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HomeMy WebLinkAboutIDOT-Gary and Hollie Ritter - B&R Oil Corop-11/14/2016Page 1 of 6 Number: 201700003067 Recorded: 8/15/2016 at 3:35:49.130 PM Fee Amount: $32.00. Revenue Tax: Sandie L. Smith, RECORDER Black Hawk County, Iowa Return to and Prepared by Katie Johnson, Right of Way Office, Iowa Department of Transportation, 800 Lincoln Way, Ames, IA 50010, 515-239-1216 Foran 634028 (01-14) �lowAooT Office of Right of Way www.iowadot.gov 800 Lincoln Way, Ames, lowa 50010 Phone: 515-239-1135 FAX: 515-239-1247 PURCHASE AGREEMENT Parcel Number: 51 County: Black Hawk Project Number: NHSX-63-6(70)--3H-07 Route Number: 63 . B and R Oil Corp. -1/2 Interest; and Seller: Gary C. Ritter and Hollie Ritter, his wife - 1/2 Interest p THIS AGREEMENT entered into this 8 ikt day of Affrip57 _ by and between, Seller and the Iowa Department of Transportatiaf, acting for the State of Iowa, Buyer. la. The Seller agrees to sell and furnish to the Buyer a conveyance document, on forms) furnished by the Buyer, and the Buyer agrees to buy the following real estate, hereinafter referred to as the premises, in parts of the following: Lot 5, Block 11, in the Original Plat on the West side of the Cedar River, In the City of Waterloo, in the County of Black Hawk, State of Iowa, -and more particularly described on page 6, Including the following buildings, improvements and other property: All land, trees, shrubs, landscaping and surfacing attached to the premises sought and described herein 2. The Buyer agrees to pay, and the Seller agrees to grant, the right of possession, convey title and surrender physical possessioq of the premises as shown on or before the dates listed below: Paymehf Amount` " , : ('Agreed-Perfdrmande ": i ` Date[of PLeffonnance' jOn conveyance of title 7 • I IOn surrender of possession $3,000.00 !On possession and conveyance I 90 days after Buyer approval $3,000.00 [Total Lump Sum Amount J I Breakdown ',`Ac/Sq Ft. [Land by fee title 0 I !Fence 0 hods woven Underlying fee title 0 ' Fence t 0 [rods barbed (Permanent easement to [the City of Waterloo to 1 construct & maintain a (retaining wall _.._.._74 In ft. DISTRIBUTION: TWO COPIES RETURNED TO BUYER (IOWA DOT) ONE COPY RETAINED BY SELLER. 51, NHSX-63-6(70)--3H-07 Page 1 of 6 File Number: 2017-00003067 Seq: 1 'Page 2 of 3. Possession of the premises is the essence of thls agreement and the Buyer may enter and assume -full use and enjoyment of the premises per the terms of this agreement. The Seller grants the Buyer the immediate right to enter the premises for the purpose of gathering survey and soil data. The Seller may surrender possession of the premises, building, Improvement, or any part thereof, prior to the time that he/she has agreed to do so, and agrees to give the Buyer 10 days notice of the Seller's Intention to surrender possession by calling the Buyer at 1-866-282-5809. 4. The Seller warrants that there are no tenants on the premises holding under lease, except: Craig Lindsey, 100 Commercial St., Waterlod, IA 50701 5. This agreement shall apply to and bind the legal successors in interest of the Seiler, and the Seller agrees to pay all liens and assessments against the premises, including all taxes and•special assessments payable until surrender of possession, as required by the Iowa Code section 427.2 and agrees to warrant good and - sufficient title. 6. The Buyer may include mortgagees, lien holders, encumbrances, and taxing authorities as payees on warrants issued In payment of this agreement. -In addition to the total lump -sum payment amount, the Buyer agrees to pay $150.00 for the cost of adding title documents required by this transaction to the Seller's abstract of title. If requested to do so, the Seller will deliver to the Iowa Department of Transportation, Office of Right of Way, 800 Lincoln Way, Ames, IA 50010, an abstract of title to the premises. The Buyer agrees to pay the cost of abstract continuation. The Seller agrees to provide the documents as may be required by Iowa Land Title Standards to convey merchantable title to the Buyer. The Seller also agrees to obtain court approval of this agreement, if requested by the Buyer, in the event title to the premises becomes an asset of any estate, trust, conservatorship or guardianship. The Buyer agrees to pay court approval costs and all other costs necessary to transfer the premises to the Buyer, except attorney fees. Claims for such transfer costs shall be paid in amounts supported by paid receipts or signed Invoices. 7. The Buyer agrees that any agricultural drain tiles that are located within the premises that are damaged or require relocation by highway construction shall be repaired or relocated at no expense to the Seller. Where the Buyer specifically agrees to construct and maintain fence, the fence shall be constructed and maintained for vehicle access control purposes at no expense to the Seller. The Buyer has the right of entry upon the Seller's remaining property along the right-of-way line, if necessary, for the purpose of connecting the drain tile, and constructing and maintaining the fence. The Seller may pasture against the fence at his/her own risk. The Buyer will not be liable for fencing private property or maintaining it to restrain livestock. 8. If the Seller holds title to the premises in joint tenancy with full rights of survivorship and not as tenants In common at the time of this agreement, the Buyer will pay any remaining proceeds to the survivor of that joint tenancy, and will accept title solely from that survivor, provided the joint tenancy has not been destroyed by operation of law or acts of the Seller. 9. These premises are' being acquired for public purposes. This transfer is exempt from the requirements for the filing of a "Declaration of Value' In accordance with Iowa Code section 428A.1. 10. The premises also Includes all estates, rights, title, and interests, Including all easements, and all advertising • devices and the right to erect such devices as are located thereon. The Seller consents to any change of grade of the highway and accepts payment under this agreement for any and all damages arising from those changes. The Seller acknowledges full settlement and payment from the Buyer for all claims per the terms of this agreement, and discharges the Buyer from liability because of this agreement and the construction of the public Improvement project. 11. The Seiler states and warrants that, to the best of the Seller's knowledge, there Is no burial site, well, solid waste disposal site, private sewage disposal systems, hazardous substance or underground storage tank on the premises, except: Old gas station may contain old underground storage tank(s). 12. This written agreement constitutes the entire agreement between Buyer and Seller and there Is no agreement to do or not to do any act or deed except as specifically provided for herein. 13. Buyer hereby gives notice of Seller's five-year right to renegotiate construction or maintenance damages not apparent at the time of the signing of this agreement as required by the Code of Iowa, Section 68.52. 14. The Sellers grant to the Buyer temporary easements for the purpose of saw cutting and constructing entrances, The Right -of -Way Design Plot Plan, attached as a page 5 of this agreement, graphically illustrates the proposed temporary easement area being granted. The temporary easement shall terminate on completion of this highway project. 15. Buyer agrees to construct a Type "B" entrance at Sta. 307+17, mainline, East side; and a Type "8" entrance at Sta. 1309+03, side road Commercial Street, South side. It is understood and agreed that the entrances at Sta. 307+74, mainline, East side; and the entrance at Sta. 1308+90, side road Commercial Street, South side; and all other entrances located within the construction limits of this highway project that are not listed or allowed in this agreement will be eliminated, 16. It Is understood and agreed that the illegal 'Can -Am' sign, located in the City ROW and overhanging the State ROW, shall be removed by the Owner before possession is given. If said sign Is not removed before possession is given, the Buyer shall remove the sign, as needed, for the project's construction. 51, NHSX-63-6(70)-3H-07 Page 2 of 6 File Number: 2017-00003067 Seri: 2 'Page 3 of 6 Seller's signature and claimant's certification: Upon due approval and execution by the Buyer, the undersigned sellers/claimants certify the total lump -sum payment amount shown here is Just and unpaid. B and R 011 Corp. BY: X /f . X G. 'fitter, Secretary 100 Commercial St. Waterloo, IA 50701 This section to be completed by a SELLER'S ACKNOWLEDGEMENT STATE OF Iowa } COUNTY OF /2/t1'',/r 141/4) } SS: On this an -c• day of A.D.2016 before me, the undersigned, a notary public in and for said state, personally appeared Gary Ritter Notary Public. CAPACITY. -CI MMED BYSIGNER: ❑ INDIVIDUAL ® CORPORATE Title(s) of CorporateOfficer(s); Secretary LEI to me personally known; or El proved to me on the basis of satisfactory evidence to be the person (s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/ their authorized capacity°es), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. KM.Lan - .ea -- —T (Sign in ink) Wkin` �z'Z C izr rrz— (Print/type name) Notary Public in and for the $tate of Iowa !' My commission expires /— 0 — oI9 (NOTARIAL SEAL) EI OM IONNO161342l :A= on 8 JANUAR , e 61, NHSX-63-6(70)-3H-07 fl Corporate Seal is affixed ® No Corporate Seal procured 0 Limited Partnership 0 General Partnership 0 ATTORNEY-IN-FACT EXECUTOR(s) or TRUSTEE(s) GUARDIAN(s) or CONSERVATOR(s) Other: SIGNER IS REPRESENTING: List name(s) of endty(ies) or person(s) B and R 011 Corp. Page 3 of 6 File Number: 2017-00003067 Seq: 3 Page d of 6 Seller's signature and claimant's certification: Upon due approval and execution by the Buyer, the undersigned sellers/claimants certify the total lump -sum payment amount shown here Is just and unpaid. Xice' X fj�Z ��-uT/7fit✓ G§ Ritter Hol Ritter G . 1924 Kamilla Ct. Waterloo, IA 50701 This section to be completed by a Notary Public. SELLER'S ACKNOWLEDGEMENT CAPACITYGI:AIMED BY:SIGNER: STATE OF Iowa } COUNTY OF , 2d,b fK/ } ss: On this adz day of JwLt- A.D. 2016 before me, the undersigned, a notary public in and for said state, personally appeared Gary C. Ritter and Hollis Ritter to me personally known; or ❑ proved to me on the basis of satisfactory evidence to be the person (s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same In his/her/ their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. t..._> !' i (Sign in ink) 1'I n HOZ/6- y � 94-(Print/type name) Notary Public in and for the State of/ Iowa My commission exp res ® INDIVIDUAL ❑ CORPORATE TItle(s) of Corporate Offlcer(s): U Corporate Seal is affixed ❑ No Corporate Seal procured ❑ Limited Partnership ❑ General Partnership " ❑ ATTORNEY-IN-FACT 0 EXECUTOR(s) or TRUSTEE(s) ❑ GUARDIAN(s) or CONSERVATOR(s) ❑ Other: aeenReoersustnm(s) or ry(is) or person(s) BUYER'S APPROVAL Recommended (Sign in (Printed Name): Approved by (Sign in (Printed Name): by ���/ Ink): X t�fiC.vas .F/0(//24., or (Date) Project Agent Scott Henning ink): X clyn/ / (Date) AUG 0 8 16 Right of ay Director Martin J. ankey / BUYER'S' ACKNOWLEDGEMENT STATE COUNTY On personally Buyer minutes, hereon, (NOTARIAL OF IOWA , } OF STORY } ss:u^, this 24' day of /4 , lli( 2016 , before me, the undersigned, appeared ROW Director, and who did say that the instrument and said right of way director to be the voluntary act and deed Martin 5. Sankey known to me to be aRight of Way Director of the was signed on behalf of the Buyer by its authority duly recorded in its acknowledged the execution of the instrument, whose signature appears of the Buyer, and by it voluntarily executed. ' IXs_ t„ .�'q, a 1 rows. VALERIE E. GOETHALS COMMISSION NO. 10573 Mfi COMMISSION EXPIRES JUNE 5, 2018 SEAL) otary Public in one- the State of Iowa 51, NHSX-63-6(70)-3H-07 Page 4of6 File Number: 2017-00003067 Seq: 4 Page 5 O\ 6 OWNER: GARY C. RITTER 0106NIW94av\ enoa IOWA DEPARTMENT OF TRANSPORTATION l'IM15eeHaubifermi. ha#IN\41069010. PROJECT DEVELOPMENT PLOT PLAN PARCEL NO.: 51 B AND R OIL CORP. SECTION: 26 T 89 N -R 13 W SCALE -111=50' . City of Waterloo Orlg!nal Plat Waterloo --Block 11 W.D. OR EASEMENT LINE: ACCESS LOCATION POINT: PROPERTY LINE: LEGEND �• s ( Y� 0IARY EASEMENT TO CU CONSTRUCT ENTRANCE 1,281 SQ.FT. COUNTY: BLACKHAWK C PROJECT N0• NHSX-63-6(70)- -3H-07 File Number: 2017-00003067 Seq: 5 Payo6o'6 ' EOMGM-011 6-15 COUNTY IOWA DEPARTMENT OF TRANSPORTATION ACQUISITION PLAT EXHIBIT "A" BLACK HAWK PROJECT NO. SECTION NNSX-63-6(701--3H-01 26 TOWNSHIP 89 N STATE CONTROL NO. PARCEL NO. RANGE Piqa &a IOWADOT 51 13.W ROW - FEE AC EASE 74 S0. FT. AC. EXCESS - FEE ACOUIREO ACCESS RIGHTS FROM STA. TO STA. MAIN LINE ACOUIREO ACCESS RIGHTS FROM STA. TO STA. SIDE ROAD ACOUIREO FROM W 0 > N U. 000 O g1aw N LA 2 - N• Y <0.x 06 60-1 0 001 0 2-1 0 F- z UX U G za 0z AC SIDE SIDE 2 W W W W • LL W LL LL W Z 4 W 4tn '-0--0 WW N 4144.4 N 2 W 3 3 W urat E F TON W.. P 0 11110 6) 7r1 W W_ ONS o FF MOT.. Z P P P V W W zoo n unzz K 01004 a z 1 m o 0 K s 0 0. J U. 0) U M-1 o lil 0 =SNF - 000 LL5J 49 P Q4 cc ue .4C j O d U J W 'b Z f=- CD m 0 0 04 CC O 0 N 1- 0, W eo S7 0 II DATE DRAWN 10-21-2014 don > OF -14 40.. 1• N > J 4 FNOJ 0 0=F0-0 "0_145 File Number: 2017-00003067 Seq: 6 FLOOD PLAIN DEVELOPMENT PERMIT WATERLOO, IOWA In accordance to the provisions of the Waterloo Zoning Ordinance No. 5079, as amended, approval of this Flood Plain Development Permit is required for all construction improvements and development located within the boundaries of the Floodway, Floodway Fringe, General Flood Plain and Shallow Flooding Overlay Districts, 1. APPLICATION INFORMATION a. Applicant's Name: Hydrite Chemical Co. Address: 114N. Main St Cottage Grove WI 53527 Telephone No.: 608-839-8126 b. Status of Applicant (owner, contract owner, agent, etc.): Owner c. Property owner's name, address and telephone number (if different from above): 2. PROJECT LOCATION a. General location ofproperty/project: WCP&N Drive and Airline Highway b. Legal description of property: Parcel "C" as shown on Plat of Survey recorded as Document 2014.007998: and Parcel "D" as shown on Plat of Survey recorded as Document 2017-002391 :in the NW 1/4 of Section 10-89-13 c. Stream: No. 13 d. 100 Year Flood Elevation (mean sea level) 862.5 e. Elevation (mean sea level) of the lowest floor (including basement) of building or of the level to which a building or structure is to be lloodproofed' 864.9 f. Zoning Classification' M-2, Heavy industrial 3. PROJECT DESCRIPTION a, Anticipated dates. of constivction: Initiation Nov. 15, 2016 Completion November, 2017 b. Estimated costs of improvements and, if applicable, the market value of the building prior to the improvements' c. Describe the use or occupancy for which the proposed work is intended: Production facility for d, Brief description of project and methods used for floodproofing• Building is slab - on -grade production facility With adjacent outdoor storage tanks. Certification: It is required that a professional engineer or land surveyor (registered in the State of Iowa) must certify that the finished fill, building floor elevations, floodproofing, or other flood protection measures were accomplished and comply with the provisions of this ordinance, Said certification shall be affixed to the plans and/or specifications of the proposed development. Signature of Certifying Engineer or Surveyor: - 6.41.4 (,.r.e //�� ,,,__ Date of Certification: Nov. 3, 2016 (Por pro1Sosd conditions) I (we) hereby certify that this application and all the above described information are true and corr et o to be, t of my (our) knowledge. ignature of Applicant City of Waterloo 11 I 7/Q of Date Date Approve By Hydrlte Legal Dept Dy:_, 0- /l 7- ;20 /� DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 OMB Control Number. 16000008 Expiration: 11/38/2018 Copy all pages of this Elevation Certificate and all enrichments for (1) community official, (2) 'neurone agent/company. and (3) building owner. SECTION A -PROPERTY INFORMATION FORM INSURANCE COMPANY USE A1. Building Owner's Name Hydrile Chemical Co. Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or BIdg. No.) or P.O. Route and Box No. Company NAIC Number: City Waterloo State Iowa Zip Code 5070 A3. Properly Description Black Hawk County Parcel A4. Building Use (e.g., Residential, A5. Lalilude/Longilude: A6. Attach al least 2 photographs A7. Building Diagram Number A8 For a building with a a) Square footage of b) Number of permanent crawlspace or enclosure(s) above adjacent grade c) Total net area of food d) Engineered flood (Lot and Block 8913-10-126-007 Non La1.42.54145 of the 1A Numbers. Tax Parcel Number, Legal Description, -Residential, Addition, Accessory, etc) Non•Residential Long. -92.36849 Horizontal Datum: etc.) ("NAD 1927 insurance. with an attached footage of attached garage of permanent good openings garage within grade area of flood openings good openings? (.'NAD 1983 garage: sq fl building it the Cedificate Is being used to obtain good aawlspace aawlspace good openings within openings openings? or endosure(s): A9. For a building or endosure(s) sq 6 a) Square in the b) Number 1.0 foot in the attached above adjacent 1.0 fool in A6.b sq in c) Total net In A9.b sq In r Yes IT No d) Engineered r Yes a-, No SECTION 8 -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community N me& Community Number Waterloo 190025 82. County Name Black Hawk B3. Stale Iowa 84. Map/Panel Number 0186 85. Sulfa F 88. FIRM Index Cale 87. FIRM Panel Effective/ Revised Dale July 18.2011 88. Flood Zone(s) AE 89. Base Flood Elevation(s) (Zone AO, use base good depth 862.5 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item RFIS Profile CFIRM (-Community Determined (-Other/Source: 811. Indicate elevation datum used for BFE in Item 89: (-NOVO 1929 67 NAVD 1988 ('Other/Source: 812. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Designation Date: n/a ('CBRS COPA 89: Area (OPA)? r Yes (•• No SECTION C • BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building elevations are based on: C2. Elevations - Zones Al - A30, AE, Complete Items C2.a -h below according ' A new Elevation Certificate will be required Benchmark Utilized: Indicate elevation datum used for the C Other/Source: Datum used for building elevations must a) Top of bottom floor(induding basement, b) Top of the next higher floor c) Bottom of the lowest horizontal structural d) Attached garage flop of slab) e) Lowest elevation of machinery or equipment Desabet sof ( type equipment and location 0 Lowest adjacent (finished) grade next g) Highest adjacent (finished) grade next h) Lowest adjacent grade at lowest elevation structural support CO -Construction Drawings' C Building Under Construction' C AH, A (with BFE), VE, VI - V30, V (with BFE), AR, ARIA. AR/AE, AR/A1 - to the building diagram specified In Item A7. In Puerto Rico only. enter when construction of the building is complete. Vertical Datum: elevations in items a) through h) below. CNGVD 1929 (e' NAVD 1988 Finished ConslNction A30, AR/AH, AR/A0. meters. Check the measurement used. ( feet r meters (2' feet C meters Cleet C meters (.'feel Cmelers deet Cmelers afeet (- meters (.'feel r meters ('feel Cmelers be the same as That used for aawlspace, or enclosure member (V Zones only) servicing the building M Comments) to building (LAG) to building (HAG) of deck or stairs, including the BFE. floor) 884.90_ - 880.90__ 884.90_ cc.AA o,,..., ee5 n '1171451 Pane '1 of IF ELEVATION CERTIFICATE OMB Control Number: 1660-0008 Expiralion: 11(302010 SECTION D • SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by land surveyor, engineer, or architect authorized by that the lnfomation an Ods Certificate represents my hest efforts to Interpret Ilia data available. I understand poareliaele by ono or Imprisonment under III U.S. Code, Socaan Wet Were latitude and longitude In Section A E Check here if attachments. provided by alicensed land surveyor? (. 'Yes ('No law to certify elevation information. I codify that any false statement may be at gURVEy' 111 zo /Q.'Wenaeii J. '• j Lupkes j �I :`, t 2088 .i j i 11 4'''' - 1 film 'ow e Cedifier's Name Wendell J. Lupkes License Number 12086 Title Professional Land Surveyor Company Name VJ Engineering Address - 1501 Technology Parkway City Cedar Falls Stale IA Zip Code 50613 Signature /.4-!), Q A- 1 a ‘A— Dale / /- .3 - tin Telephone +1 (3 9) 266.5829 r Copy both sides of this 6 eevaiion Certificate for ( ) community official, (2 insurance agent/company, and (3) building owner. Comments (including type Lowest Adjacent grade I of equipment and location , per C2(e), If applicable)" al truck docks on north end of building Signature Date SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones A0 and A (Wil Sections A, B,end C. For E1. Provide elevation ink highest adjacent grade a) Top of bottom foo orenclosure) Is b) Top of bottom Boo or enclosure) Is E2. For Building Diagram higher floor (elevation C2 E3. Attached garage (lop E4. Top of platform of m servicing the building Is 65, Zone AO only: If ho fld management ordinanco7l out BFE), complete Items Items E1 -E4, use natural ovation for the following (HAG) and the lowest (including basement, crawlspace, (Including basement cravdspaco' 6 -9 with permanent flood bin Bre diagrams) of the of stab) is chinery and /or equipment depth number is available, ryes r No (Unknown. El -E5. 111110 Certificate is Intended grade. if available. Check the andcheck the appropriate boxes adjacent grade (LAG), . to support measurement used. to show whether (' (eelC meters ('Icer rmelers A ((ems 8 and/or r feel r a LOMA or LOMR-F request. complete In Puerto Rico only. enter meters. the elevation Is above or below the ❑ above or ■below the HAG. ❑above or ❑below the LAG. 9 (see pages 8 -9 of Instructions), the next meters ❑ above or ❑ below the HAG. 0 above or ❑ below the HAG. ❑ above or • below the HAG: openings provided building Is In Section - r feet C meters r (eel C meters elevated In accordance certify this information Is the top of the bottom Poor The local official must with the community's floodplain In Section 0. ISECTION F -PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or ot'(ner's community -Issued BFE) eu(heezed representative who completes Sections A, B, and E for Zone A (without a FEMA•issuod or r Zone AO must sign here. The statements in Sections A, e, and E ere correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name: AddressLv N, s Pc.f-y(Cic stud . City arooLeie id, Slate to' ZIP Code 530:is Signature \LPDate ^ Telephone ? f,a -1C( —1 L+G o I r''.7/ !fa •� F Comments ❑ Check here If. attachments. CCAAA 00 '11(7 1c, Pana d of 1 F OMB Control Number: 10640008 Expiration: 118012018 SECTION G. -COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's Iloodpluln management ordinance can complete Sections A, B, C (or E), and G of This Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used In Items G8 - 610. In Puerto Rico only, enter meters. G1. [] The information in Section C was taken from other documentation Thal has been signed and sealed by a licensed surveyor, engineer, or architect who Is aulhodzed by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) 02.❑ A community official completed Section E for a building located in Zone A (without a FEMAdssued or community -issued BFE) or Zone AO. 03. [] The following information (Items G4 -G10) is provided for community floodplain management purposes. G4. Permit Number 05, Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for, r New Construction G8. Elevation of as -built lowest floor (including basement) of the building: G9. BFE or (In Zone AO) depth of flooding at the site: 010. Community's design flood elevation:rfeel r Substantial Improvement _- (-feel rmelers Datum building r feel r- Datum meters rmeters Datum Local Official's Name Title Community Name Telephone Signature Date Comments fl Check here if attachments. LC IAA c....., AOC n' Q r+n a, /OOP 1 siOISIA01 45 6Z8S-99Z-61f - osol 'spoil mpa3 dosrymd h6o1ou4a91 IOSI 6ul oauj6u3 fA °mot 'oopoloM NVld 311s uoisuodx3 o4IJPAR 0 coco Hydrile Expansion PAVING/GRADING PLAN Walorlo°, Iowa VJ Engineering 1501 Technology Parkway Cedar Falls, Iowa — 319-266-5829 oi na 1 - revisions dle/ Page 1 of 1 EXHIBIT "A" The West 67 feet of the East 100 feet of the North 5 acres of the South 10 acres of the Northwest '% of the Southeast Quarter of Section 36, Township 89 North, Range 13 West, City of Waterloo, Iowa. And also, the East 67 feet of Lots 1 and 2 of Sunkist Addition, City of Waterloo, Iowa. File Number: 2015-00008550 Seq: 2