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Backup Documents 09/25-26/2012 Item #16A 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIj 6 A 3 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines#1 through#4 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#4,complete the checklist,and forward to Sue Filson(line#5). Route to Addressee(s) Office Initials Date (List in routing order) 1. Judy Puig GMD Planning & Regulation/Operations 2. 3. 4. 5 Ian Mitchell, Supervisor, BCC Office Board of County Commissioners 5I2 Il L 6. Minutes and Records Clerk of Court's Office a�Zr�(r2 PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval.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,including Sue Filson,need to contact staff for additional or missing information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the item.) Name of Primary Staff Jennifer Baker Phone Number 252-2444 Contact Agenda Date Item was September 25,2012 Agenda Item Number 16.A.3 Approved by the BCC Type of Document Lien — 50.,`.s s On�,1 ` Number of Original 1 Attached �-^ Documents Attached 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. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. This includes signature pages from ordinances, resolutions,etc. signed by the County Attorney's Office and signature pages from 931 contracts,agreements,etc.that have been fully executed by all parties except the BCC Chairman and Clerk to the Board and possibly State Officials.) 2. 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 3. 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. 4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 5. In most cases(some contracts are an exception),the original document and this routing slip should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval. 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! 6. The document was approved by the BCC on 9/25/2012 (enter date)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. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05 16A3 This Instrument Prepared By: Jen Baker INSTR 4747011 OR 4841 PG 3217 RECORDED 10/3/2012 10:13 AM PAGES 1 Code Enforcement Department DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT 2800 North Horseshoe Drive COLLIER COUNTY FLORIDA Naples, FL 34104 REC$10.00 (239) 252-2440 RELEASE AND SATISFACTION OF LIEN KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and personal property owned by: Palmira Munoz, Respondents The lien was recorded on May 13, 2011 in Official Records Book 4681, Page 2084, in the Official Records of Collier County, State of Florida. The lien secures the principal sum of Three Thousand six hundred twelve dollars and twenty nine cents, plus accrued interest and penalties, if any, and imposes certain obligations against real property situated in Collier County, Florida, which property is described as follows: GOLDEN GATE UNIT 2 BLK 59 LOT 19 2051 44th Terrace SW Naples, FL Collier County, a political subdivision of the State of Florida, by execution of this Release and Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners as satisfaction of the lien and hereby cancels said lien. The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist. ATTEST • BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA By: By ID!" lerk Fred W. Coyle, Charima i*St ,'>'to Chat �► 3lonatu't 9 Not Approved as to form and legal sufficiency Je Wri• t As-'st- t County Attorney