The URL can be used to link to this page

Home My WebLink AboutGrimm, David S. and Dalen A. 02.11.2022 (RECORDED) 1111111E1111111001111111111 H UII IIII IIII III Doc ID: 010395720001 Type: GEN Recorded: 02/24/2022 at 03:33:58 PM Fee Amt: $12.00 Page 1 of 1 Revenue Tax: $0.00 Black Hawk County Iowa SANDIE L. SMITH RECORDER Q Q File2022-00017098 C,U lJC, l.c�f3.1✓�C\rr, Prepared by Martin M. Petersen, City Attorney, 715 Mulberry,Waterloo,IA, 50703,telephone(319)291-4327 TAX STATEMENT: David S.Grimm and Dalen A.Grimm, 1231 W.Sixth Street,Waterloo,Iowa SPACE ABOVE THIS LINE FOR 50702 RECORDER QUIT CLAIM DEED For the consideration of ($1.00) One and no/100 Dollar(s) and other valuable consideration, plus costs CITY OF WATERLOO, IOWA does hereby Quit Claim to David S. Grimm and Dalen A. Grimm, Husband and Wife, as joint tenants with full rights of survivorship, 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: Lot 11, Block 1, Pommer's Subdivision, Waterloo, Black Hawk County, Iowa. (formerly known as 811 Williston Avenue, Waterloo, Iowa) This transaction exempt from Documentary Stamp and Declaration of Value per Iowa Code§428A.2(6)(2020). 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: February 11, 2022 CITY OF WATERLOO, IOWA c Quentin Hart, Mayor ATTEST: /i_eizko.„ Kelley Felche, ity Clerk STATE OF IOWA, COUNTY OF BLACK HAWK ) ss On this 11th day of February,2022,before me,the undersigned, a Notary Public in and for the State of Iowa, personally appeared Quentin Hart and Kelley Felchle,to me personally known, and who,being by me duly sworn, did say that they are the Mayor and City Clerk, respectively, of the City of Waterloo, Iowa; that the aL f€ixed;to the foregoing instrument is the corporate seal of the corporation, and that the instrument was signed an TVle®04 y of the corporation by authority of its City Council as contained in the Resolution adopted by tlke t,}r�geurric l; _ Council Action No. 160474 of the City Council on the 20th day of September,2021, and that Oti in Hli ; Felc le acknowledged the execution of the instrument to be their voluntary act and deed an vnd�.,olluptar `"ac deed,of thetorporation,by it voluntarily executed. 4�wya a� 'g ot. Public in .nd for the State of low 1"!/. i/ntticq��It l J� � Cry fF i �6J r -1 S k d (" a lD,) IIII III III IIIII OIII II II1 I IIIII I II IIIII II II 11 I II Doc ID: 010395730002 Type: GWH Kind: GROUND WATER HAZARD STATEMENT Recorded: 02/24/2022 at 03:34:21 PM Fee Amt: $0.00 Page 1 of 2 Black Hawk County Iowa SANDIE L. SMITH RECORDER File9998-00021520 REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name City of Waterloo, Iowa Address 715 Mulberry Street Waterloo IA 50703 Number and Street or RR City,Town or P.O. State Zip TRANSFEREE: Name David and Dalen Grimm Address 1231 W. 6th Street Waterloo IA 50702 Number and Street or RR City, I own or N.U. State Lip Address of Property Transferred: �-�. a Number and Street or RR City, I own,or P.O. State Lip Legal Description of Property: (Attach if necessary) Lot 11, Block 11, Pommer's Subdivision, Waterloo, Black Hawk County, 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) O 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) 0 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) O 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) 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. O 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 REVIEWED THE INSTRUCTIONS FOR THIS FORM AN TH HE ORMATION STATED ABOVE IS TRUE AND CORRECT. Signature. Telephone No.: (319 )291-4366 (Transferor or Agent) FILE WITH RECORDER DNR form 542-0960 (July 18, 2012)