Backup Documents 04/25/2023 Item #16D 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 Q 2
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
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�ei�in the County Attorney Office no later
than Monday preceding the Board meeting. "'_'�.1
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is lrea complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to e ounty Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Lisa N. Carr Community and Human in7t 4/25/2023
Services Division
2. County Attorney Office County Attorney Office of
�(1
3. BCC Office Board of County Z!// I Commissioners f 4772 3
4. Minutes and Records Clerk of Court's Office
1 2t 2b234'31m
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 Lisa N. Carr,Grants Coordinator, II Phone Number 239.252.2339
Contact/Department
Agenda Date Item was April 25,2023 Agenda Item Number 16.D.2
Approved by the BCC
Type of Document Release of Lien: Maria Sebastian n/k:/a Number of Original
Attached Maria Andres Jimenez and Pascual Documents Attached
Sebastian
PO number or account 791-138791-649030 33686.1
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? LNC
2. Does the document need to be sent to another agency for additional signatures? If yes, X
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 LNC
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 X
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 LNC
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 LNC
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip LNC
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. Be aware of your deadlines!
8. The document was approved by the BCC on 4-25-23 and all changes made during the
meeting have been incorporated in the attached document. The County Attorney's 00 +
Office has reviewed the changes,if applicable. flirt
9. Initials of attorney verifying that the attached document is the version approved by the
BCC, all changes directed by the BCC have been made, and the document is ready for the SO
Chairman's signature.
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
� 6D 2
INSTR 6397548 OR 6242 PG 3495
RECORDED 5/3/2023 11:47 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by:Irma Jimenez REC$10.00 INDX$1.00
Collier County Community and Human Services
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 Lien
Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable
Housing Dwelling (the "Impact Fee Lien") executed by Maria Sebastian n/k/a Maria Andres
Jimenez and Pascual Sebastian, to COLLIER COUNTY, recorded on 08/05/2005 in Official
Records Book 3861, Page 1454,of the Public Records of Collier County,Florida,in consideration
of$7,051.70 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 423 INDEPENDENCE PHASE TWO, ACCORDING TO THE PLAT THEROF, AS RECORDED
IN PLAT BOOK 43, PAGES 64 THROUGH 66, 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 this 2.,) day of
I 1 P K 1(_ 2023, Agenda Item No. 16.D. 'Z .
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL(', F ; CLERK COLLIER COUNTY, FLORIDA
n7
By: By:
DEPUTY L Rick LoCastro, Chairman
Attest as to.ChairrneWs
signature only
Approved for form and legality:
Derek D. Perry 47
�
Assistant County Attorney CI
ti
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