HomeMy WebLinkAboutA013 - Real Estate Transfer - Groundwater Hazard Statement REAL LJTA l E 11ZAINJ1''L;IC -UROUNUWA' EN,HAGAIW STA-l-EIVIENT
Please read the filing instructions.pn the reverse side BEFORE completing this form.
PART I - TO BE COMPLETED BY TRANSFEROR
(Please Type or Print Legibly)
TRANSFERORName Scott E. Randall
Address 420 S. 17th Street Ames IA 50010
Number and Street or RR City,Town or P.U. State Zip
TRANSFEREE Name Grand Aspen Subdivision to the City of Ames
Address 515 Clark Avenue, Ames, IA 50010
Number and Street or RR City,Town or P.O. State Zip
Address of Property Transferred
Number and Streel or RR _ _ - _ City,Town,or P.O. State Zip -- — — --
Legal Description of Property See attached
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.,
2.Solid Waste Disposal (check one)
There is no known solid waste disposal site on this property.
❑ There is a solid waste disposal site on this property, but no notice has been received from the Department of Natural Resources that the
site,is deemed to be potentially hazardous.
❑ There is a solid waste.disposal site on this property which has been deemed to be potentially hazardous by the Department of Natural
Resources.The location(s)of the site(s)is stated below.
3. hazardous Wastes(check one) r
,[There is no known hazardous waste on this property.
❑ There is hazardous waste on this property and it is being managed In accordance with Department of Natural Resources rules.
4. Underground Storage Tanks(check one)
(�I here 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,)
p There is an underground storage tank or tanks on this property.The type(s),size(s)and any known substance(s)contained are described
below.. -
5. Nate Burial Site(check one)
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)is stated.below.The known identifying information of the
decedent is stated below. ✓
Information, if any, required by statements checked above:
Attachment for Additional Information?Y/N If so, n unber of pages
1 HEREBY DECLA T INFORM ION CO ART 1 OF THIS STATEMENT 1S TRUE AND CORRECT
Signature: Telephone Number: 7—3�
frraixsferur a r�erm)
PART 11.-TO BE COMPLETED-BY RECORDER ® _
Date of Instrument T O� Book/I.D. 06 3 8 1
_.. _. Page/I.D. _..._....._ __...__
Date of Recor io�n
1 D City or' wnship P�s
p�
Deed tract ❑ County
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DNR form (July 99) FI,LG WITH RECORDER 542-0960
(See Instruction 116)
1. u <
Parcel A being a resurvey of Parcel "A" in the Southeast Quarter of the southeast
Quarter of Section 10, Township 83 North, Range 24 West of the 5th P.M., City of
Ames, Story County, Iowa, as recorded in Book 9, Page 228 in the office of the
Recorder of Story County, Iowa on January 15, 1991, and being more particularly
described as follows:
Commencing at the Southeast Corner of said Section 10;thence N00°33'08"W.50.00
feet along the east line of the Southeast Quarter of the Southeast Quarter of said
Section 10 to the northerly right of way of South 16`h Street in the City of Ames,
Iowa and the Point of Beginning; thence continuing N00°33'08"W. 1283.55 feet to
the Northeast Corner of the Southeast Quarter of the Southeast Quarter of said
Section 10; thence S89005'21"W. 1167.66 feet along the north line of the Southeast
Quarter of the Southeast Quarter of said Section 10 to the abandoned easterly_right
of way--line of the'-Chicago and Northwestern Transportation Company; thence
S32042'01"W.286.11 feet along said right ofway line;thence S00°24'59"E, 1030.93
feet to the north right of way of South 161h Street;thence N89042'33"E. 1326.98 feet
to the point of beginning, containing 38.41 acres.