Backup Documents 10/23/2018 Item #16D10 Tbtec. ( 0 (7_5 1 1, 1
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 D 1 u
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 and Human 10/17/18
Services ...,,Ak
2. Jennifer Belpedio County Attorney Office
3. BCC Office Board of County
Commissioners VES t/ \c.\7_,-4k\%%
4. Minutes and Records Clerk of Court's Office ,,. /--,,/t.,, t.,
li- tli,n
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/CHS Phone Number 252-2336
Contact/ Department
Agenda Date Item was 10/23/2018 Agenda Item Number 16.D. 1'®
Approved by the BCC
Type of Document Release of Lien—1 AHDBA Number of Original 1
Attached Documents Attached
PO number or account _ - ...V.A..,
number if document is tT5t �,[
to be recorded 1\1 ' 7 r
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is - • ' (Not
appropriate. (Initial) (k____..ble)
1. Does the document require the chairman's original signature? 564
2. Does the document need to be sent to another agency for additional signatures? If 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 SG
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 SG
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 SG
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 10/23/2018 and all changes made during the SG r
meeting have been incorporated in the attached document. The County Attorney's 047-37 o : e
Office has reviewed the changes,if applicable. 012;;- qi`et.
9. Initials of attorney verifying that the attached document is the version approved by t F.,, !' i it
BCC,all changes directed by the BCC have been made,and the document is ready or the /,` fly . a
Chairman's signature. - t
i Revised 11/30/12
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;
16010
INSTR 5629593 OR 5566 PG 62
RECORDED 10/26/2018 9:15 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by: Susan Golden REC$10.00
Collier County Community and Human Services
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 Affordable Housing Density Bonus and executed by Thomas Moonan, an
unmarried man to Collier County, recorded on 01/23/2008 in Official Records Book 4323, Page
2089, and Subordination of Affordable Housing Density Bonus Lien recorded on 09/23/2014 in
Official Record Book 5078, Page 3421 of the Public Records of Collier County, Florida, in
consideration of $0.00, receipt of which is hereby acknowledged does satisfy, remise, release,
quitclaim, exonerate and discharge the Affordable Housing Density Bonus Agreement against the
premises conveyed by said Lien and more particularly described as follows:
LOT 189,AVE MARIA UNIT 13,MIDDLEBROOKE TOWNHOMES,A SUBDIVISION ACCORDING TO THE
PLAT THEREOF RECORDED AT PLAT BOOK 48,PAGES 48 THROUGH 53,IN 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
C) ' (O.QIcO:.5 , 2018, Agenda Item Number t IQ,b, 'tt
ATTEST: . BOARD O' 0 ' TY COgoIr: ONERS
CRYSTAL K. KINZEL, CLERK COLLI CO . Y F r�. 0 ./
•
By: CLL- \ 1 _ ,,� C . By: , All(A $,..•
r , D PUTY CLERK i REW SOLIS, CHAIRMAN
Attest as to . airm
signature only.
Approved as to form and legality:
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Jenm r A. Belpe . Dj
Assistant County Attorney0 rg
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