Backup Documents 10/10/2023 Item #16D2 5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 ffi '
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 fomardcd 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. Lisa N. Can Community and Human LNC 10/10/2023
Services _
2. County Attorney Office County Attorney Office
00P (o hi1z-3
3. BCC Office Board of County
Commissioners IZl.I y / / . tot/it/2.3
4. Minutes and Records Clerk of Court's Office r„A V`n F (0-11- 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 Lisa N. Can,Grants Coordinator II, Phone Number 239-252-2339
Contact/Department Community and Human Services Division
Agenda Date Item was October 10, 2023 Agenda Item Number 16.D. 2
Approved by the BCC
Type of Document Recommendation to approve a Release of Number of Original 1
Attached Lien in the amount of $15,981.90 for full Documents Attached
payment of an Immokalee Area Residential
Impact Fee Deferral approved as part of an
impact fee deferral program for properties
located within the Immokalee Enterprise
Zone.
PO number or account
number if document is 791-138791-649030 33686.1
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? YES
2. Does the document need to be sent to another agency for additional signatures? If yes, LNC
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 LNC
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 10/10/2023 and all changes made during
the meeting have been incorporated in the attached document. The County A 0 n optic;
Attorney's Office has reviewed the changes,if applicable, his
9. Initials of attorney verifying that the attached document is the version approved by the oV` /A is
BCC, all changes directed by the BCC have been made,and the document is ready for the
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
Instructions
1) Return signed copies to:
Lisa N. Car
Grants Coordinator II
Collier County Government I Community and Human Services
3339 E. Tamiami Trail, Bldg. H, Suite 211
Naples, FL 34112
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
16 43 ?
INSTR 6466999 OR 6298 PG 1654
RECORDED 10/20/2023 9:13 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$10.00 INDX$1.00
Prepared by:Lisa N.Carr
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 Manuel V. Cuevas and Antonia De
Cuevas and Eagle Ridge Subdivision,LLC,to COLLIER COUNTY,dated April 13,2006 and
recorded on September 1,2006 in Official Records Book 4098,Page 2683 et seq.,of the Public
Records of Collier County, Florida, in consideration of$15,981.90 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 6, MILAGRO PLACE, AS RECORDED IN PLAT BOOK 41, PAGES 89-90,
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.
Thi Release of Lien was approved by the Board of County Commissioners on this
f 0 day of OC 2023, Agenda Item No. t � .
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK COLLIER COUNTY, FLORIDA
By: _1(11kBY 1 _._.
Attest as to Chairman's ,Deputy Clerk Rick LoCastro, Chairman
signature only
A p ved for form nd legality:
Derek D. Perry `5
Assistant County Attorney cb\cl'
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