Backup Documents 11/14/2023 Item #16A14 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 A 14
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pinh paper. s flitch to original(Imminent. The completed routing slip and original dottiMrnis are to he forwarded to the County A html ey Office
at the Iflue the Om is placed oil the agenda. All completed routing slips anti original documents must be received in the County Attorney Office no later
than Monday preceding the Hoard meeting.
**NEW** ROUTING SLIP
Completr routing lines 41 through#2 as appropriate for additional signatures,dates,and/or information medal. if the document is already complete with the
exception of the Chairman's signature draw it line through routing I Ines 41 through 42,corn toe the checklist,and forward to the County Attorney Office.
Route to Addressee(s)o.ist in routitis order) Office Initials Date
1.
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3 County Attorney Office County Office ....
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Attorney
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4. BCC Office ,C.,
Board ot ounty
Commissioners i[
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5. Minutes and Records Clerk of Court's Office
cy , ti itp ,23615.0
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PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who crcatediprepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,.mac need to contact staff for additional or missin,infoiration.
Name of Primary Staff Diane Lynch,G VICDD ORM Phone Number 239-252-4283
Contact / De.artment
Agenda Date Item was Agenda Item Number I 16A14
A roved by the BCC ,
T3r pc of Document MOA-Pee Schedule Number of Original l I
...
Attached Documents Attached
PO number or account
number if document is I
,
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"NA"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
I. Does the document require the chairman's original signature? dint
2. Does the document need to be sent to another agency for additional signatures? if yes, NA
provide the Contact Information(Name;A,ency;Address;Phone)on an attached sheet.
3, Original document has been signed/initialed fir legal sufficiency. (All documents to be dial
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 dml
document or the final negotiated contract date whichever is a licable.
6. -Sign here"tabs are placed on the appropriate pages indicating where the Chairman's dml 111.111
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 arc time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware ofyour deadlines!
8. The document was approved by the BCC on I 111412023_and all changes made N L. ,, -fs'7''
..;,,„;, ,,,,N!..,,,,
during the meeting have been incorporated in the attached document. The County , i( IN
Attorney's Offiee has reviewed the changes,if applicable.
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9. Initials of attorney verifying that the attached document is the version approved by the /( 1
BCC,all changes directed by the BCCC ,,k-..., an
have been made,and the document is ready for the , , op 0,ot X
Chairman's signature, I \ tit:Wine.
1. Forms,'County l'ormsil3CC Forms/Original Documents Routing Slip ViiVir'S Original 9,03,04,Revised I 26.05,Revised 2.24.05:Revised I I/30/12
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Memorandum of Agreement for Onsite Sewage Treatment and Disposal
Systems (OSTDS) Plan Review, Fee Collection, and Reconciliation
For the mutual benefit of the parties involved,this memorandum of agreement("MOA")is between the
Florida Department of Health in Collier County("Department")and Collier County Board of County
Commissioners%Collier County Growth Management Community Development Department("County")
in the interest of facilitating timely permitting for the protection of the health and safety of the population of
Collier County.
I. The Department agrees to:
1. Allow the County's intake staff to receive septic system permit applications and related
documentation,plans, and associated fees on the Department's behalf. Fees shall be
collected in accordance with:
a. Collier County Resolution No. 2016-244,pg. 7,associated with OSTDS (See
Collier County Health Department—Fee Schedule and Collier County Health
Department—Billing Scheme, attached and incorporated herein as Attachment I)
b. Rule 62-6.030,F.A.C.
2. Use the County's CityView database for entering permit review statuses. Including:
a. "Approved"when a permit is issued or existing system approval is granted,
b. "Rejected"when additional information is needed,and
c. "Not Applicable"when a review has been completed and no document needs to
be created by the Department.
3. Use the County's CityView dataset for inspection scheduling and inspect jobs that are
correctly scheduled through the CityView system.
4. Enter inspection results in the CityView system by close of business,on the day the
inspection occurs.
5. Enter all additional fees over the life of the permit into the CityView system prior to final
septic system approval.
6. Reconcile fees collected and posted the previous month in CityView with the fees charged
to septic permits in the Department's EHD system.
7. Provide education to intake staff on any observed errors.
8. If changes are requested by the Department to the County for CityView,this will require a
minimum of 90-day notice.
a. Contacts for CityView updates and changes for the Department include:
Rachel VanBlaricom Rachel.VanBlaricom(a f health.gov,Division Director
Dante Palumbo Dante.Palumboavilhealth.gov,Program Supervisor
II. The County agrees to:
1. Receive payment on behalf of the Department and forward payment in the form of a
monthly check from the County Clerk's Office made out to the"Florida Department of
Health in Collier County".
a. Fees shall be collected in accordance with:
i. Collier County Resolution No. 2016-224,pg. 7
ii. Rule 62-6.030,F.A.C.
b. All money for the Department must be collected in whole and sent to the
Department on one check.
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i. No payment shall be split into a partial amount.
ii. No refund shall be granted on behalf of the Department.
c. Provide the Department with the necessary reports for reconciling any and all
money collected and/or sent to the Department.
2. Ensure that the Department has access to septic system permit applications,related
documentation,and plans within one day of receipt by the County.
3. Provide the Department with the necessary access to the CityView database,including
licensing and hardware.
4. Collect any outstanding fees accumulated throughout the life of the permit,such as
reinspection fees or permit revision fees, and forward payment to the Department as part of
the monthly check.
5. Communicate any and all CityView updates and policy changes to the Department within
two(2)days of the updates/changes.
a. Contacts for CityView updates and changes for the Department include:
Rachel VanBlaricom Rachel.VanBlaricom fihealth.gov,Division Director
Dante Palumbo Dante.Palumb0(aJflhealth.eov,Program Supervisor
III. CONTACTS: All notices or correspondence to be given under this MOA shall be made in writing
and mailed,emailed,or hand-delivered to the other party at the address set forth below:
For the Department:
Program Specific Inquiries
Rachel Van Blaricom
Environmental Administrator
3339 Tamiami Trail E,Naples,FL,34112
239-252-5528
Rachel.VanBlaricom(ii flhealth.gov
Billing Specific Inquiries
Mairelys Diaz Rodriquez
Accountant II
3339 Tamiami Trail E,Naples,FL,34112
239-252-8211
Maire lys.DiazRodriguezWl health.gov
For the County:
Evelyn Trimino
Manager—Finance Operations
2800 N.Horseshoe Drive,Naples,FL 34104
239-252-4317
Evelyn.Trimino@colliercountyfl.gov
Kirsten Wilkie
Manager—Business Center
2800 N.Horseshoe Drive,Naples,FL 34104
239-252-5518
Kirsten.Wilkie(aa.colliercountyfl.gov
CAC?/
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Marlene Serrano Division
Manager
2800 N.Horseshoe Drive,Naples.FL 34104
239-252-2422
Mai lene.Serrano a coil ivrt;upt\flov
IV. MUTUAL RESPONSIBILITIES/CONDITIONS:
I. In the event of an identified discrepancy:
a. The Department will notify County staff of a discrepancy within 30 days of
receipt of the county check.
b. If an overpayment is the result of incorrectly assessed Department fees,the
customer shall be provided with information on how to obtain a refund directly
from the Department.
e. Under no circumstance should an overpayment be addressed with the creation of
a bond account or other means of withholding funds from the Department until
the full refund has been executed.
2 Maintain open lines of communication between inter-department contacts.
3. Each party reserves the right to change its point of contact without written agreement but
will notify the other party within a reasonable period of time after such a change.
V. TERM AND RENEWAL
Unless terminated earlier as provided herein,the term of this MOA shall be effective on the latest
date of signature by the parties. This MOA shall renew automatically for one(1)year period unless
terminated by the parties in accordance with the terms of this MOA.
This MOA may he terminated by either the County or Department for any reason,at any time, with
or without prior notice and with or without cause upon written notice to the other party.
IN WITNESS WHEREOF,the parties approve this 3-page MOA and have caused it to be executed by
their undersigned officials who are duly authorized.
Collier County Board of County Commissioners Florida Department of Health in Collier County
Signature Signature/---::::
Kossler
, \ ,
---
Rick LoCastro, Chairman Title
11/1 4/2023
Date Date
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Approved as to form and legality
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KRO-L ot-- -
Ry TAL K. , 7 ,,, ,-,.,, . ,.
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Heidi Ashton-Ciao i 0-5-23 L
Managing Assistant County e. z 06019 Cletk '
Attorney A est as to Chairman S 7
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16A14
Attachment I
Collier County Health Department-Fee Schedule
°SIDS
Development Plan Review(one-time fee) 2 .00 20.00
Incidental Plan Review(ore-time fee) 10.00 10.00
Construction Permit Application (onetime fee) 160.00 160.00
Final Cover inspection(one-time fee) 75.00 75.00
ATtI Permit(annual fee) 150.00 150.00
PEST Permit(annual fee) 200.00 200.00
Rernspe tion(one•tame fee) 75.00 75.00
Repair Permit(one-time fee) 200.00 200.00
Septic Letter(one-time fee) 30.00 30.00
Collier County Health Department-Billing Scheme
Approved Approving Antt to
Scheme Current Fee Head-
Amount Entity
quarters
OSTDS Construction Application and Plan Review,New $ 100.00 State $ 8.00
OSTDS Construction Permit(New or Mod,Amendment) $ 55.00 State $ 4.40
New OSTDS Construction System Inspection $ 75.00 State $ 6.00
OSTDS OSTDS Construction System Inspection Research Fee $ 5.00 State $ 5.00
Construction Permit Application$160.00 $ 160.00 BCC $ -
Final Cover Inspection $ 75.00 BCC $ -
"Ftealth App/ReviewJ2-Inspections" $ 470.00
Florida Administrative Code 62-6.030-Fees
"Application and approval for existing system,if system inspection is not required" $35.00
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