Backup Documents 09/27/2016 Item #16F 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPT "2g-��
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 F 1
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU
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.
2.
3. County Attorney Office County Attorney Office JAB 9/27/16
4. BCC Office Board of County b,.`
Commissioners VICAJ R\z-cVo
5. Minutes and Records Clerk of Court's Office 7)(Y\ (z (i I:(13,41
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 Paula Fleishman, Senior Operations Capital Project 252-2924
Contact/ Department Analyst Planning, Impact
Fees and Program
Management
Division
Agenda Date Item was 9/27/16 Agenda Item Number '/ 1810
Approved by the BCC ' 1.6 -'1<
Type of Document Release of Lien-- 2.-Onk,- 0— Number of Original One
Attached Documents Attached
PO number or account ,.a
number if document is •s e,
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 STAMP OK} JAB
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 JAB
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 JAB
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 JAB
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 9/27/16 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 'd
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,R: ised 2.2ised 11/30/12
INSTR 5317152 OR 5318 PG 727
RECORDED 9/28/2016 2:09 PM PAGES 1
This instrument prepared by: DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Paula Fleishman REC$10.00
Collier County Growth Management Department
2685 Horseshoe Drive South,Unit 103
Naples,Florida 34104 16 F 1
(239)252-2924
RELEASE OF LIEN
KNOWN ALL MEN BY THESE PRESENTS: That Collier County, whose post office address
is 3299 East Tamiami Trail, Naples, Florida, 34112, the owner(s) and holder(s) of a certain
Agreement for Fee Payment Assistance Program executed by Lucy Zuniga DBA Lucy Hair
Design to Collier County, recorded on December 22, 2006, in Official Records Book 4159,
Pages 0844 et seq. of the Public Records of Collier County, Florida, and a certain
Amendment to Agreement for Fee Payment Assistance Program, executed by Lucy Zuniga,
individually and as the authorized officer of Lucy Salon, Inc. recorded on November 1,
2011, in Official Records Book 4731, Page 3226 et seq. of the Public Records of Collier,
Florida, hereby does release from lien on properties more particularly described as follows:
Parcel ID: 81681680101 Fred Whidden's, Block 4, Lot 6
Parcel ID: 81681680208 Fred Whidden's, Block 4, Lot 7
The undersigned is authorized to and does hereby release this Lien with respect to the above-
named properties, and consents to this lien being forever discharged of record with respect to
said property.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY,FLORIDA
•
By: t t B
Attest as _"' •�:tv Clerk b onna Fiala, Chair
signature only.
Approved as to form and legality:
Jennifer A. Belpeco
Assistant County A ney 9 Gsb