Backup Documents 12/09/2014 Item #16F1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 c
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 (0( I 2-6 Z
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.
2.
3. County Attorney Office County Attorney Office Zc\ li
/s vz.Vkik
4. BCC Office Board of County T
Commissioners H
cS r.7.V&t
5. Minutes and Records Clerk of Court's Office
1'\VJ ,40 albseo
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 (-� \ Phone Number
Contact/ Department V A v\\--R t \ S`!\iYV.0 a-a.cl a
Agenda Date Item was \W.ter1/4tct. Agenda Item Number 1
Approved by the BCC \-4\
\A 1eieS 1 c .
Type of Document `�� Number of Original
Attached 2"i_. as c- --\ .'`) Documents Attached
PO number or account
number if document is 1 \'')AGi-)0^ �kt.p‘J3J
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? AP
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. I•114
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed -k
,�
by the Office of the County Attorney. Cl
4. All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other parties except the BCC Chairman and the Clerk to the Board OA
5. The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable. ker-
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 Wit
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 131`1 (enter date)and all changes made
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
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 t
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
16 F , 1
This instrument prepared by:
Paula Fleishman INSTR 5062663 OR 5103 PG 1541
Collier County Growth Management Division RECORDED 12/12/2014 2:20 PM PAGES 2
2800 North Horseshoe Drive DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Naples,Florida 34104 COLLIER COUNTY FLORIDA
(239)252-2924 REC$18.50
RELEASE OF LIEN
KNOWN ALL MEN BY THESE PRESENTS: That Collier County, whose post office address
is 3301 East Tamiami Trail, Naples, Florida, 34112, the owner(s) and holder(s) of a certain
Impact Fee Agreement executed by Crestview Park II, Ltd. to Collier County, executed and
recorded on March 13, 2007 in Official Records Book 4301, Page 3802 of the Public
Records of Collier County, Florida, hereby does release from lien the real property described
in Exhibit"A" (attached), owned by Crestview Park II, Ltd.
The undersigned is authorized to and does hereby release this lien as to the whole of the above-
described real property and consents to this lien being discharged of record.
Dated this day of rte'-'( e Mt bet-, 2014.
ATTESTic•P'1 . P.;'.4r" BOARD OF COUNTY COMMISSIONERS
DWIa,Ht E. BROCK;' Ierk COLLIER COUNTY,FLORIDA
.f 7 l
By: inirk. .._ k ee By: Lt` i6, •
:DU , -rk TOM HENNIN , Cha'4 an
Attest as to chaifl a 't
sianat!Irp nniv
Appr, ed ,s to forte----'-- --
and l to .P' `tency:
Jeffrey!• ", •w
Count • 1 rney
16F .
EXHIBIT"A"
HM PROJECT 12001106
1/31/2006
REF.DWG.I B 5764
Pa9e 2 of 2
BEARINGS SHOWN HEREON REFER TO THE EAST LINE OF TRACT 2,ARROWHEAD RESERVE AT
LAKE TRAFFORD- PHASE ONE ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
42, PAGES 94 THROUGH 111 OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA AS BEING
S.01°11'04'E.
HOLE MONTES, INC.
CERTIFICATE OF AUTHORIZATION LB#1772
f% ,04011; 4 1:
THOMAS M. MURPH w, a• �A
bbv
CMCJ
16 F , 1
This instrument prepared by:
INSTR 5062664 OR 5103 PG 1543
Amy Patterson RECORDED 12/12/2014 2:20 PM PAGES 2
Collier County Growth Management Division DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
2800 North Horseshoe Drive COLLIER COUNTY FLORIDA
Naples,Florida 34104 REC$18.50 INDX$1.00
(239)252-5721
RELEASE OF LIEN
KNOWN ALL MEN BY THESE PRESENTS: That Collier County, whose post office address
is 3301 East Tamiami Trail, Naples, Florida, 34112, the former owner(s) and holder(s) of a
certain Impact Fee Agreement executed by Audinio and Lourdes A. Beltran and Habitat for
Humanity to Collier County, executed on February 21, 2005 and recorded in Official
Records Book 3748, Page 2040 of the Public Records of Collier County, Florida, hereby
does release from lien the real property described in Exhibit"A" (attached), currently owned by
Bernardo Martinez Hernandez and Odilia Balderas Villanueva.
The undersigned is authorized to and does hereby release this lien as to the whole of the above-
described real property and consents to this lien being discharged of record.
`fin
Dated this 4 day of -C C. e Wt b e r', 2014.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIQHT,E. BR,OCK, Clerk COLLIER COUNTY, FLORIDA
B f-y,-)- Iti)-3L-' - "-.- *4 B ilk
Attest as to Chairman's' •uty Cl•rk TOM E ING, Ch.• an
i
snature ilnt
Appro ed . to form
if
and le;,al _ ency:
4111,,Jeffrey 1,, ' ow
County 'tt III ney
16 F 1
EXHIBIT"A"
LEGAL DESCRIPTION
OWNERSHIP
ADDRESS
1236 Allegiance Way, Immokalee Florida 34142
Lot 34, Independence Phase I,as recorded in Plat Book 41,Pages 44—46 of the
Public Records of Collier County,Florida
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