Backup Documents 09/10/2013 Item #16A31 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP A
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 H 3 1
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 ��' 4113 l3
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 9/10/13
4. BCC Office Board of County C7kA>b�
'Commissioners \(.f /5/ `:t. 113�t3
5. Minutes and Records Clerk of Court's Office
'i 13 13 i v corL
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 Marlene Serra o/Code Enforcement Phone Number 239-252-248
Contact/ Department
Agenda Date Item was 09/10/13 Agenda Item Number 16A31
Approved by the BCC
Type of Document Release of Lien-Kolak 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? MS
2. Does the document need to be sent to another agency for additional signatures? If yes, MS
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 MS
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's
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 MS
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 �4
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip MS
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 09/10/13 (ente~"date)and all changes KN
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 KN l
BCC, all changes directed by the BCC have been made,and the document is ready f r the
Chairman's signature. \I
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
16A31
INSTR 4890128 OR 4965 PG 1775
This Instrument Prepared By: RECORDED 9/16/2013 8:59 AM PAGES 1
Colleen Crawley DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Code Enforcement Department COLLIER COUNTY FLORIDA
2800 North Horseshoe Drive REC$10.00
Naples, FL 34104
(239) 252-5892
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:
John Kolak,
Respondents
The lien was recorded November 8, 2010 in Official Records Book 4621, Page 2442, in
the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Sixteen Thousand eight hundred twelve dollars and thirty eight cents, plus
accrued interest and penalties, if any, and imposes certain obligations against real
property situated in Collier County, Florida, which property is described as follows:
SATURNIA LAKES PLAT ONE LOT 133
1372 Areca CV Naples, FL
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 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 BOAR' OF OUNTY;COMMISSIONERS
DWIGHT E..aRS 'CK Clerk COL 1E7 C UN Y, 'LORIDA
By By.
i-p '' , erk Veorgia A. Hiller, Esq.,
Attestas to Chaimlaa's Chairwoman
signature gnly
Approved as to form and legality and requires majority vote for approval
l
Kevin Noell
Assistant County Attorney