Backup Documents 10/10/2023 Item #16D1 SORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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 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 routin: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. Carr Community and Human LNC 10/10/2023
Services
2. County Attorney Office County Attorney Office D 1010 Z3
3. BCC Office Board of County
Commissioners P.L. /113b`� 10/IIIZ3
4. Minutes and Records Clerk of Court's Office MF
PRIMARY CONTACT INFORMATION V
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 Community and Human Services Division
Agenda Date Item was October 10, 2023 Agenda Item Number 16.D. 1
Approved by the BCC
Type of Document Recommendation to approve and authorize Number of Original 1
Attached the chairman to sign one(1)Release of Lien Documents Attached
for full payment in the amount of
$11,296.25, pursuant to Agreement for
Deferral of 100% of Collier County Impact
Fees for Owner-Occupied Affordable
Housing Dwellings.(General Fund 0001)
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 fmal 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 fQ o e
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the O
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
tlj
r�Q� tkY
Q' 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
16pI
!NSTR 6467000 OR 6298 PG 1655
RECORDED 10/20/2023 9:16 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$10.00
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 Habitat for Humanity of Collier County,
Inc., to COLLIER COUNTY, dated June 13, 2022 and recorded on June 21, 2022 in Official
Records Book 6143, Page 2486 et seq., of the Public Records of Collier County, Florida, in
consideration of$11,296.25 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:
WHITAKER WOODS A CONDOMINIUM UNIT 203, OF THE PUBLIC
RECORDS OF COLLIER COUNTY,FLORIDA
Parcel ID No. 81750000120
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
day of Cc-bI pew 2023, Agenda Item No. Us. i I
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK COLLIER COUNTY, FLORIDA
By: By:
Deputy Clerk Rick LoCastro, Chairman
Attest as to Chairman's
signature only
App o ed for form and legality:
IcOe
Derek D. Perry
Assistant County Attorney
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