Backup Documents 01/13/2026 Item #16D 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 12/9/25 BCC TG
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. Michelle Rubbo Community and Human MR 1/8/26
Services
2. County Attorney Office— County Attorney Office
1/13
3. BCC Office Board of County
Commissioners Dk iy,,p,�J I iI y
4. Minutes and Records Clerk of Court's Office r( ll'1914'41.41
egate
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 Michelle Rubbo Phone Number (239)252-6030
Contact/ Department
Agenda Date Item was 1/13/26 Agenda Item Number 16.D.6
Approved by the BCC
Type of Document RELEASE OF LIEN Number of Original 1
Attached Documents Attached
PO number or account 1053-138791-649030-33907.1
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 STAMP OK MR
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 MR
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 MR
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 MR
document or the foal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MR
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 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 above date and all changes made during ! ,\1 uc
the meeting have been incorporated in the attached document. The County ‘ioi
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 54/ nb ,tsxk g El+o
Chairman's signature. '"`((
1 1004- 4 r
INSTR 6774427 OR 6545 PG 1824
RECORDED 1/15/2026 9:20 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by:Michelle Rubbo REC$10.00
Collier County Communit. and I luman Sets ices
3339 E. I'amianti'rail,Building II,4211
Naples. FI.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
Agreement for Deferral of 100°'i, of Collier County Impact Fees for Single-Family Affordable
Housing Dwelling executed bti Evelyn Mercado, to COLLIER COUNTY, recorded on
10/28/2004 in Official Records Book 3668, Page 2382 of the Public Records of Collier County.
Florida. having met the 15-year affordability housing obligation associated with the S7,570.20 of
SHIP Impact Fee Waivers, of which is hereby acknowledged does satisfy. remise. release,
quitclaim.exonerate and discharge the Impact Fee Lien against the premises conveyed by said lien.
and more particularly described as tbllows:
The North 82.5 feet of the South 412.5 feet of the East One-Half of Tract 40,NAPLES FARM SITES,
Section 24,Township 29 South, Range 26 East,according to the plat thereof recorded in Plat Book
4,Page 34,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 \l\3\a , Agenda
Item Number__I6.D,(p
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL. K. KIN/EL, CLERK COLLIER COUNTY, FI;ORIDA
•,!. •' 'i," ,•'-',:i;'ic?
t �°- DC By:
'• �� : I)I.I'UTY CI •I•RK DAN KOWAI., C AIRPI:RSO:
;; ,, R 'Attest as to Chairmanls
signature only.
Appro‘ n and legality:
Jeffrey A. at o . County Attorney