Backup Documents 06/28/2016 Item #16D 5 a Rez001,0 -1-5-"Yt (47
ORIGINAL DOCUMENTS CHECKLIST & ROUTINI S p6 5
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 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. Wendy Klopf Community and Human i Y� 't�
Services �A.s .� `�l
2. County Attorney Office-Emily County Attorney Office (� ,) , 1 ,''
Pepin `
3. BCC Office Board of County \c
Commissioners �� -- \```,
4. Minutes and Records Clerk of Court's Office
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 Wendy Klopf/CHS Phone Number 252-2901
Contact/ Department
Agenda Date Item was 06.28.2016 Agenda Item Number 16.D.5
Approved by the BCC
Type of Document Release of Lien-CWIF Number of Original 3
Attached Documents Attached
PO number or account 1-$10.00 Check rr1c '
number if document is 2-Habitat for Humanity Recording Account
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? p0 k._01/4.1/41 WK
2. Does the document need to be sent to another agency for additional signatures? If yes, NA
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 WK
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 Chauruan's signature line date has been entered as the date of BCC approval of the WK
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 WK
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 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 06/28/2016 and all changes made during WK
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 WK
BCC, all changes directed by the BCC have been made, and the document is ready for the
Chairman's signature.
I:Forms/County Forms CCF s/Original Documents Routing Slip WS Original 9.03.*Revised 1.26.05,Revised 2.24.k;Revised 11/30/12 ,�,
1605
INSTR 5286510 OR 5291 PG 764
RECORDED 7/6/2016 3:40 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Prepared by: Wendy Klopf COLLIER COUNTY FLORIDA
Collier County Community and Human Services REC$10.00
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3299 E.
Tamiami Trail,Naples,Florida 34112, the owner(s) and holder(s) of a certain Lien Agreement for Deferral of
100% of Collier County Impact Fees for Owner Occupied Affordable Housing Dwelling Units (the "Impact Fee
Lien") executed by Babett Moser to Collier County, recorded on
04/10/2008 in Official Records Book 4348, Page 1168, of the Public Records of Collier County, Florida, in
consideration of$ 17,104.22 plus interest, receipt of which 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:
Unit 1401,Vista III at Heritage Bay Commons,a Subdivision as recorded in Plat Book 43,Pages 46 through 54 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.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK,CLERK OF COINER COUNTY,FLORIDA
awls,
By: , "� By:
, • c
Chairman Donna Fiala, District 1 Commissioner
Attest as tb� ► ` e .
signature only.
Approval for fo/...nd legality:
// pp)
_I __� :>
Emily R. '-'in
Assistant County Attorney
x
1605 ,
INSTR 52865R 56:19:1 PG 1017
RECORDED 77R/66,1,;),0102 PM PAGES 1
DWIGHT E. BK, ERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Prepared by: Wendy Klopf REC$10.00
Collier County Community and Human Services
3339 E.Tamiami Trail,Building H,#211 —
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3299 E.
Tamiami Trail,Naples, Florida 34112, the owner(s) and holder(s) of a certain Lien Agreement for Deferral of
100%of Collier County Impact Fees for Owner Occupied Affordable Housing Dwelling Units (the "Impact Fee
Lien") executed by Jean T. Cheribin and Immacula Leo to Collier County, recorded on
10/20/2010 in Official Records Book 4616, Page 75 , of the Public Records of Collier County, Florida, in
consideration of$ 14,591.26 plus interest, receipt of which 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 11,Regal Acres,according to the plat thereof,as recorded in Plat Book 49,Pages 87 through 90, inclusive,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.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK,CLERK OF CO IER COUNT ,FLORIDA •
By: ,, . a k __:,. � By:
Attest ast: '* `' Chairman Donna Fiala, District 1 Commissioner
4. si. - rey ,
dVa ,
Emily R. '•sin
Assistant County Attorney
1 6 0 5
INSTR 5286577 OR 5291 PG 1018
RECORDED 7/6/2016 4:02 PM PAGES 1
Prepared by: Wendy Klopf DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Collier County Community and Human Services COLLIER COUNTY FLORIDA
3339 E.Tamiami Trail,Building H,#211 REC$10.00
Naples,FL 34112 _
THIS ' • - -. -. G
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 Units (the "Impact Fee
Lien") executed by Corcotte Michel to Collier County, recorded on
11/03/2009 in Official Records Book 4505, Page 2596, of the Public Records of Collier County, Florida, in
consideration of$14,987.08 plus interest, receipt of which 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 64,Liberty Landing,according to the plat thereof,as recorded in Plat Book 47,Pages 71 through 73, inclusive,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.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK OF COL ER COUNTY,FLORIDA
By: t By:
IEPC=EfiK Cha Irma Donna Fiala, District 1 Commissioner
Attest as �r. an S_
signature only.
A eproval for for, and legality:
do a
Emily R. lin
Assistant County Attorney