Backup Documents 06/27/2017 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 b 8
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
coIt,t6THE 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 Irk
Services
2. County Attorney Office County Attorney Office 'a
3. BCC Office Board of County
Commissioners
4. Minutes and Records Clerk of Court's Office 1 C(aa-Cn- /1
;sr
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 06.27.17 ✓ Agenda Item Number 16.D.8
Approved by the BCC
77
Type of Document Release of Lien Number of Original 1
Attached Documents Attached
PO number or account Please use the SHIP account string for
number if document is recording:791-138791-649030-33467.1 V
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? 6 . P d V V ti I Pi
2. Does the document need to be sent to another agency for additional sit . - : 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 Chairman'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 06.27.17 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
BCC,all changes directed by the BCC have been made,and the document is ready for the i
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
1608
INSTR 5423483 OR 5410 PG 705
RECORDED 6/28/2017 4:32 PM PAGES 2
DWIGHT E.BROCK,CLERK OF THE CIRCUIT COURT
Prepared by:Wendy Klopf COLLIER COUNTY FLORIDA
Collier County Community&Human Services Division REC$18.50
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 Impact
Fee Waiver Agreements executed by Immokalee Habitat for Humanity, Inc. to Collier
County, having met the 15 year affordability housing obligation associated with the $62,872.32
of SHIP Impact Fee Waivers, of which is hereby acknowledged does remise, release, quitclaim,
exonerate and discharge from the lien and operation of the said agreement, that certain portion of
the premises conveyed by said lien, more particularly described as follows:
See Exhibit A
The undersigned is authorized to and does hereby release these Liens with respect to the above-
named properties, and consents to these Liens being forever discharged of record with respect to
said properties.
This Release of Lien was approved by the Board of County Commissioners on -
3mt. c,1 1 , 2017, Agenda Item Number \t.pt .
nrwr
AXTEST: BOARD OF CGI COMMISSIONERS
DW HT E. BRO ;:.CLERK OF COLLI•" ,,• . TY, FLORIDA
=r \ By: 'L✓
est aSoo.ERK PENNY TA - HAIL
sianatt re Qnt�.
App Va oro and legality:
Jennifer Belpedio 032
\
Assistant County Attorney 9 S
��a
16138
EXHIBIT A
LOTS 1,3,4,5,7,9,10,11,12,13,14,15,17,18,19&20 HIGHANDS HABITAT SUBDIVISION,
ACCORDING TO THE PLAT THEREO, RECORDED IN PLAT BOOK 25, PAGE 61 OF
THE PUBLIC RECORDS OF COLLIER COUNTY.
15 year Lien Impact Fee
BCC Approval CO date affordability Legal Description Folio (OR/Pg) Amount
date/Item# end date
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 1 50120000066 2100/1849 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 3 50120000105 2100/1863 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 4 50120000121 2100/1870 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 5 50120000147 2100/1877 $ 3,929.52
09/12/95 Item 16A9 12/18/1996 12/18/2011 Highlands Habitat,Lot 7 50120000189 2100/1891 $ 3,929.52
09/12/95 Item 16A9 02/28/1997 02/28/2012 Highlands Habitat,Lot 9 50120000228 2100/1905 $ 3,929.52
09/12/95 Item 16A9 03/09/1997 03/09/2012 Highlands Habitat,Lot 10 50120000244 2100/1912 $ 3,929.52
09/12/95 Item 16A9 04/29/1997 04/29/2012 Highlands Habitat,Lot 11 50120000260 2100/2105 $ 3,929.52
09/12/95 Item 16A9 04/07/1997 04/07/2012 Highlands Habitat,Lot 12 50120000286 2100/2112 $ 3,929.52
09/12/95 Item 16A9 04/07/1997 04/07/2012 Highlands Habitat,Lot 13 50120000309 2100/2119 $ 3,929.52
09/12/95 Item 16A9 12/18/1996 12/18/2011 Highlands Habitat,Lot 14 50120000325 2100/2126 $ 3,929.52
09/12/95 Item 16A9 12/18/1996 12/18/2011 Highlands Habitat,Lot 15 50120000341 2100/2133 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 17 50120000383 2100/2147 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 18 50120000406 2100/2154 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 19 50120000422 2100/2161 $ 3,929.52
09/12/95 Item 16A9 05/13/1996 05/13/2011 Highlands Habitat,Lot 20 50120000448 2100/2168 $ 3,929.52
Total $ 62,872.32