Backup Documents 06/28/2011 Item #16C3ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALI, ORIGINAL DOCUMENTS SENT TO
3 �
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original ducunrenl. Origin t documents should be hand delivered to the Board Offico . lie completed routing slip and original
documents arc to be forwarded to the hoard Office only aftu the Board has taken action on the item]
ROUTING SLIP 3
Complete routing lines NI through 44 as appropriate for add uional signatures, dates, and/or information needed If the document is already complete with the
,=m6 ,n nfthe Chairman's aignoture draw a line through routing lines Hl lhrou tt4, eomolete the checklist. and forward to sue Filson (line45).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
i.
appropriate.
(Initial)
Applic able)
2.
June 28, 2011
Agenda Item Number
16C3
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
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4.
Executive Summary. Exhibit A, and
- `lumber of Original
Attached
5. Executive Manager
Board of County Commissioners
4
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 createNpreptned the executive
summary. Primary eomact information is needed in the event one of Vic addressees above, indading Fxecutive Manager, need to contact staff fur additional or
missing imbrination. 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 itrm 1
Name of Primary Staff
Pam Callis
Phone Number
252 -2359
Contact
appropriate.
(Initial)
Applic able)
Agenda Date Item was
June 28, 2011
Agenda Item Number
16C3
Approv ed by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
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"hype of Ijocument
Executive Summary. Exhibit A, and
- `lumber of Original
Attached
Satisfactions of Notice of Claim of Lien
Documents Attached
INSTRUCTIONS & CHECKLIST
UTILITY BILLING AND CUSTOMER SERVICE DOES NOT REQUIRE COPIES OF
DOCUMENTS FILED WITH THE CLERK OF COURT — WE ONLY REQUIRE AN OFFICIAL
RECEIPT FROM THE CLERK.
Fears/ County Forms/ BCC Ponns/ Original Documents Routing Slip W WS Original 903.(1. Revised 126.05, 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)
Applic able)
I.
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,
resolutions, etc. signed by the County Attorney's Office and signattue 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.)
o.
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
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
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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 the Executive Manager in the BCC office within 24 hours of BCC
approval. 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!
6.
The document was approved by the BCC on 6 -28 -2011 enter date) and all changes
made during the meeting have been incorporated in the attached document. The
G
County Attorney's Office has reviewed the changes, if applicable.
UTILITY BILLING AND CUSTOMER SERVICE DOES NOT REQUIRE COPIES OF
DOCUMENTS FILED WITH THE CLERK OF COURT — WE ONLY REQUIRE AN OFFICIAL
RECEIPT FROM THE CLERK.
Fears/ County Forms/ BCC Ponns/ Original Documents Routing Slip W WS Original 903.(1. Revised 126.05, Revised 2 24 05
This instrument prepared by:
Jennifer B. White
Assistant County Attorney
Office of the County Attorney
3299 East Tamiami'Frail, Suite 800
Naples, Florida 34112
(239) 252 -8400
J.6 C3
INSTR 4580956 OR 4697 PG 340
RECORDED 7/1/2011 8:49 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
SATISFACTION OF NOTICE OF CLAIM OF LIEN
FOR WATER SYSTEM IMPACT FEES, WATER TAPPING FEES,
AND SANITARY SEWER SYSTEM IMPACT FEES
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS EX- OFFICIO THE
GOVERNING BOARD OF THE. COLLIER COUNTY WATER -SEWER DISTRICT, was the owner and holder of a certain
Lien against:
WILLIAM ANTHONY PETRUZZI
4471 32 "' AVENUE. S.W.
NAPLES, FL 33999
The Lien was recorded on the 15 " day of December 1994, in Official Record Book 2011, Page(s) 1854, in the
Office of the Clerk of the Circuit Court of Collier County, State of Florida. The Lien secures the principal sum of One
Thousand One Hundred Dollars and No Cents ($1,100.00), plus accrued interest and penalties, if any, and imposes certain
obligations against real Property situated in Collier County, Florida, described as follows:
BEGINNING AT THE N.W. CORNER OF LOT 100 OF N.G.& T. CO. LITTLE FARMS NO. 2
SUBD. THEN S 89 26' 40 E 116.81 FT.; THENCE S 0 09'50" W 69.5 FT.; THENCE N 89 27'00"W
116.81 hT.; THENCE N 0 09'00" F 69.5 FT. TO POINT OF BEGINNING, AS DESCRIBED IN
THAT DOCUMENT RECORDED IN OR BOOK 1890, PAGE 34 OF THE PUBLIC RECORDS OF
COLLIER COUNTY, FLORIDA.
FOLIO NUMBER: 61840400003
Collier County, a political subdivision of the State of Florida, and the Collier County Water -Sewer District, a
political subdivision of the State of Florida, hereby acknowledges receipt of payment in full Satisfaction of the Lien and
hereby cancels the Lien.
The Clerk of the Circuit Court is hereby directed to record this Satisfaction of Lien in the Official Records of
Collier County, Florida, to acknowledge that the Lien ceases to exist.
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County, Florida, and as Ex- Officio the
Governing Board of the Collier County Water -Sewer District, acting through its Chairman, directs execution and recording
of this Satisfaction of Lien, by action of the Board thi.%"day - {/ r 201 I .
ATTEST:
DW 9LYN BROCK, CLE(ZK���
Atttit ,g----- 1"tieputyClerl<
4iyn"Ure 0014 .
Approved as to fermi and legal sufficiency:
Jennifer B. White
Assistant County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA; AS TFIE
GOVERNING BODY OF COLLIER
COUNTY AND AS EX OFFIdO THE
GOVERNING BOARD OF THE COLLIER
COUNTY WATER -SEWER DISTRICT
By: 7 `-„yam W. co-'&
FRED W. COYLE, C IAIRMA
This instrument prepared by:
Jennifer B. White
Assistant County Attorney
Office of the County Attorney
3299 East Tamiami Trail, Suite 800
Naples, Florida 34112
(239) 252 -8400
16C3
INSTR 4580957 OR 4697 PG 341
RECORDED 7/1/2011 8:49 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
SATISFACTION OF NOTICE OF CLAIM OF LIEN
FOR WATER SYSTEM IMPACT FEES, WATER TAPPING FEES,
AND SANITARY SEWER SYSTEM IMPACT FEES
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS EX- OFFICIO THE
GOVERNING BOARD OF TI IE COLLIER COUNTY WATER -SEWER DISTRICT, was the owner and holder of a certain
Lien against
JAN K. JACKSON, a single person
134 7 "' STREET =TRAIL ACRES
NAPLES, FI, 33962
The Lien was recorded on the 14 ... day of November 1994, in Official Record Book 2002, Page(s) 0328, in the
Office of the Clerk of the Circuit Court of Collier County, State of Florida. The Lien secures the principal sum of One
Thousand Five Hundred Eighty Dollars and No Cents ($1,580.00), plus accrued interest and penalties, if any, and imposes
certain obligations against real property situated in Collier County, Florida, described as follows:
LOT 37, BLOCK 2, TRAIL ACRES, UNIT 2, ACCORDING TO PLAT TI IEREOF RECORDED IN
PLAT BOOK 4, PAGE 62, PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA, AS
DESCRIBED IN THAT DOCUMENT RECORDED IN OR BOOK 780, PAGE 434 OF THE
PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA.
FOLIO NUMBER: 77262080008
Collier County, a political subdivision of the State of Florida. and the Collier County Water -Sewer District, a
political subdivision of the State of Florida, hereby acknowledges receipt of payment in full Satisfaction of the Lien and
hereby cancels the Lien.
The Clerk of the Circuit Court is hereby directed to record this Satisfaction of Lien in the Official Records of
Collier County, Florida, to acknowledge that the Lien ceases to exist.
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County, Florida, and as Ex -Officio the
Governing Board of the Collier County Water -Sewer District, actin * through its Chairman, directs execution and recording
of this Satisfaction of Lien, by action of the Board thisa } ay JUIVC ,201 1.
ATTEST:
DWIGHT E. BROOK, �L,V,RK
s e ,uty Clerk
itgnatw e w i o
Approved as to form and legal sufficiency:
1
Jennifer B. Wfiite
Assistant County Attorney
BOARD OF COUNTY COMMISSIONERS.
COLLIER COUNTY, FLORIDA, AS THE
GOVERNING BODY OI COfLIER
COUNTY AND AS EX OFFICIO THE
GOVERNING BOARD OF THE COLLIER
COUNTY WATER -SEWER DISTRICT
By:� W
FRED W. COYLE, CHAIRM