Backup Documents 04/28/2020 Item #16D 7 NS
7..\\,40 ORIGINAL
AC OMPPANY ALL ORIGINAL DOCUMENTOS SENT TOLIP31,50v
1 6 0 7
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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. Maria Aldana Community and Human ,1TZ 4/23/2020
Services
2. Jennifer Belpedio County Attorney Office q 2)laaab
3. BCC Office Board of County
Commissioners �,Zi 1-30-i:
4. Minutes and Records Clerk of Court's Office "-1-C_
fy Lt 136 20 a ''.;):3
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 Maria Aldana,Grants Support Specialist Phone Number 239-252-2338
Contact/ Department —Community and Human Services
Agenda Date Item was 4/28/2020 Agenda Item Number 16.D.7
Approved by the BCC
Type of Document IF Release of Lien—Harrelson Number of Original
Attached Documents Attached 1
PO number or account 123-155974-649030-32001.1
number if document is
to be recorded
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. Does the document require the chairman's original signature? 3}4; r. -f OK MA
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 MA
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 N/A
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 MA
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MA
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
should be provided to the County Attorney Office at the time the item is input into SIRE. (-1.43,
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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!
8. The document was approved by the BCC 4/28/20 and all changes made during the N/A is not
meeting have been incorporated in the attached document. The County Attorney's Dab an option for
Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC, all changes directed by the BCC have been made,and the document is ready for the an option for
Chairman's signature. / this line.
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
1b07
INSTR 5861581 OR 5757 PG 3388
RECORDED 51112020 8:07 AM PAGES 1
Prepared by:Maria Aldana CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Collier County Community and Human Services COLLIER COUNTY FLORIDA
3339 E.Tamiami Trail,Building H,#211 REC$10.00
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 Lien
Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable
Housing Dwelling(the "Impact Fee Lien") executed by Sarah Harrelson,to COLLIER COUNTY,
recorded on 3/15/2006 in Official Records Book 3998, Page 2535 of the Public Records of Collier
County, Florida, in consideration of$15,329.68 ($12,263.74 plus interest) having met the term is
hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the Impact
Fee Lien against the premises conveyed by said Impact Fee Lien and more particularly described
as follows:
LOT 16,Bristol Pines,according to the map or plat thereof,recorded in Plat Book 43,Page 78,of the Public
Records of Collier County,Florida.
The undersigned is authorized to and does hereby satisfy and 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.
This Release of Lien was approved by the Board of County Commissioners on 11L� 1IAGu
Agenda Item Number 1 •D.7 .
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K.E KIN7L, CLERK COLLIER COUNTY, FLORIDA
1- , ; , Ai , i .t '�
atittj: By:
.T y � . �,� est, � e ! CLERK BURT L. SAUNDERS, CHAIRMAN
Approved for form and legality:
Jenni er A. \\a
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Assistant Countyy -).1,•))\‘
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