Backup Documents 11/08/2011 Item #16D12 Are-tv-4- -,i,aeloct,;%01
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 11 ) ks
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE/
ROUTING SLIP D 1 2
Complete routing lines#1 through#4 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#4,complete the checklist,and forward to Ian Mitchell(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Priscilla Doria Housing, Human&Veteran PD 11/10/2011
Services Department
3.
4. Ian Mitchell, Executive Manager Board of County Commissioners Q I(
'tti it
5. Minutes and Records Clerk of Courts 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 Ian Mitchell,needs 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
item.)
Name of Primary Staff Priscilla Doria Housing,Human and Phone Number 252-5312
Contact Veteran Services Please call or e-mail
for Dick up
Agenda Date Item was November 8,2011 Agenda Item Number 16.D.12
Approved by the BCC
Type of Document One(1)Release of Lien-Density Bonus Number of Original 1
Attached Signature needed on all documents. Documents Attached
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. Original document has been signed/initialed for legal sufficiency.(All documents to be PD
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 possibly State Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's PD
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 PD
document or the fmal negotiated contract date whichever is applicable.
4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's PD
signature and initials are required.
5. In most cases(some contracts are an exception),the original document and this routing slip PD
should be provided to Ian Mitchell 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 11/08/2011(enter date)and all changes PD N/A is not
made during the meeting have been incorporated in the attached document.The an option for
County Attorney's Office has reviewed the changes,if applicable. line 6.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05
16012
INSTR 4627493 OR 4737 PG 735
RECORDED 11/16/2011 2:41 PM PAGES 1
Prepared by: DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Priscilla Doria COLLIER COUNTY FLORIDA
Collier County REC$10.00
Housing,Human&Veterans Services Dept
3339 E.Tamiami Trail,Building H,#211 - - - --
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3299 E.
Tamiami Trail, Naples, Florida 34112, the owner(s) and holder(s) of a certain Affordable Housing
Density Bonus Development Agreement Lien executed by Holly A. Pergola to Collier County, recorded
on 10/27/2006 in Official Records Book 4128, Page 1779, of the Public Records of Collier County,
Florida, hereby does remise, release, quitclaim, exonerate and discharge from the lien and operation of the
said agreement, that certain portion of the premises conveyed by said lien, more particularly described as
follows:
Unit 8103, Botanical Place, a condominium, according to the declaration of Condominium,
recorded in Official Records Book 3933, Page 2592, of the Public Records of Collier County,
Florida.(4430 Botanical Place Circle,Unit 103,Naples ,FL 34112)
The undersigned is authorized to and does hereby release this Lien with respect to the above-
named property, and consents to this Lien being forever discharged of record with respect to said
property.
Dated this 3 day of K1 O IN(2011.
ATTE 1"....... ` BOARD OF COUNTY COMMISSIONERS
DWIIT E. BR' Clerk COLLIER COUNTY, FLORIDA
•
(A)' C.,-4-x0.k.
: per l By:
$1 esi:. d s Ld.,r l at)Clerk FRED W. COYLE, CHAIRMAN // /si-)0 i 1
Approved as to form and
legal.sufficiency:
Jeff E./Wright
Assistant County Attorney