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Backup Documents 12/10-11/2013 Item #16A10ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 14'#- "er TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 C� 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. Complete routing lines # I through #2 as appropriate for additional signatures, dates, and/or information needed If the document is already cokeete wiilt 10 exception of the Chairman's signature, draw a line throuah routine lines # I through #2. complete the checklist and forward to the County Attnmev Offire Route to Addressees (List in routing order) Office Initials Date 1. a ro riate. Initial Applicable) 2. 12/10/13 Agenda Item Number 16-A-10 3. County Attorney Office County Attorney Office KN 12/10/13 4. BCC Office Board of County Commissioners Number of Original L Z` V A t-5, 5. Minutes and Records Clerk of Court's Office ,r -- 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 Serrano, Code Enforcement Phone Number 252-2487 Contact / Department a ro riate. Initial Applicable) Agenda Date Item was 12/10/13 Agenda Item Number 16-A-10 Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, KN Type of Document Release & Satisfaction - Pepper Number of Original One Attached Original document has been signed/initialed for legal sufficiency. (All documents to be Documents Attached PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is 111-138911-649030 to be recorded All handwritten strike -through and revisions have been initialed by the County Attorney's KN INSTRUCTIONS & CHECKLIST 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 Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes N/A (Not a ro riate. Initial Applicable) 1. Does the document require the chairman's original signature? 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 J 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 12/10/13 and all changes made during KN 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 thA KN BCC, all changes directed by the BCC have been made, and the document is ready for e Chairman's signature. 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 This Instrument Prepared By: Marlene Serrano Code Enforcement Department 2800 North Horseshoe Drive Naples, FL 34104 (239) 252-2487 16A10 INSTR 4925037 OR 4993 PG 97 RECORDED 12/17/2013 11:34 AM PAGES 1 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC $10.00 RELEASE AND SATISFACTION OF LIEN KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and personal property owned by: Crystal Pepper, Respondent The lien was recorded on September 20, 2010, in Official Records Book 4606, Page 590, in the Official Records of Collier County, State of Florida. The lien secures the principal sum of Five Thousand, Eight Hundred and Twenty Seven Dollars and Ninety Six Cents, plus accrued interest and penalties, if any, and imposes certain obligations against real property situated in Collier County, Florida. Collier County, a political subdivision of the State of Florida, by execution of this Release and Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners as satisfaction of the lien and hereby cancels said lien. The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist. ATTEST DWIGHT E.1 R0C Clerk "Att@St a$ t0 Choftapputy Clerk �F . �rture cola Approved as to form and legality Kevin Noell Assistant County Attorney BOARDPF POPNTY COMMISSIONERS COLLI R PUNTY, FLORIDA 1 By: G rgia A. Hiller, Esq., Chairwoman