Backup Documents 09/11/2018 Item #16E3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO ? 6 E 3 '4
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATUREm
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.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JABi 1/8/19
4. BCC Office Board of County \c"..
Commissioners 5 / \ _`s
5. Minutes and Records Clerk of Court's Office
,per a---0gPrin
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 Tanya Williams PSD/Library 239-252-5391
Contact/Department /
Agenda Date Item was 144-9 ''/l��!z Agenda Item Number /‘E -3
Approved by the BCC
Type of Document Acknowledgement Number of Original 1
Attached Documents Attached
PO number or account n/a
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable col i i wh ever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signatur - -= JAB
2. Does the document need to be sent to another agency for additio ignatures? If yes, NA
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 JAB
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 NA
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 JAB
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 JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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. BBe�awar_e of your deadlines!
8. The document was approved by the BCC on 9-and all changes made during the JAB
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 JAB
the BCC,all changes directed by the BCC have been made,and the document is
ready for the Chairman's signature.
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I: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
Ann P. Jennejohn 1 6 E 3
From: Ann P.Jennejohn
Sent: Thursday,January 10, 2019 4:54 PM
To: WilliamsTanya
Subject: Item#16E3 (9-11-2018 BCC Meeting)
Attachments: Backup Documents 09_11_2018 Item #16E3.pdf
Hi Tanya,
A signed copy of Item #16E3, from the
Boards September 11, ?018 BCC Meeting
is attached for you records.
Thank you!
Ann Jennejohn, Sr. Deputy Clerk
Board Minutes Sr Records Department
Collier County Value Adjustment Board
23,3-252-8406
i6E3
Model Acknowledgement of Conditions
For Mitigation of Property in a Special Flood Hazard Area
With FEMA Grant Funds
Property Owner Collier County Government
Street Address 417 N 1 sr Street
City Immokalee , State Florida Zip Code 34142
Deed dated 06/05/1972 , Recorded Book 456, Page 584
Tax map 2E04
Block & Parcel Legal Description: 4 47 29 NE1/4 OF NE1/4 OF NE1/4 OR 456 PG 584,
LESS OR 4615 PG 838
Base Flood Elevation at the site is 33.5' (NAVD) 34.8' (NGVD).
Map Panel Number 12021C0145H , effective date 5/16/2012
As a recipient of Federally-funded hazard mitigation assistance under the Hazard Mitigation
Grant Program, as authorized by 42 U.S.C. §5170c /Pre-Disaster Mitigation Program, as
authorized by 42 U.S.C. §5133 /Flood Mitigation Assistance Program, as authorized by 42
U.S.C. §4104c / Severe Repetitive Loss, as authorized by 42 U.S.C. §4102a, the Property Owner
accepts the following conditions:
1. That the Property Owner has insured all structures that will not be demolished or
relocated out of the SFHA for the above-mentioned property to an amount at least
equal to the project cost or to the maximum limit of coverage made available with
respect to the particular property, whichever is less, through the National Flood
Insurance Program (NFIP), as authorized by 42 U.S.C. §4001 et seq., as long as the
Property Owner holds title to the property as required by 42 U.S.C. §4012a.
2. That the Property Owner will maintain all structures on the above-mentioned property
in accordance with the flood plain management criteria set forth in Title 44 of the
Code of Federal Regulations (CFR) Part 60.3 and Collier County Code of Laws and
Ordinances, Chapter 62, as long as the Property Owner holds title to the property.
These criteria include, but are not limited to, the following measures:
i. Enclosed areas below the Base Flood Elevation will only be used for
parking of vehicles, limited storage, or access to the building;
ii. All interior walls and floors below the Base Flood Elevation will be
unfinished or constructed of flood resistant materials;
iii. No mechanical, electrical, or plumbing devices will be installed below
the Base Flood Elevation; and
iv. All enclosed areas below Base Flood Elevation must be equipped with
vents permitting the automatic entry and exit of flood water.
For a complete, detailed list of these criteria, see Collier County Code of Laws and
Ordinances, Chapter 62, attached to this document.
1
1 6E3 ,
3. The above conditions are binding for the life of the property. To provide notice to
subsequent purchasers of these conditions, the Property Owner agrees that Collier
County Government will legally record with the county or appropriate jurisdiction's
land records a notice that includes the name of the current property owner(including
book/page reference to record of current title, if readily available), a legal description
of the property, and the following notice of flood insurance requirements:
"This property has received Federal hazard mitigation assistance. Federal law
requires that flood insurance coverage on this property must be maintained during
the life of the property regardless of transfer of ownership of such property.
Pursuant to 42 U.S.C. §5154a, failure to maintain flood insurance on this property
may prohibit the owner from receiving Federal disaster assistance with respect to
this property in the event of a flood disaster. The Property Owner is also required
to maintain this property in accordance with the flood plain management criteria
of Title 44 of the Code of Federal Regulations Part 60.3 and Collier County Code
of Laws and Ordinances, Chapter 62."
4. Failure to abide by the above conditions may prohibit the Property Owner and/or any
subsequent purchasers from receiving Federal disaster assistance with respect to this
property in the event of any future flood disasters. If the above conditions are not
met, FEMA may recoup the amount of the grant award with respect to the subject
property, and the Property Owner may be liable to repay such amounts.
This Agreement shall be binding upon the respective parties' heirs, successors, personal
representatives, and assignees.
THE COUN �•: ' ••LLIER
By: /�"ph
'
W. I cDaniel,Jr
Ch: rman
of the County of Colli
& Item# 11-'Q
Co`11e2J^4.')� (a (Sol Agenda ( �t
[Name of Property Owner] ! / gate
Date t ,Ib 'ici
WITNESSED BY: Recd 1
1�
Il
13 m reputy Cie4$
[Name of Witness]
[SEAL] �,
Apprw,ea as to form and legality
ATTEST zsla.
CRYSTAL K.
BY:`"""'`"IAA -'� _4 •c 2 Assistant County Atto
tki
Attest as to CI rm.