Backup Documents 03/13/2012 Item #16A 3ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE :)I LL)
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.) 1
ROUTING SLIP 1
# 1 throw #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete w5thA3
Complete routing Imes through gn
.1..,.,, o t:.,,. thr„..ah ,ti— ij— St thrppoh 114 complete the checklist- and forward to Sue Filson (line 45).
cxccpuou of uie i.uauu,au s s. ..a...re, ..A..........� ........ ...........a
Route to Addressee(s)
(List in routing order)
...._.... - - °-__ _ ..., - - - --
Office
Initials
Date
1. Judy Puig
GMD Planning &
Regulation/Operations
(Initial)
3,13
viol �.
2.
Agenda Item Number
16.A.3
Approved by the BCC
3.
Type of Document
4.
Number of Original
1
Attached
5 Ian Mitchell, Supervisor, BCC Office
Board of County
Commissioners
%
` S Z-
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
Name of Primary Staff
Jennifer Baker
Phone Number
252 -2444
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
March 13k 2012
Agenda Item Number
16.A.3
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Release of Lien
Number of Original
1
Attached
I
I Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
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
by the Office of the County Attorney. This includes signature pages from ordinances,
(V7
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
All handwritten strike- through and revisions have been initialed by the County Attorney's
N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval.
M
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!
The document was approved by the BCC on. % X01 (enter date) and all changes
6.
4Vyu(
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes, if applicable.
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
MEMORANDUM 16 A3
Date: March 19, 2012
To: Jen Baker, Code Enforcement Specialist
Code Enforcement
From: Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re: Release of Lien — 5133 20th CT SW
Attached you will find one (1) copy of the document, as referenced above
(Agenda Item #16A3) and approved by the Board of County
Commissioners on Tuesday, March 13, 2012.
The Original was kept by the Minutes and Records Department as part
of the Board's Official Record.
If you have any questions, please contact me at 252 -8411.
Thank you.
Attachment
16 A3
This Instrument Prepared By:
Jen Baker
Code Enforcement Department
2800 North Horseshoe Drive
Naples, FL 34104
(239) 252 -2440
INSTR 4670480 OR 4776 PG 1021
RECORDED 3/20/2012 10:50 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:
Estate of Alan D. Montgomery,
Respondents
The lien was recorded on July 15, 2011 in Official Records Book 4702, Page 121, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of
Five Thousand Seven Hundred twelve dollars and twenty nine 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:
GOLDEN GATE UNIT 5 BLK 165 LOT 18
5133 20TH Ct SW 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
DWIGHT E.; BROCK, Clerk
B
AtLtst #t, tj- tk yCIerk
Approved a's` Ito form and legal sufficiency
t
Jeff Uri ht
Assis it County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: IL4 (A). C'j,
Fred W. Coyle, Chari