Backup Documents 09/26/2017 Item #16D23 c • 113
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP1 6 IJ 2
3
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. Susan Golden Community & Humani()\ f/ \
`i"
Services
2. Jennifer Belpedio County Attorney Office t _ 1,\a6 )i
3. BCC Office Board of County 7V\Commissioners / p\2-\`—1
4. Minutes and Records Clerk of Court's Office 10(02ferl 2:
phi
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 Susan Golden • Phone Numbe
Contact/ Department CHS 252-2336
Agenda Date Item was 9/26/2017 / 16.D.23
Approved by the BCC _
Type of Document Release of Lien Number of Original 3 ,7177
Attached _ Documents Attached
PO number or account
number if document is 111.138759.649030(County Wide IF Def)
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 if
- v.�e v Original is
NOT required
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 t es
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 N/A
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
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
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
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 6/28/16 and all changes made during the �j
meeting have been incorporated in the attached document. The County Attorney's Cl(7✓`�
Office has reviewed the changes,if applicable.
^
9. Initials of attorney verifying that the attached document is the version approved by the 1
BCC,all changes directed by the BCC have been made, and the document is ready for the
Chairman's signature.
1: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 Q -\--3\
16023
INSTR 5454891 OR 5437 PG 392
RECORDED 10/4/2017 11:09 AM PAGES 1
Prepared by: Susan Golden 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 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 Myriam Seide to Collier County,
recorded on 10/20/2010 in Official Records Book 4616, Page 71 of the Public Records of
Collier County, Florida, in consideration of$15,246.26 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 69, 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.
This Release of Lien was approved by the Board of County Commissioners on -
4/ _(4' , 2017,Agenda Item Number t L
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK,clerk COLLIE' C• _' TY, FLORIDA
41P
By: auk
e.o.c. By: /Attest as toputy Clerk Penny Tayl to' airman /
signature only."
Approved as to form and legality:
Jennifer A. Belpe (�j
Assistant County Attorney �O� ,a,3
5\
16023 3
INSTR 5454892 OR 5437 PG 393
RECORDED 10/4/2017 11:09 AM PAGES 1
Prepared by: Susan Golden 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 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 Jessica McNulty to Collier County,
recorded on 2/01/2006 in Official Records Book 3975, Page 2275, of the Public Records of
Collier County, Florida, in consideration of$6,970.16 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 404, BUILDING 1, BOTANICAL PLACE, A CONDOMINIUM, ACCORDING TO THE DECLARATION
OF CONDOMINIUM THEREOF RECORDED IN OFFICIAL RECORDS BOOK 3933, PAGE 2655, 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.
This Release of Lien was approved by the Board of County Commissioners on -
t7�.(10 , 2017,Agenda Item Number Ic
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK;.Clerk COLLIE' C TY, FLORIDA
AV
•
B 4 • B //
A #7 nuty Clerk Penny Tayl•or airman ,
Attest as to i
signature only.
Approved as to form and legality:
IP
Jennifer A. Belpedio ,
Assistant County Attorney
16023
54:19031401 R 5437 PG 394
RECORDEINSTR542017 11:09 39 PAGES 1
DWIGHT E.BROCK,CLERK OF THE CIRCUIT COURT
Prepared by: Susan Golden 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 Vanessa Duckworth to Collier
County, recorded on 9/14/2017 in Official Records Book 4282, Page 688, of the Public Records
of Collier County, Florida, in consideration of $13,616.20 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 17, TRAIL RIDGE, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 44,
PAGES 71 THROUGH 77, 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.
Thiselease of Lien was approved by the Board of County Commissioners on -
a I,0....
, 2017, Agenda Item Number tI2. a
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIE'0 TY, FLORIDA
By: (i_/ a C. By: // -
citw .
Attest as t0 , puty Clerk Penny Tayl N hairman OF
i r
signature only.
Approved as to form and legality:
fj.cx..R
pi_y� \
Jennifer A. Belpedio O��\
Assistant County Attorney <Ir.
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