Backup Documents 02/26/2013 Item #16D 4ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP JbtJ
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE y
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office F�
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.
c
Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already comple wi
exception of the Chairman's signature, draw a line through routing lines # 1 throw #2, complete the checklist, and forward to the Coun Attorney Office.
Route to Addressees (List in routing order) Office In'tia Date
1. Barbetta Hutchinson HHVS nn A -%I I
V
2. Jennifer B. White, ACA Office located in HHVS `
Count Attorney Office Department ��w 7, \2g��
3. BCC Office Board of County `
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
Barbetta Hutchinson
Phone Number
252 -4228
Contact / Department
avvropriate.
(Initial)
Applicable)
Agenda Date Item was
2/26/13
Agenda Item Number
16134
Approved by the BCC
Does the document need to be sent to another agency for additional signatures? If yes,
N/A
Type of Document
Release of Lien
Number of Original
I
Attached
Original document has been signed/initialed for legal sufficiency. (All documents to be
Documents Attached
PO number or account
S e£ ok TM C tA C O C N FC ve-
number if document is
to be recorded
7�+ le-
INSTRUCTIONS & CHECKLIST
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
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
avvropriate.
(Initial)
Applicable)
1.
Does the document require the chairman's original signature?
Y
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
Y
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
Y
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
Y
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
Y
signature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
N/A
should be provided to the County Attorney Office at the f e the item is input into SIRE.
Some documents are time sensitive and require forward Tallahassee within a certain
time frame or the BCC's actions are nullified. Be awa of your deadlines!
8.
The document was approved by the BCC on 2/26/1 and all changes made during the
Y
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
vb�
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
16,04
INSTR 4808423 OR 4893 PG 2318
RECORDED 3/7/2013 12:46 PM PAGES 1
Prepared by: DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Collier County COLLIER COUNTY FLORIDA
Housing, Human & Veterans Services Dept 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 Impact
Fee Agreement executed by Jeremiah L. Giles to Collier County, recorded on May 31, 2006 in
Official Records Book 4046, Page 2632, of the Public Records of Collier County, Florida, in
consideration of $8,947.84, receipt 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:
Unit 205, Building 9, 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 (4420 Botanical Place Circle #205, Naples, FL 34112).
The undersigned is authorized to and does hereby 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 -
F.e ht X sn' 0 (V , 2013, Agenda Item Number / & • q.
ATTEST:
DWIGHT. `BROCK; C&erk
By.
fag 0 Chal - Duty Clerk
a#rre,�nly .
Approved as to form and
legal suffieil" ncy:
Jeff E Wnght
Assist County Attorney
Lo
OF COUNTY COMMISSIONERS
MOUNTYALORIDA
A. Miller, Esq., Chairwoman