HomeMy WebLinkAboutA019 - Real Estate Transfer - Groundwater Hazard Statement REAL ESTATE TRANSFER -GROUNDWATERHAZARD STATEMENT
Please read the filing instructions on the reverse side BEFORE completing this form.
PART I - TO BE COMPLETED BY TRANSFEROR
(Please Type or Print Legibly)
TRANSFEROR Name Erben Hunziker and Margaret Hunziker Apartments,L.L.C.
Address 105 S. 16th Street,Ames,Iowa 50010
Number and Street or RR City,Town or P.O. State zip
TRANSFEREE Name Longview Subdivision First Addition
Address
Number and Street or RR City,Town or P.O. State zip
Address of Property Transferred -
Number and Street or RR City,Town or P.O. State zip
Legal DescriptionofProperty See Addendum 1
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.`So}id Waste Disposal (check one)
0 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)ofthe site(s)is stated below.
3. Hazardous Wastes (check one)
i 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. Un0erground Storage Tanks (check one)
gtThere 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 or tanks on this property.The type(s),size(s)and any known substance(s)contained are described
below.
5.FTFhere
te Burial Site (check one)
are no known private burial sites on this property.
here is a private burial site on this property.The location(s)ofthe site(s)is stated below.The known identifying information ofthe
decedent is stated below.
Information,if any,required by statements checked above:
Attachment for Additional Information`s/N If so,number of pages 1
I HEREBY D ARE HAT THE FORMAT N CONTAINED IN PART 1 OF THIS STATEMENT IS TRUE AND CORRECT
Signature: Telephone Number:(515)233-4450
(Transferor or Agent)
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PART 11 - TO BE COMPLETED BY RECORDER .02 — -0 ''d 7 6
Date of Instrument O Book/I.D. Page/I.D.
Date of Rec rdin �/ /O Ci or nship I' / 66
P�a
Deed Contract ❑ County ru
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DNR form(July 99) FILE WITH RECORDER 542-0960
(See Instruction#6)
Addendum
Addendum 1
A replat of: Outlot U, except the South 50.00 feet, thereof, and, the West 30.00 feet of
Outlot S, except the South 50.00 feet, thereof, and, the West 30.00 feet of Outlot T; all in
Duantless Subdivision First Addition, an official plat, City of Ames, Story County, Iowa,
said tract of land being subject to and together with any and all easements of records. Said
tract of land contains 11.16 acres, more or less.