Backup Documents 10/10/2017 Item #16D 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 5
f'O,51`525\--4&:9P93-'t(( 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. Wendy Klopf Community and Human v°k 10.10.17
Services
2. County Attorney Office County Attorney Office a /9 1- 1
3. BCC Office Board of County V\VA
Commissioners YVV5 f ko\koV'..
4. Minutes and Records Clerk of Court's Office tD � 1T
� � ^
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 Wendy Klopf/C S Phone Number 252-2901
Contact/ Department _
10.10.17 Agenda Item Number 16D5
Type of Document Release of Lien Number of Original 2
Attached Documents Attached
PO number or account Please use the SHIP account string for
number if document is recording:791-138791-649030-33467.1
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? 4-V:4 v•-•-•-1) ®K
2. Does the document need to be sent to another agency for additi al signatures? If yes, NA
provide the Contact Information(Name;Agency;Address;Phone 'an attached sh
3. Original document has been signed/initialed for legal sufficiency. (All documents to be WK
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 WK
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 WK
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 10.10.17and all changes made during the WK
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 fo he
Chairman's signature.
A
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/
INSTR 5457673 OR 5439 PG 1178
RECORDED 10/11/2017 4:00 PM PAGES 2
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC$18.50
Prepared by:Wendy Klopf
Collier County Community&Human Services Division
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDING
,6 05
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 Impact
Fee Waiver Agreements executed by Habitat for Humanity of Collier County, Inc. to Collier
County, having met the 15 year affordability housing obligation associated with the $129,772.20
of SHIP Impact Fee Waivers, 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:
See Exhibit A
The undersigned is authorized to and does hereby release these Liens with respect to the above-
named properties, and consents to these Liens being forever discharged of record with respect to
said properties.
This Release of Lien was approved by the Board of County Commissioners on -
cr - 1C) , 2017, Agenda Item Number 1L005 .
ATTEST: �. BOARD IF ' • ► Y COMMISSION RS
DVS T I . BROC ERK OF COL % ' 'ioUNTY,FLORIDA
B y: /A1
-,::T.e,st as to(r ;'ijCLERK PENNY T 40/'I R, CHAP
X41dl' f'MI-in arttl legality:
Jennifer A.Belpedio CT97 (31
Assistant County Attorney c(7\
16 05
EXHIBIT A
Various lots as listed below for, Amended Plat of Naples Manor Extension, As Recorded in Plat
Book 3, Page 101 of the Public Records of Collier County, Florida.
County 15 year
Managers CO date affordability Legal Description Folio Lien Impact Fee
Approval end date (OR/Pg) Amount
Naples Manor Extension,
2/5/2001 12/28/01 12/28/16 Block 4, Lot 7 62201080003 2777/2021 $7,698.82
Naples Manor Extension,
12/7/2000 03/21/02 03/21/17 Block 4, Lot 19 62201560002 2756/3282 $7,698.82
Naples Manor Extension,
12/7/2000 12/06/01 12/06/16 Block 4, Lot 20 62201600001 2756/3288 $7,698.82
Naples Manor Extension,
7/17/2001 03/06/02 03/06/17 Block 4, Lot 32 62202080002 2864/648 $7,698.82
Naples Manor Extension,
7/17/2001 03/21/02 03/21/17 Block 4, Lot 37 62202280006 2864/640 $7,698.82
Naples Manor Extension,
7/17/2001 03/06/02 03/06/17 Block 4, Lot 38 62202320005 2864/0632 $7,698.82
Naples Manor Extension,
12/7/2000 12/14/01 12/14/16 Block 5, Lot 6 62203120000 2756/3294 $7,698.82
Naples Manor Extension,
8/3/1999 02/18/00 02/18/15 Block 5, Lot 13 62203400005 2578/2547 $7,140.34
Naples Manor Extension,
8/3/1999 02/18/00 02/18/15 Block 5, Lot 14 62203440007 2578/2554 $7,140.34
Naples Manor Extension,
2/23/1999 04/13/00 04/13/15 Block 5, Lot 16 62203520008 2518/1431 $6,779.52
Naples Manor Extension,
2/23/1999 04/20/00 04/20/15 Block 6, Lot 10 62204480008 2518/1438 $6,779.52
Naples Manor Extension,
2/8/2000 12/28/00 12/28/15 Block 7, Lot 20 62205120008 2640/1066 $7,140.34
Naples Manor Extension,
2/8/2000 01/11/01 01/11/16 Block 7, Lot 22 62205200009 2640/1080 $7,140.34
Naples Manor Extension,
2/8/2000 01/11/01 01/11/16 Block 7, Lot 23 62205240001 2640/1087 $7,140.34
Naples Manor Extension,
1/7/1999 01/03/00 01/03/15 Block 11, Lot 26 62206400002 2502/806 $6,169.52
Naples Manor Extension,
1/7/1999 12/17/99 12/17/14 Block 11, Lot 27 62206440004 2502/820 $6,169.52
Naples Manor Extension,
8/5/1999 04/20/00 04/20/15 Block 12, Lot 5 62207440003 2578/2540 $7,140.34
Naples Manor Extension,
8/3/1999 04/20/00 04/20/15 Block 12, Lot 6 62207480005 2578/2575 $7,140.34
Total $129,772.20
INSTR 5457674 OR 5439 PG 1180
RECORDED 10/11/2017 4:00 PM PAGES 2
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Prepared by:Wendy Klopf REC$18.50
Collier County Community&Human Services Division
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDIN
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 Impact
Fee Waiver Agreements executed by Immokalee Habitat for Humanity, Inc. to Collier
County, having met the 15 year affordability housing obligation associated with the $67,864.72
of SHIP Impact Fee Waivers, 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:
See Exhibit A
The undersigned is authorized to and does hereby release these Liens with respect to the above-
named properties, and consents to these Liens being forever discharged of record with respect to
said properties.
This Release of Lien was approved by the Board of County Commissioners on -
Cr-Lk-cke c` l C) , 2017, Agenda Item Number t(00.
ATTEST: / BOARD 0 • Y COMMISSIONE•S
DW T E,BROc CLERK OF COLL 5" 4' TY,FLORIDA
By. 4417s as t _`� t1tIN16LERK PENNY TCHAI'
signature`oniyV.
Approval for foffn and legality:
Jennifer A. Belpedi
Assistant County Attorney (°31 ,r
C6`
EXHIBIT A
1605
Various lots as listed below for, Naples Manor Extension, as recorded in Plat Book 3, page 101
of the Public Records of Collier County, Florida.
County 15 year
Managers CO date affordability Legal Description Folio Lien Impact Fee
Approval end date (OR/Pg) Amount
Naples Manor Extension,
7/3/1995 06/30/97 06/30/12 Block 2, Lot 10 62200560003 2083/1369 $6,169.52
Naples Manor Extension,
7/3/1995 04/15/96 04/15/11 Block 5, Lot 8 62203200001 2083/1383 $6,169.52
Naples Manor Extension,
7/3/1995 04/15/96 04/15/11 Block 5, Lot 9 62203240003 2083/1390 $6,169.52
Naples Manor Extension,
7/3/1995 01/31/97 01/31/12 Block 6, Lot 2 62204280004 2083/1411 $6,169.52
Naples Manor Extension,
7/3/1995 12/27/96 12/27/11 Block 6, Lot 3 62204300007 2083/1418 $6,169.52
Naples Manor Extension,
7/3/1995 03/19/97 03/19/12 Block 6,Lot 5 62204330006 2083/1528 $6,169.52
Naples Manor Extension,
7/3/1995 03/19/97 03/19/12 Block 6,Lot 6 62204340009 2083/1535 $6,169.52
Naples Manor Extension,
7/3/1995 03/19/97 03/19/12 Block 7, Lot 16 62204960007 2083/1549 $6,169.52
Naples Manor Extension,
7/3/1995 04/15/96 04/15/11 Block 11, Lot 43 62207080007 2083/1556 $6,169.52
Naples Manor Extension,
7/3/1995 06/09/97 06/09/12 Block 13, Lot 3 62207760000 2083/1563 $6,169.52
Naples Manor Extension,
7/3/1995 06/09/97 06/09/12 Block 13, Lot 4 62207800009 2083/1570 $6,169.52
Total $67,864.72