Backup Documents 03/27/2018 Item #16D 1 -;4' 1
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6 D 1
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TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
a` THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
runt on pink paper .2.o;a<i3kt_,? ,a e �,f a.aE�ioetinwl“.,;a.F <<�o aiErm .eo etc ;�:t9.�.'a�xaatty Attorney Office
at the time the item isplraced on the agenda. Ali completed routing slips and original documents must he received in the Comity Attorite 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 routinglines#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 11/K 03.27.18
Services
2. County Attorney Office County Attorney Office D aR7 3/a7I o7 t g
3. BCC Office Board of County (tS
Commissioners Ji-4-bs) 3-a7-5/
4. Minutes and Records Clerk of Court's Office L (6:34°A 6;34on
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/CHS Phone Number 252-2901
Contact/ Department
03.27.18 Vf Agenda Item Number 16D1
Type of Document Release of Lien Number of Original 1 /
Attached Documents Attached ✓
PO number or account Please use the 791-138791-649030-
number if document is 33525.1.1 account string for recording:
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable col sa'i,which9yer is Yes N/A(Not
appropriate. ‘\ (Initial) Applicable)
1. Does the document require the chairman's original signature? l a K4144 \
2. Does the document need to be sent to another agency for additional 'gnatures If yes, / NA
provide the Contact Information(Name;Agency;Address;Phone)on attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All d ents to b 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 341K
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 03.27.18 and all changes made during WK // % of
the meeting have been incorporated in the attached document. The County R'®",��
Attorney's Office has reviewed the changes,if applicable. 1 �r?a!1=
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 3 "'
s aaPeeGtm
Chairman's signature. =8 ' .,,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 11/30/12
16D1
INSTR 5531993 OR 5492 PG 875
RECORDED 3/29/2018 4:57 PM PAGES 3
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Prepared by:Wendy Klopf COLLIER COUNTY FLORIDA
Collier County Community&Human Services Division REC $27.00
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 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 $186,291.98
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 -
c X--C. -7 ,2018,Agenda Item Number i LoC)t
' P it r
ATTEST BOARD O' CO . COMM . S
DWIGHT E. 1 ROC"' CLERK OF CO ER P TY,FLO D , .
a: ,.:.'
-I-KA-1'GL By: .�
'` :;;;,pumnimaIRK ANDY SOLIS,CHAIRMAN
,,atur a only.
ApproVul for for 'and legality:
tenni er A.Belpedio \lS
Assistant County Attorne CLQ
\\
0
EXHIBIT A 16 D 1
Various lots as listed below for, Carson Lakes Subdivision, As Recorded in Plat Book 34, Pages
94 through 96, inclusive, of the Public Records of Collier County, Florida.
15 year Organization Fee
CO date affordability Legal Subdivision Name AORct Amount
end date
Habitat for
12/30/2002 12/30/2017 Lot 1 Carson Lakes Humanity 2929/755 $4,848.82
Habitat for
12/30/2002 12/30/2017 Lot 2 Carson Lakes Humanity 2935/763 $4,848.82
Habitat for
12/30/2002 12/30/2017 Lot 3 Carson Lakes Humanity 2935/755 $4,848.82
Habitat for
8/30/2002 8/30/2017 Lot 5 Carson Lakes Humanity 2934/2616 $4,848.82
Habitat for
8/30/2002 8/30/2017 Lot 6 Carson Lakes Humanity 2934/2608 $4,848.82
Habitat for
6/21/2002 6/21/2017 Lot 7 Carson Lakes Humanity 2864/0616 $4,848.82
Habitat for
6/21/2002 6/21/2017 Lot 8 Carson Lakes Humanity 2864/0608 $4,848.82
Habitat for
6/20/2002 6/20/2017 Lot 9 Carson Lakes Humanity 2864/600 $4,848.82
Habitat for
5/8/2002 5/8/2017 Lot 10 Carson Lakes Humanity 2707/2263 $4,736.34
Habitat for
4/29/2002 4/29/2017 Lot 11 Carson Lakes Humanity 2707/2269 $4,736.34
Habitat for
4/22/2002 4/22/2017 Lot 13 Carson Lakes Humanity 2707/2281 $4,736.34
Habitat for
4/22/2002 4/22/2017 Lot 14 Carson Lakes Humanity 2707/2287 $4,736.34
Habitat for
4/22/2002 4/22/2017 Lot 15 Carson Lakes Humanity 2707/2395 $4,736.34
Habitat for
3/6/2002 3/6/2017 Lot 16 Carson Lakes Humanity 2707/2401 $4,736.34
Habitat for
3/26/2002 3/26/2017 Lot 17 Carson Lakes Humanity 2707/2407 $4,736.34
Habitat for
3/26/2002 3/26/2017 Lot 18 Carson Lakes Humanity 2707/2413 $4,736.34
Habitat for
1/24/2001 1/24/2016 Lot 20 Carson Lakes Humanity 2707/2425 $4,736.34
Habitat for
3/20/2001 3/20/2016 Lot 21 Carson Lakes Humanity 2707/2431 $4,736.34
Habitat for
3/20/2001 3/20/2016 Lot 22 Carson Lakes Humanity 2707/2437 $4,736.34
Habitat for
4/17/2001 4/17/2016 Lot 23 Carson Lakes Humanity 2707/2443 $4,736.34
Habitat for
4/17/2001 4/17/2016 Lot 24 Carson Lakes Humanity 2707/2449 $4,736.34
Habitat for
4/17/2001 4/17/2016 Lot 27 Carson Lakes Humanity 2707/2641 $4,736.34
1 6 D 1
Habitat for
4/17/2001 4/17/2016 Lot 28 Carson Lakes Humanity 2707/2647 $4,736.34
Habitat for
4/18/2001 4/18/2016 Lot 29 Carson Lakes Humanity 2707/2653 $4,736.34
Habitat for
6/14/2001 6/14/2016 Lot 30 Carson Lakes Humanity 2707/2659 $4,736.34
Habitat for
6/14/2001 6/14/2016 Lot 31 Carson Lakes Humanity 2707/2665 $4,736.34
Habitat for
6/14/2001 6/14/2016 Lot 32 Carson Lakes Humanity 2707/2671 , $4,736.34
Habitat for
6/14/2001 6/14/2016 Lot 33 Carson Lakes Humanity 2707/2677 $4,736.34
Habitat for
5/8/2002 5/8/2017 Lot 35 Carson Lakes Humanity 2707/2689 $4,736.34
Habitat for
12/4/2001 12/4/2016 Lot 36 Carson Lakes Humanity 2707/2233 $4,736.34
Habitat for
5/8/2002 5/8/2017 Lot 37 Carson Lakes Humanity 2707/2239 , $4,736.34
Habitat for
12/28/2001 12/28/2016 Lot 38 Carson Lakes Humanity 2707/2245 $4,736.34
Habitat for
12/21/2001 12/21/2016 Lot 39 Carson Lakes Humanity 2707/2251 $4,736.34
Habitat for
8/12/2002 8/12/2017 Lot 41 Carson Lakes Humanity 2864/592 $4,848.82
Habitat for
6/26/2002 6/26/2017 Lot 42 Carson Lakes Humanity 2864/656 $4,848.82
Habitat for
12/5/2002 12/5/2017 Lot 43 Carson Lakes Humanity 2934/2600 $4,848.82
Habitat for
12/5/2002 12/5/2017 Lot 44 Carson Lakes Humanity 2934/2592 $4,848.82
Habitat for
12/5/2002 I2/5/2017 Lot 45 Carson Lakes Humanity 2934/2584 $4,848.82
Habitat for
12/30/2002 12/30/2017 Lot 46 Carson Lakes Humanity 2934/2576 $4,848.82
$186,291.98