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Home My WebLink AboutNoe and Selivy Sibrian Quit Claim and RE Transfer-3/6/2017 (RECORDED)02 1111111111111131151111111111III IIIII IIIII 11111111 Doc ID: 007594310002 Type: GEN Recorded: 04/05/2017 at 03:42:22 PM Fee Amt: $17.00 Page 1 of 2 Revenue Tax: $0.00 Black Hawk County Iowa SANDIE L. SMITH RECORDER Fi1e2017-00017450 /1 Prepared by David R. Zellhoefer, City Attorney, 715 Mulberry, Waterloo, IA, 50703, telephone (319) 291-4327 TAX STATEMENT: For Dollar(s) does Noe I. and Selivy Sibrian, 425 Independence Ave., Waterloo, IA 50703 SPACE ABOVE THIS LINE FOR RECORDER QUIT CLAIM DEED the consideration of ($1,000.00) One Thousand and no/100 and other valuable consideration, plus costs CITY OF WATERLOO, IOWA hereby Quit Claim to NOE I. AND SELIVY SIBRIAN, husband and wife as -oint tenants with full rights of survivorshi 1, and not as tenants in common, all our right, title, interest, estate, claim and demand in the following -described real estate in Black Hawk County, Iowa: This Each Words feminine Dated �r •ice tai See attached Exhibit "A" — legal description. transaction exempt from Documentary Stamp and Declaration of Value per Iowa Code §428A.2(6) (20B). of the undersigned hereby relinquishes all rights of dower, homestead and distributive share in and to the real estate. and phrases herein, including acknowledgment hereof, shall be construed as in the singular or plural number, and as masuline or gender, according to the context. Bch 6, 2017 CITY OF WATERLOO, IOWA io.r A 1t .i.: Quentin Hart, Mayor Kelley STATE personally say that foregoing of the Council Kelley and deed Felche City Clerk OF IOWA, COUNTY OF BLACK HAWK ) ss On this 6th day of March, 2017, before me, the undersigned, a Notary Public in and for the State of Iowa, appeared Quentin Hart and Kelley Felchle, to me personally known, and who, being by me duly sworn, did they are the Mayor and City Clerk, respectively, of the City of Waterloo, Iowa; that the seal affixed to the instrument is the corporate seal of the corporation, and that the instrument was signed and sealed on behalf corporation by authority of its City Council as contained in the Resolution adopted by the City Council, under Action No. 146120 of the City Council on the 6th day of March, 2017, and that Quentin Hart and Felchle acknowledged the execution of the instrument to be their voluntary act and deed and the voluntary act of the corporation, by it voluntarily executed. 4,0A, •C NANCY HIGBY ' .- NO.788229 / COMMISSION • " MYCOJ�IMIIX FRES SI 'ow* Notary Public in for the Sta e of Iowa /1 Exhibit "A" Legal Description — Portion of Right -of -Way to be Conveyed That part of Block Five (5), Cowin's 2nd Addition to Waterloo, Iowa, described as follows: Commencing at the Southwest corner of aforesaid Block Five (5); thence N88°51'26"E Two Hundred Fifteen and Fifty-four Hundredths (215.54) feet along the South line of said Block Five (5) to the Southeast corner of parcel described in Document No. 2016-03074 in the Black Hawk County Recorder's Office and to the point of beginning; thence continue N88°51'26"E Twenty and Sixty-five Hundredths (20.65) feet still along said South line; thence Northwesterly Two Hundred Fifty-nine and Eighty Hundredths (259.80) feet along the arc of a curve concave Southerly having a radius of Seven Hundred Thirty-nine and Sixty Hundredths (739.60) feet and a long chord of Two Hundred Fifty-eight and Forty-seven Hundredths (258.47) feet which bears N61°33'54"W; thence S26°46'23"W Thirteen and Fourteen Hundredths (13.14) feet to the Northeasterly line of aforesaid parcel; thence Southeasterly Two Hundred Forty-one and Twenty-six Hundredths (241.26) feet along said Northeasterly line and along the arc of a curve concave Southerly having a radius of Seven Hundred Twenty-six and Sixty Hundredths (726.60) feet and a long chord of Two Hundred Forty and Fifteen Hundredths (240.15) feet which bears S62°16'04"E to the point of beginning containing 3,257 square feet. 3 1111111111II11111II 111111111111111111111111111111111 1111111 III Doc ID 007594320003 Ty e GWH K1 d GROUND WATER HAZARD STATEMENT Re orded: 04/05/2017 at 03:42:46 PM Fee Amt: $0.00 Pape 1 of 3 Black Hawk County Iowa SANDIE L. SMITH RECORDER F11e9998_00005304 REAL ESTATE TRANSFER -GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name CITY OF WATERLOO, IOWA Address 715 MULBERRY STREET, WATERLOO, IOWA 50703 Number and SUeet or RR TRANSFEREE: Name NOE I. AND SELIVY SIBRIAN Cay. Town or P C. State Zlp Address 425 INDEPENDENCE AVENUE, WATERLOO, IOWA 50703 Numoer and S,reetor HR 1ows or P.U. State Lip Address of Property Transferred: Right of Way Adjacent to 2006 Dubuque Road Waterloo Towa um Nber an Streetor HH Gty,1own. or P.U. Stale by Legal Description of Property: (Attach if necessary) See attached legal description 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) El 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) E 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) 51 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) 5. Private Burial Site (check one) 11 There are no known private burial sites on this property. O There is a private burial site on this property. The location(s) of the site(s) and known identifying information of the decedents) is stated below or on an attached separate sheet, as necessary. 6. Private Sewage Disposal System (check one) t 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. O 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. O 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. O 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]: O 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: I HEREBY DECLARE THAT ( HAVE REVIEWED THE INSTRUCTIONS FOR THIS FORM AN E NFORMATION STATED ABOVE IS TRUE AND CORRECT. - l or Agent) Signatur FILE WITH RECORDER Telephone No.: ( 319 ) 291-4366 DNR form 542-0960 (July 18, 2012) Exhibit "A" Legal Description — Portion of Right -of -Way to be Conveyed That part of Block Five (5), Cowin's 2nd Addition to Waterloo, Iowa, described as follows: Commencing at the Southwest corner of aforesaid Block Five (5); thence N88°51'26"E Two Hundred Fifteen and Fifty-four Hundredths (215.54) feet along the South line of said Block Five (5) to the Southeast corner of parcel described in Document No. 2016-03074 in the Black Hawk County Recorder's Office and to the point of beginning; thence continue N88°51'26"E Twenty and Sixty-five Hundredths (20.65) feet still along said South line; thence Northwesterly Two Hundred Fifty-nine and Eighty Hundredths (259.80) feet along the arc of a curve concave Southerly having a radius of Seven Hundred Thirty-nine and Sixty Hundredths (739.60) feet and a long chord of Two Hundred Fifty-eight and Forty-seven Hundredths (258.47) feet which bears N61 °33'54"W; thence S26°46'23"W Thirteen and Fourteen Hundredths (13.14) feet to the Northeasterly line of aforesaid parcel; thence Southeasterly Two Hundred Forty-one and Twenty-six Hundredths (241.26) feet along said Northeasterly line and along the arc of a curve concave Southerly having a radius of Seven Hundred Twenty-six and Sixty Hundredths (726.60) feet and a long chord of Two Hundred Forty and Fifteen Hundredths (240.15) feet which bears S62°16'04"E to the point of beginning containing 3,257 square feet. 3