Backup Documents 06/25/2019 Item #16D17 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 1 7
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 Initi Date
1. Susan Golden Community and Human 6/18/19
Services
2. Jennifer Belpedio County Attorney Office Dcue cjs)ic)
3. BCC Office Board of County �,,3V-W5,L\
Commissioners W75/ ,t kc‘
4. Minutes and Records Clerk of Court's Office �(ti (0r2 b'tq
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 informatio .
Name of Primary Staff Susan Golden/CHS Phone Number 252-2336
Contact/ Department
Agenda Date Item was 6/25/2019 Agenda Item Number 16.D. it-1-
Approved by the BCC
Type of Document Two Releases of Lien(Bristol-Halm) / Number of Original 2
Attached Documents Attached
PO number or account 111-138759-649030
number if document is
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? 0 V NA
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 T lahassee within a certain
time frame or the BCC's actions are nullified. Be aware of ur deadlines!
8. The document was approved by the BCC 6/25/2019 an all changes made during the SG f t
meeting have been incorporated in the attached document. The County Attorney's eat
Office has reviewed the changes,if applicable. + Ig
9. Initials of attorney verifying that the attached document is the version approved by the SP( °
BCC,all changes directed by the BCC have been made,and the document is ready for t cte za ¢+ B
Chairman's signature. Ami
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
16017
INSTR 5734004 OR 5647 PG 3439
RECORDED 7/2/2019 8:16 AM PAGES 3
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by:Susan Golden REC$27.00 INDX$16.00
Collier County Community&Human Services Division
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 certain Lien
Agreement with Developer for Deferral of Specified Collier County Impact Fees for Owner
Occupied Affordable Housing Dwelling Units executed by Bristol Pines, LLC (Developer) to
Collier County, recorded on 05.06.20*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:
See Exhibit A
The undersigned is authorized to and does hereby release these Liens with respect to the above-
named properties, and consents to these Liens being forever discharged of record with respect to
said properties.
This Release of Lien was approved by the Board of County Commissioners on -
�y�r1e., 2-5 ,2019,Agenda Item Number -
ATTEST: ''' . ". BOARD OF, •• • 4 ISSIONERS
LLQ
CRYSTAL K. KINZE , CLERK OF Y,FLO' •A
By: _ �• By: C• _�
Attest as lg..r r � : 'K W IAM L. M DANIEL,JR., 'AIRMAN
AAtria'nd legality:
`°
Jenni er A. Bele. • D
Assistant County Attorney w, 5,
160 17
EXHIBIT A
Various units as listed below for, Bristol Pines, Phase II, according to the plat thereof, as recorded
in Plat Book 46, Page 67, of the Public Records of Collier County, Florida.
File#
Recorded OR Legal Developer's Current Amount
Date Book/Page Description Name Owner of Lien
FY16-053- 05/06/2016 5270/2499 Lot 162, Bristol Pines, Michelle $8,831.17
CWIF Bristol Pines, LLC Picone
Phase Il
FY 16-054- 05/06/2016 5270/2503 Bristol Pines, Ludenor
C WIF Lot 170,
Bristol Pines, LLC Brito $8,838.53
Phase II
FY16-056- 05/06/2016 5270/2511 Lot 211, Bristol Pines, John
CWIF Bristol Pines, LLC Mulholland/
Phase II Gloria $8,742.93
Gomez
FY16-057- 05/06/2016 5270/2515 Lot 210, Bristol Pines, Ersin, $8,519.87
CWIF Bristol Pines, LLC Duzenli/V.
Phase II Montoya
FY16-058- 05/06/2016 5270/2519 Lot 203, Bristol Pines, Kristine $8,519.87
CWIF Bristol Pines, LLC Hunt
Phase II
FY16-059- 05/06/2016 5270/2523 Lot 202, Bristol Pines, William $8,519.87
CWIF Bristol Pines, LLC Garcia
Phase II
FY16-060- 05/06/2016 5270/2527 Lot 195, Bristol Pines, Maria Anez $8,519.87
CWIF Bristol Pines, LLC
Phase II
FY16-061- 05/06/2016 5270/2531 Lot 194, Bristol Pines, Patrick& $8,519.87
CWIF Bristol Pines, LLC Sandra pd 3/8/19
Phase II Halm sold to Chk#1336
Joanne 08
Halm
FY16-062- 05/06/2016 5270/2535 A portion of Bristol Pines, Katia $8,519.87
CWIF Lot 260 in LLC Justiniano
favor of Lot
257,BP, Ph II
FY16-063- 05/06/2016 5270/2541 A portion of Bristol Pines, Henry& $8,519.87
CWIF Lot 260 in LLC Lillian
favor of Lot Vasquez
259, BP,Ph II
FY16-064- 05/06/2016 5270/2547 Lot 187, Bristol Pines, Gregory Kee $8,519.87
CWIF Bristol Pines, LLC Sold
Phase II 4/26/2019
16017
FY16-065- 05/06/2016 5270/2551 A portion of Bristol Pines, Erkin $8,831.17
CWIF Lot 266 in LLC Ergashev
favor of Lot
265,BP,Ph II
FY16-067- 05/06/2016 5270/2557 Lot 157, Bristol Pines, Ana S. $8,831.17
CWIF Bristol Pines, LLC Prado
Phase II
bJ
160 17
INSTR 5734005 OR 5647 PG 3442
RECORDED 7/2/2019 8:16 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Jason Rummer 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 with Developer for Deferral of specified of Collier County Impact Fees for Owner
Occupied Affordable Housing Dwelling Units (the "Impact Fee Lien") executed by PATRICK
HALM,A MARRIED MAN, to Collier County,recorded on 05.06.2016 in Official Records Book
5270,Page 2531, of the Public Records of Collier County,Florida, in consideration of $8,519.87
, 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 194, BRISTOL PINES, PHASE II, ACCORDING TO THE PLAT BOOK 46, PAGE 67, 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 June LS.,
2019, Agenda Item Number k b -\`'�,.
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK COLLIER COUNTY, FLORIDA
(- 17.. A OA.
BY:• C �� e By:
'A d LERK WILLIE• L. MCDANIEL, JR. C IRMAN
Att ,as�o
Signe
Approved as to form and legality:
Jenni3?
er A. Belped. `�Q\
Assistant County Attorney S