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HomeMy WebLinkAboutQuit Claim Deed - 1527 E. 4th Street-1/17/201711 11 iii 11 11 ilii 11 1111111111111 11 iii 11 Doc ID: 007580200002 Type: GEN Recorded: 03/21/2017 at 01:32:41 PM Fee Amt: $17.00 Page 1 of 2 Revenue Tax: $0.00 Black Hawk County Iowa SANDIE L. SMITH RECORDER F11e2017-00016321 4 C -t -- ter' o T' a= d Zel l h occe r - Prepared by: James E. Nervig, Attorney at Law, 6701 Westown Parkway, Suite 100, West Des Moines, IA 50266 515-274-1450 Return to: City of Waterloo, 715 Mulberry St., Waterloo, IA 50703 Address Tax Statement: City of Waterloo, 715 Mulberry St., Waterloo, IA 50703 QUIT CLAIM DEED For the consideration of One Dollar ($1.00) and other valuable consideration, Michael B. Mowat and Gina M. Mowat, husband and wife, and Barry J. Kubat and Michelle A. Kubat, husband and wife, as grantors, hereby quit claim to the City of Waterloo, Iowa, as grantee, all of the grantors' right, title, claim and demand in the following described real estate in Black Hawk County, Iowa: North Addition, the North fifty-two (52) feet of Lot One (1) in Block Four (4), the North fifty-two (52) feet of the East twenty-one (21) feet of Lot Two (2) in Block Four (4); situated in theounty of Black Hawk and State of Iowa Coo l i�I C:1 lets -'�v► $ 5oO v o V ever►ak s'tiwk toC re y vi r Words and phrases herein, including acknowledgment hereof shall bb construed as in the singular or plural number, and as masculine, feminine or neuter gender, according to the context. Dated: //-7//7 ichael B. Mowat Gina M. Mowat --7Baty J. Kubat ffilde,& c41 -4 -d --- Michelle A. Kubat STATE OF NEBRASKA, COUNTY OF DOUGLAS This record was acknowledged before me on /' 7 , 2017, by Michael B. Mowat and Gina M. Mowat, husband and wife, and Barry J. Kubat and Michelle A. Kubat, husband and wife. GENERAL NOTARY -State of NebrasIca KIMBERLY J. TIEKEN My Comm. Exp. April 18, 2019 2 MENIEMNIMMIMIN D c ID 007580210003 Type GWH K nd GROUND WATER HAZARD STATEMENT R corded: 03/21/2017 at 01:33:30 PM F e Amt: $0.00 Pape 1 of 3 Black Hawk County Iowa SANDIE L. SMITH RECORDER F11e9998-00005148 REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name See Attachment Address Number and Street or RR City, Town or PO State Zip TRANSFEREE: Name City of Waterloo Address 715 Mulberry St. Waterloo IA 50703 Number and Street or RR City, Town or PO State Zip Address of Property Transferred: 1527 E. 4th St. Waterloo IA 50703 Number and Street or RR City, Town or PO State Zip Legal Description of Property: (Attach if necessary) North Addition, the North fifty-two (52) feet of Lot One (1) in Block Four (4), the North fifty-two (52) feet of the East twenty-one (21) feet of Lot Two (2) in Block Four (4); situated in the County of Black Hawk and State of Iowa 1. Wells (check one) © There are no known wells situated on this property. ❑ There is a well or wells situated on this property. The type(s), location(s) and legal status are stated below or set forth on an attached separate sheet, as necessary. 2. Solid Waste Disposal (check one) There is no known solid waste disposal site on this property. ❑ There is a solid waste disposal site on this property and information related thereto is provided in Attachment #1, attached to this document. 3. Hazardous Wastes (check one) ❑' There is no known hazardous waste on this property. ❑ There is hazardous waste on this property and information related thereto is provided in Attachment #1, attached to this document. 4. Underground Storage Tanks (check one) There are no known underground storage tanks on this property. (Note exclusions such as small farm and residential motor fuel tanks, most heating oil tanks, cisterns and septic tanks, in instructions.) ❑ There is an underground storage tank on this property. The type(s), size(s) and any known substance(s) contained are listed below or on an attached separate sheet, as necessary. FILE WITH RECORDER DNR Form 542-0960 July 18th 2012 cmz 5. Private Burial Site (check one) 0 There are no known private burial sites on this property. ❑ There is a private burial site on this property. The location(s) of the site(s) and known identifying information of the decedent(s) is stated below or on an attached separate sheet, as necessary. 6. Private Sewage Disposal System (check one) El All buildings on this property are served by a public or semi-public sewage disposal system. ❑ This transaction does not involve the transfer of any building which has or is required by law to have a sewage disposal system. ❑ There is a building served by private sewage disposal system on this property or a building without any lawful sewage disposal system. A certified inspector's report is attached which documents the condition of the private sewage disposal system and whether any modifications are required to conform to standards adopted by the Department of Natural Resources. A certified inspection report must be accompanied by this form when recording. ❑ There is a building served by private sewage disposal system on this property. Weather or other temporary physical conditions prevent the certified inspection of the private sewage disposal system from being conducted. The buyer has executed a binding acknowledgment with the county board of health to conduct a certified inspection of the private sewage disposal system at the earliest practicable time and to be responsible for any required modifications to the private sewage disposal system as identified by the certified inspection. A copy of the binding acknowledgment is attached to this form. ❑ There is a building served by private sewage disposal system on this property. The buyer has executed a binding acknowledgment with the county board of health to install a new private sewage disposal system on this property within an agreed upon time period. A copy of the binding acknowledgment is provided with this form. ❑ There is a building served by private sewage disposal system on this property. The building to which the sewage disposal system is connected will be demolished without being occupied. The buyer has executed a binding acknowledgment with the county board of health to demolish the building within an agreed upon time period. A copy of the binding acknowledgment is provided with this form. [Exemption #9] ❑ This property is exempt from the private sewage disposal inspection requirements pursuant to the following Exemption [Note: for exemption #9 use prior check box]: ['The private sewage disposal system has been installed within the past two years pursuant to permit number Information required by statements checked above should be provided here or on separate sheets attached hereto: Signature: I HEREBY DECLARE THAT I HAVE REVIEWED THE INSTRUCTIONS FOR THIS FORM AND THAT THE INFORMATION STATED ABOVE IS TRUE AND CORRECT. !d• ` Telephone No.: (888) 635-7030 (Transferor or Agent) Tno.nscenocS FILE WITH RECORDER DNR Form 542-0960 July 18th 2012 cmz REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT Attachment — Transferor Names and Addresses Michael B. Mowat and Gina M. Mowat 12012 Douglas Circle Omaha, NE 68154 Barry J. Kubat and Michelle A. Kubat 134 S. 122nd Street Omaha, NE 68154