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Home My WebLink AboutQuit Claim Deed - 200 Miriam Street-1/7/2017IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111IIIIIIIIIIIIIIIIII IIII Doc ID 007580220002 Type GEN Recorded: 03/21/2017 at 01:36:23 PM Fee Amt: $31.40 Page 1 of 2 Revenue Tax: $14.40 Black Hawk County Iowa SANDIE L. SMITH RECORDER File2017-00016322 * 1 0 rr Wa.X7U10.01�qv� Z Z.A.0l 044_ Prepared by: James E. Nervig, Attorney at Law, 6701 Westown Parkway, Suite 100, West Des Moines, IA 50266 515-274-1450 Return to: Michael B. Mowat, 12012 Douglas Circle, Omaha, NE 68154 Address Tax Statement: Michael B. Mowat, 12012 Douglas Circle, Omaha, NE 68154 QUIT CLAIM DEED For the consideration of One Dollar ($1.00) and other valuable consideration, GreyFox Properties, LLC, as grantor, hereby quit claims to Michael B. Mowat and Gina M. Mowat, husband and wife, and Barry J. Kubat and Michelle A. Kubat, husband and wife, as tenants in common, as grantees, all of the grantor's right, title, claim and demand in the following described real estate in Black Hawk County, Iowa: Shilliam's Third Subdivision, the West sixty-six (66) feet of Lot One (1) in Block Ten (10); situated in the County of Black Hawk and State of Iowa By execution of this deed on behalf of grantor, the undersigned represents and warrants to grantees that the grantor is a member -managed limited liability company, that the execution of this deed is authorized by the company's operating agreement, that all of the members of the grantor limited liability company have consented to the execution of this deed by the undersigned, and that this deed is given by the grantor limited liability company in the ordinary course of the activities of the company. Words and phrases herein, including acknowledgment hereof, shall be construed as in the singular or plural number, and as masculine, feminine or neuter gender, according to the context. Dated: 1 /7/17 GreyFox Properties, LLC By: M&K Holdings, LLC, its sole Member By: Michael B. Mowat Member of M&K Holdings, LLC STATE OF NEBRASKA, COUNTY OF DOUGLAS This record was acknowledged before me on I ' 7 , 2017, by Michael B. Mowat, as Member of M&K Holdings, LLC, sole Member of GreyFox Properties, LLC, a limited liability company. A GENERAL NOTARY -State of Nebraska My Coomm. Exp. Apr1118, 2019 2 11111111 1111 I iii IIIII11111 i111i 11111 1I D 1111111111111111111111111IIUI HU 111 Doc ID 007580230003 Typ GWH Kind GROUND WATER HAZARD STATEMENT Recorded: 03/21/2017 at 01:37:29 PM Fee Amt: $0.00 Page 1 of 3 Black Hawk County Iowa SANDIE L. SMITH RECORDER F11e9998-00005149 REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name GreyFox Properties, LLC Address 13110 Birch Drive, Suite 148-257 Omaha NE 68164 Number and Street or RR TRANSFEREE: Name See Attachment City, Town or PO State Zip Address Number and Street or RR City, Town or PO State Zip Address of Property Transferred: 200 Merriman St. Waterloo IA 50703 Number and Street or RR City, Town or PO State Zip Legal Description of Property: (Attach if necessary) Shilliam's Third Subdivision, the West sixty-six (66) feet of Lot One (1) in Block Ten (10); situated in the County of Black Hawk and State of Iowa 1. Wells (check one) 0 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. 9 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) J 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 18'"2012 cmz 5. Private Burial Site (check one) El 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) 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. (Transferor or Agent) 6' if Pet,ape.t.-Kes , tax.. Telephone No.: (888) 635-7030 FILE WITH RECORDER DNR Form 542-0960 July 18th 2012 cmz REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT Attachment — Transferee 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. 122"d Street Omaha, NE 68154