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Backup Documents 06/28/2011 Item #16C4ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO -� 1-b THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE //1��� Print on pink paper. Attach to original document Original documents should be hand delivered bi the Board Office. The completed routing slip and �g� documents are to be forwarded to the Board Office only after the Board has taken action on the item.) iiiiii ROUTING SLIP Complete routing lines k I through 94 as appropriate for additional signatures, dates, and/or information needed If the document is already completewith the _rfl,> . ;—o ...P d,— a IPP, u,rnn..I. rondnv lints N1 thnuieh 94_ comnlete the checklist. and forward to Sue Filson (line45). Route to Addressee(s) (List in routing order Office Initials Date 1. appropriate. (initial) Applic able) 2. June 28, 2011 Agenda Item Number 1604 3. signed by the Chairman, with the exception of most letters, must be reviewed and signed 4. Number of Original Type of Docurent 5. Executive Manager Board of County Commissioners Documents Attached 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 createcVprepared the executive summary. Primary contact information is needed in the event one ol'the addressees above. inelnling Executive Manager, need to contact staff for additional or missing information. All original documents needing the BCC Chairman's signature arc to be delivered to the BCC orrice only after the BCC has acted to approve the it— i 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 1604 A proved by the BCC signed by the Chairman, with the exception of most letters, must be reviewed and signed Executive Summary, Exhibit A, and Number of Original Type of Docurent Attached Satisfactions of Notice of Promise To Pay 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. I: Forms / County Forms/ BCC Forms / Original Documents Routing Slip W WS Original 9,03.04, Revised 1.26.05. Revised 224.05 X08- � /or5a- �y�o3o Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. (initial) Applic able) 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, 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 os iibl State Officials.) 2. 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 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 re wired. 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 �cs 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 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. I: Forms / County Forms/ BCC Forms / Original Documents Routing Slip W WS Original 9,03.04, Revised 1.26.05. Revised 224.05 X08- � /or5a- �y�o3o Prepared by: Jennifer B. White Assistant County Attorney Office of County Attorney 3299 East Tamiami Trail, Suite 800 Naples, Florida 34112 (239) 252 -8400 1604 INSTR 4580961 OR 4697 PG 348 RECORDED 7/1/2011 8:49 AM PAGES I DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC $10.00 SATISFACTION OF NOTICE OF PROMISE TO PAY AND AGREEMENT TO EXTEND PAYMENT OF WATER AND /OR SEWER SYSTEM IMPACT FEE KNOW ALL MEN BY "THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS, 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 Agreement with the following: JAN K. JACKSON, a single person Whose mailing address is 134 7 "i STREET -FRAIL ACRES NAPLES, FL 33962 Bearing the date of the 9 "' day of July 2001, recorded in Official Record Book 2855 Page(s) 2496, in the Office of the Clerk of the Circuit Court of Collier County, State of Florida, which Agreement imposes a lien on the subject real property. The Lien secures the principal sum of Three Thousand One Hundred Fifty Eight Dollars and Sixty Cents ($3,158.60) 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 THEREOF 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, acting through its Chairman, directs execution and recording of this Satisfaction of Lien, by action of the Board this day of U—UNE , 2011. ATTEST DWI T E. BLOCK ILERK�y L4w�_L_ Attest as togle�k �i9rutwY �,l4 Approved as tto�fomi an legal sufficiency: �� Tel Jennifer`B. White Assistant County Attorney BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS- FX- OFFICIO THE GOVERNING BOARD OF THE COLLIER COUNTY WATER -SEWER DISTRICT BY: _ FRED W. COYLE, CHAIRMAN) Prepared by: Jennifer B. White Assistant County Attorney Office of County Attorney 3299 East Tamiami Trail, Suite 800 Naples, Florida 34112 (239) 252 -8400 16C4 INSTR 4580962 OR 4697 PG 349 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 PROMISE TO PAY AND AGREEMENT TO EXTEND PAYMENT OF WATER AND /OR SEWER SYSTEM IMPACT FEE KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OP COLLIER COUNTY AND AS EX- OFFICIO THE GOVERNING BOARD OF THE COLLIER COUNTY WATER -SEWER DISTRICT, was the owner and holder of a certain Agreement with the following: MARIE WITHERS, A SINGLE PERSON Whose mailing address is P.O. BOX 1435 ROOKER BAY DRIVE, FL 34114 Bearing the date of the I '` day of March 2002, recorded in Official Record Book 2990 Page(s) 1179, in the Office of the Clerk of the Circuit Court of Collier County, State of Florida, which Agreement imposes a lien on the subject real property. The Lien secures the principal sum of Seven Hundred Twenty Nine Dollars and Eighteen Cents ($729.18) plus accrued interest and penalties, if any, and imposes certain obligations against real property situated in Collier County, Florida, described as follows: LOT 139, PORT AU PRINCE, ACCORDING TO TI IE PLAT THEREOF, AS RECORDED IN PLAT BOOK 13, PAGE 51, PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. FOLIO NUMBER: 68345400006 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 this th day of TUNE 2011. ATTEST: 1 D HT E. BR K, CLERK 13 �p 1� st �s Deputy Clerk Ii it, qp��� 1 Approved'�ao toriand legal sufficiency: Jennifer B'White Assistant County Attorney BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS EX-OFFICIOTHE GOVERNING BOARD OF "FHE;COLLIER COUNTY WATER -SEWER DISTRICT BY: W, FRED W. COYLE, CHAIRMA Prepared by: Jennifer B. White Assistant County Attorney Office of County Attorney 3299 East Tamiami Trail, Suite 800 Naples, Florida 34112 (239) 252 -8400 16C4 INSTR 4580963 OR 4697 PG 350 RECORDED 7/1/2011 8:49 AM PAGES 2 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC $18.50 SATISFACTION OF NOTICE OF PROMISE TO PAY AND AGREEMENT TO EXTEND PAYMENT OF WATER AND /OR SEWER SYSTEM IMPACT FEE KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS, 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 Agreement with the following: WILLIAM D. COLLINS 111, A SINGLE MAN Whose mailing address is 951 Barefoot Williams Rd Naples, FL 34113 Bearing the date of the 21" day of November 2003, recorded in Official Record Book 3448 Page(s) 2701, in the Office of the Clerk of the Circuit Court of Collier County, State of Florida, which Agreement imposes a lien on the subject real property. The Lien secures the principal sum of Two Thousand Six Hundred Forty Five Dollars and No Cents ($2,645.00) plus accrued interest and penalties, if any, and imposes certain obligations against real property situated in Collier County, Florida, described as follows: THE NORTH HALF OF THE EAST HALF OF THE SOUTHEAST QUARTER OF THE NORTHEAST QUARTER OF THE NORTHWEST QUARTER, LYING WEST OF BAREFOOT WILLIAMS ROAD, AND THE NORTH HALF OF THE WEST HALF OF THE SOUTHWEST QUARTER OF THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER, LYING WEST OF BAREFOOT WILLIAMS ROAD, SECTION 4, "TOWNSHIP 51, SOUTH, RANGE 26 EAST, COLLIER COUNTY, FLORIDA AND SUBJECT TO A 30 FOOT RIGHT OF WAY FOR ROAD PURPOSES EXTENDING ALONG THE NORTH BOUNDARY LESS THE SOUTH 75 FEET OF THE NORTH HALF OF THE EAST HALF OF THE SOUTFEAST QUARTER OF THE, NORTHEAST QUARTER OF THE NORTHWEST QUARTER LYING WEST OF BAREFOOT WILLIAMS ROAD AND THE SOUTH 75 FEET OF THE NORTH HALF OF THE WEST HALF OF THE SOUTHWEST QUARTER OF THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER LYING WEST OF BAREFOOT WILLIAMS ROAD, SECTION 4, TOWNSHIP 51 SOUTH, RANGE 26 EAST, COLLIER COUNTY, FLORIDA. "THIS PROPERTY IS THE SAME PREMISES DESCRIBED IN THE DEED DATED 2/24/95 RECORDED IN O.R. BOOK 2034, PAGE 1462, AS AMMENDED TO CORRECT THE LEGAL Pagc 1 of 2 16C4 DESCRIPTION BY THE CORRECTIVE DEED DATED 3/3/97, RECORDED IN O.R. BOOK 2312, PAGE 172 OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. FOLIO NUMBER: 00728160002 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 this aft% day of TUNE_ 2011. ATTEST: DWIGHT E. BLOCK, CLERK t st s>, : i' i40giw of gniftur� . oai � Approved as to fffm`and legal sufficiency: � -�� V,� Jennifer B. White Assistant County Attorney BOARD OF COUNTY COMMNSIONERS COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY AND AS EX- OFFICIO THE GOVERNING BOARD OF THE COLLIER COUNTY WATER -SEWER DISTRICT BY: _ W FRED W. COYLE, CHAIR Page 2 A'2