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Backup Documents 09/24/2013 Item #16F 11-� ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPI0 io?T- TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO l c)-&-(3 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 tty FOro�y Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County rc later than Monday preceding the Board meeting. Complete routing lines #I 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 #I through #2, complete the checklist, and forward to the County Attorney Office. Route to Addressees (List in routing order) Office Initials Date 1. appropriate. Initial Applicable) 2. 9/24/13 Agenda Item Number 3. County Attorney Office County Attorney Office JAB V'!S 9/25/13 4. BCC Office Board of County Commissioners �k b� Two — one of each 5. Minutes and Records Clerk of Court's Office Documents Attached 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 Amy Patterson, Impact Fees Phone Number 252 -5721 Contact / Department appropriate. Initial Applicable) Agenda Date Item was 9/24/13 Agenda Item Number Approved by the BCC Does the document need to be sent to another agency for additional signatures? If yes, %6—IF— k Type of Document Releases of Lien — Nonhomme & Doria Number of Original Two — one of each Attached Original document has been signed/initialed for legal sufficiency. (All documents to be Documents Attached PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is by the Office of the County Attorney. to be recorded All handwritten strike - through and revisions have been initialed by the County Attorney's JAB 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 appropriate. Initial Applicable) 1. Does the document require the chairman's original signature? JAB 2. Does the document need to be sent to another agency for additional signatures? If yes, JAB 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 JAB 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 final 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 JAB 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 9/24/13 and all changes made during the JAB meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. lip 9. Initials of attorney verifying that the attached document is the version approved by the JAB BCC, all changes directed by the BCC have been made, and the document is ready for d 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 This instrument prepared by: Amy Patterson Collier County Office of Management and Budget 16F1 2800 North Horseshoe Drive I NSTR 4897943 OR 4971 PG 2440 Naples, Florida 34104 RECORDED 10/3/2013 8:10 AM PAGES 2 (239) 252 -5721 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC $18.50 RELEASE OF LIEN KNOWN ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3301 East Tamiami Trail, Naples, Florida, 34112, the owner(s) and holder(s) of a certain Impact Fee Agreement executed by Henry C. Nonhomme and Marie L. Alexandre to Collier County, executed on January 12, 1999, and recorded on January 14, 1999, in Official Records Book 26102, Page 0279 of the Public Records of Collier County, Florida, hereby does release from lien the real property described in Exhibit "A" (attached). The undersigned is authorized to and does hereby release this lien as to the whole of the above - described real property and consents to this Agreement and lien being discharged of record. , tt Dated this � -ati day of u T 61A (� , 2013. ATTEST: DWIGHT E. BROCK, Clerk Bp . Y: .A `Attest as' ��t01' 0 > si"a t on y ,� Approved as to form and legality: BOARD OF COUNTY COM SSIONERS COLLIER COUNTY, FLO A 1 By: Clerk G A . HILLER, ESQ. CHAIRWOMAN Jennifer A. Belpe County Attorney X10 a� 16F1 Exhibit "A" LEGAL DESCRIPTION LOT 11, BLOCK 36, GOLDEN GATE, UNIT 2, ACCORDING TO THE PLAT THEREOF OF RECORD IN PLAT BOOK 5, PAGES 65 THROUGH 77, OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. 16F1 This instrument prepared by: Amy Patterson Collier County Office of Management and Budget INSTR 4897944 OR 4971 PG 2442 2800 North Horseshoe Drive RECORDED 10/3/2013 8:10 AM PAGES 2 Naples, Florida 34104 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT (239) 252 -5721 COLLIER COUNTY FLORIDA REC $18.50 RELEASE OF LIEN KNOWN ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3301 East Tamiami Trail, Naples, Florida, 34112, the owner(s) and holder(s) of a certain Impact Fee Agreement executed by Priscilla Doria to Collier County, executed on July 28, 2006, and recorded on July 28, 2006, in Official Records Book 4079, Page 1760 of the Public Records of Collier County, Florida, hereby does release from lien the real property described in Exhibit "A" (attached). The undersigned is authorized to and does hereby release this lien as to the whole of the above - described real property and consents to this lien being discharged of record. Dated this J4*' ► day of 2 V�ta"A er , 2013. ATTEST: DWIGHT E.( , K, Clerk \k.�'R .ail y M Approved as to form and legality: Jennifer A. Belpe .15 Assistant County Attorney �� -y \� BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA II CHAIRW ESQ. 16F1 Exhibit "A" LEGAL DESCRIPTION LOT 19, BRISTOL PINES, ACCORDING TO THE MAP OR PLAT THEREOF RECORDED IN PLAT BOOK 43, PAGE 78, OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA