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Home My WebLink AboutAntioch Baptist Church-12.14.2009 (RECORDED) J L 1111 11011111101111110001 I II Doc ID: 010207220001 Type: GEN Recorded: 07/09/2021 at 04:07:10 PM Fee Amt: $12.00 Page 1 of 1 Revenue Tax: $0.00 Black Hawk County Iowa SANDIE L. SMITH RECORDER File2022-00000675 )4 �� pc\t CC) Prepared by James E. Walsh, Jr., City Attorney, 715 Mulberry, Waterloo, IA, 50703, telephone (319) 291-4327 TAX STATEMENT: Antioch Baptist Church,426 Sumner Street,Waterloo,IA 50703 SPACE ABOVE THIS LINE FOR RECORDER QUIT CLAIM DEED For the consideration of ($1,320.00) One Thousand Three Hundred Twenty and no/100 Dollar(s) and other valuable consideration, plus costs CITY OF WATERLOO, IOWA does hereby Quit Claim to Antioch Baptist Church all our right, title, interest, estate, claim and demand in the following-described real estate in Black Hawk County, Iowa: Lot 10, Block 6, Howrey & McWilliams Addition, City of Waterloo, Iowa; locally known as 317 Oneida Street, Waterloo, Iowa. This transaction exempt from Documentary Stamp and Declaration of Value per Iowa Code§428A.2(6)(2009). Each of the undersigned hereby relinquishes all rights of dower,homestead and distributive share in and to the real estate. Words and phrases herein,including acknowledgment hereof,shall be construed as in the singular or plural number,and as masculine or feminine gender,according to the context. Dated: December 14, 2009 CITY OF WATERLOO, IOWA Timothy J. ley, May ATTEST: C, to_ icutot Carol ailor, Deputy City Clerk STATE OF IOWA, COUNTY OF BLACK HAWK ) ss On this 14th day of December, 2009, before me, the undersigned, a Notary Public in and for the State of Iowa, personally appeared Timothy J. Hurley and Carol Failor, to me personally known, and who, being by me duly sworn, did say that they are the Mayor and Deputy City Clerk, respectively, of the City of Waterloo, Iowa; that the seal affixed to the foregoing instrument is the corporate seal of the corporation, and that the instrument was signed and sealed on behalf of the corporation by authority of its City Council as contained in the Resolution adopted by the City Council, under Council Action No. 130358 of the City Council on the 14`h day of December, 2009, and that Timothy J. Hurley and Carol Failor acknowledged the execution of the instrugwant. ,pe their voluntary act and deed and the voluntary act and deed of the corporation, by it voluntarily exeetited...-i\fi i= " X otary ublic in and for the State f Io ra 0. vc, r�� gip~ ,34;..p +roc ICi (t-) ƒ ` ( \ a \ \ 3 \ j G 2 \ \ < ~ < 3 / E \ § 5 R . c) \ - 0 , c / k\ 0 - \ ® \ \ \ Q x , \ 0 0 § 1 § 5 % s d ] > O } w \ . \ V / \ / ® _ § § \ 9 ) § \ \ / 2 a \ § § 5 \ 2 \ £ § % 4 2 & 111101111111111110101011111111111111111111111 Doc ID: 010207230002 Type: GWH Kind: GROUND WATER HAZARD STATEMENT Recorded: 07/09/2021 at 04:07:20 PM Fee Amt: $0.00 Page 1 of 2 Black Hawk County Iowa SANDIE L. SMITH RECORDER File9998-00019250 REAL ESTATE TRANSFER-GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name City of Waterloo Address 715 Mulberry Street Waterloo IA 50703 Number and Street or RR City,Town or PO State Zip TRANSFEREE: Name Antioch Baptist Church Address 426 Sumner Street Waterloo IA 50703 Number and Street or RR City,Town or PO State Zip Address of Property Transferred: Formerly 317 Oneida Street Number and Street or RR City,Town or Po State Zip Legal Description of Property: (Attach if necessary) Lot 10, Block 6, Howrey&McWilliams Addition,Waterloo, Black Hawk County, Iowa 1.Wells(check one) ❑X 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) X❑ 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) X❑ 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) ❑X 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. July 18th 2012 cmz FILE WITH RECORDER DNR Form 542-0960 5.Private Burial Site(check one) O 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. Q 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: I HEREBY DECLARE THAT I HAVE REW D T INSTRUCTIONS FOR THIS FORM AND THAT THE INFORMATION STATED ABOVE IS TRUE AND CO' 'ECT. Signatu Telephone No.: `7 Imo'(• 2_9`( -Lf zG-(� ransferor or Agent) July 18th 2012 cmz FILE WITH RECORDER DNR Form 542-0960