Backup Documents 12/12/2017 Item #16D12 •
Cat led tILe,
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACC
OMPANY ALL
DOCUMENTS SENT TO rj
THE BOARD OF COUNTY COMMS ONERS OFFICE FOR SIGNAT6
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. Susan Golden Community and Human '
Services 1
2. Jennifer Belpedio County Attorney Office Q I e
3. BCC Office Board of County
Commissioners YN.c/S t\77--. 4%
4. Minutes and Records Clerk of Court's Office —RY1 004fie 3:24106-1
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 miss' information.
Name of Primary Staff Susan Golden/C .S Phone Number 252-2336
Contact/ Department
Agenda Date Item was 12/12/2017 Agenda Item Number 16.D.12
Approved by the BCC
Type of Document Release of LienNumber of Original
Attached I I U 13 43 641.IP ti C) Documents Attached 1
PO number or account _ uj�c)(
number if document is
to be recorded # a 1' i3 S9` (1,CC7``tq ()
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? S-1,r.p 4313-
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 SG
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 SG
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 SG
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 12/12/2017 and all changes made during the SG 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 the /A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the uS option for
Chairman's signature. is line.
Sv�,t1C.o\l€ 2.:253b ) \4•C ..\\4
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 5506327 OR 5474 PG 2214
RECORDED 2/6/2018 10:35 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC$10.00
Prepared by: Susan Golden
Collier County Community and Human Services � /
6
3339 E.Tamiami Trail,Building H,#211 L
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 Affordable Housing Density Bonus (the "AHDB Lien") executed by Rebecca D.
Christopher to Collier County, recorded on 09/07/2006 in Official Records Book 4109, Page
0304, of the Public Records of Collier County, Florida, in consideration of$0.00, receipt of which
is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the
Affordable Housing Density Bonus Agreement against the premises conveyed by said AHDB 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 December 12,2017,Agenda
Item Number 16.D.4.
ATTEST: BOARD OF CO ► Y COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER CO 'ITY LURID
/.
By: By:
;,. A eputy Clerk Andy olis,Chairman
Attest as to -`•i 's.
signature
Approved as to form and legality:
Jenm r A. Belpedio
Assistant County Attorney