 OR 5435 PG 328
RECORDED 9/27/2017 4.15 PM PAGES 1
DWIGHT E BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
This Instrument Prepared By: REC $10.00
Marlene Serrano
Code Enforcement Division
2800 North Horseshoe Drive
Naples, FL 34104
(239) 252-2440
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
H & H 29th Ave Holdings LLC,
Respondent
The lien was recorded on August 19, 2011, in Official Records Book 4712, Page 448, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of two
hundred twenty two thousand six hundred ($222,600), plus accrued interest and penalties, if any,
and imposes certain obligations against real property situated in Collier County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners
as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in
the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BRQ,,K, 'Clerk COLLIER '2010Y, FLORIDA
ate'ars
1 " // ,-NBy: ti ►, BY
Clituty Clerk Penny Tayll hairman de
Date: q 1eto ',Drt Date: "\\2s...V1
Attest as to Chairman's
Approved as V§tfilieMINegality
--- V./-Z >1
Kevin Noell
Assistant County Attorney