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Van Buren St Vacate - Lenox AveMEMORANDUM June 22, 2002 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Vacating Petition -A Portion of Van Buren Street (Formerly Lenox Avenue) In response to a request from Michael W. and Sally A. Basten, Public Works Director Mike Koch is recommending the vacation of a portion of Van Buren Street (formerly Lenox Avenue) at lsborn Avenue. He further recommends a public hearing be set for the disposition of the City's interest in the subject area on July 15, 2002, and further recommends that the purchase price be established at $573.78, plus platting, publication and filing fees. The City has no plans for the utilization of this portion of Van Buren Street, except for reserving the utility easements as noted. I concur with the recommendation and respectfully request Mayor and City Council approval. Michael C. Van Milligen MCVM/jh Attachment cc: Barry Lindahl, Corporation Counsel Cindy Steinhauser, Assistant City Manager Michael A. Koch, Public Works Director CITY OF DUBUQUE, IOWA MEMORANDUM June 24, 2002 TO: Michael C. Van Milligen, City Manager FROM: Koch, Public Works Director SUBJECT: Vacating Petition -A Portion of Van Buren Street (Formedy Lenox Avenue) INTRODUCTION This is in response to a request from Michael W. and Sally A. Basten for the vacating of a portion of Van Buren Street (formerly Lenox Avenue) at Isborn Avenue. DISCUSSION The attached plat shows the proposed portion of Van Buren Street (formerly Lenox Avenue) to be vacated. The abutting property is owned by Michael W. and Sally A. Basten, who plan on building an attached garage. The area proposed to be vacated is excess right-of-way due to a realignment of Van Buren Street when a longer curve was constructed at Isborn Avenue. The area to be vacated is divided into one lot numbered Lot 119A of Lenox Addition in the City of Dubuque, Iowa. Perpetual easement rights will be reserved on a portion of Lot 119A for maintenance of the existing sanitary sewer and other utilities as indicated on the plat. The area outside the easement has been valued at $1.22 per square foot. Giving credit for the surveying costs, the purchase price was established at $573.78. RECOMMENDATION The City has no plans for the utilization of this portion of Van Buren Street (formerly Lenox Avenue), except for reserving the utility easements as noted. I would recommend that the area indicated by Lot 119A of Lenox Addition on the attached plat be vacated, and that a public hearing be set for the disposition of the City's interest in the subject area on July 15, 2002. I would further recommend that the purchase price be established at $573.78, plus platting, publication and filing fees. ACTION TO BE TAKEN The recommendation of the City Manager should be approved and a public hearing should be scheduled on the vacate of the property through adoption of the enclosed resolutions and ordinance. MAK/vjd Prepared by Ronald J. Turner, P.L.S. MICHAEL W. BASTEN 2804 Van Buren Dubuque. Iowa. 52001-5439 563-583-9578 April 11, 2002 Honorable Mayor Terry Duggan and City Council 50 W. 13th Street Dubuque, Iowa 52001 Honorable Mayor Terry Duggan and City Council, I am interested to see if I could acquire a portion of City property in accordance with the City of Dubuque vacating procedures. I have coordinated this with the City Engineer's office to have the area checked for sewer utilities and was given a preliminary indication that the vacating is favorable. The property is located at 2804 Van Buren Ave. at the comer of Isbom Ave., The reason for my purchase of this land is to add on a garage. I have already added to the house that I originally paid seventeen thousand dollars for and now is appraised over one hundred thousand dollars. I will build the garage to blend into my existing house. My wife and I have cared for this City property for 24 years. We have over 100 feet of well groomed hedges with hosta plants bordering the house side, and a huge rock garden in the center of this property which you are welcome to come and see. This will not be affected with my addition, as I will work closely with the City Engineer's Office to obtain written consent of the contiguous property owners. Thank you for your consideration in this matter.If there is any further information I can provide, please contact me at the above address and phone nmber. Michael W. Basten AVE PENNSYLVANtA AVE PENNSYLVANIA AVE PURPOSE: VAN BUREN STREET VACATE NORTH Prepared by: Ronald J. Turner, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa (553) 589-4270 RESOLUTION NO. 344-02 RESOLUTION APPROVING PLAT OF THE PROPOSED VACATED PORTION OF VAN BUREN STREET (FORMERLY LENOX AVENUE) Whereas, there has been presented to the City Council of the City of Dubuque, Iowa, a plat dated the 19th day of June, 2002, prepared by Buesing & Associates, describing the proposed vacated portion of Van Buren Street (formerly Lenox Avenue); and Whereas, said plat conforms to the laws and statutes pertaining thereto. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the plat dated the 19th day of June, 2002, prepared by Buesing & Associates, relative to the real estate hereinabove described be and the same is hereby approved, and the Mayor and City Clerk be and they are hereby authorized and directed to execute said plat for and on behalf of the City of Dubuque, Iowa. Section 2. The City of Dubuque reserves unto itself a perpetual easement including the right of ingress and egress thereto, for the purpose of erecting, installing, constructing, reconstructing, repairing, owning, operating, and maintaining water, sewer, drainage, gas, telephone, television cable, fiber optics, and electric lines as may be authorized by the City of Dubuque, Iowa, as shown on the Plat of Survey of Lot 119A of Lenox Addition in the City of Dubuque, Iowa. Section 3. That the City Clerk be and is hereby authorized and directed to file said plat and certified copy of this resolution in the office of the Recorder in and for Dubuque County, Iowa, Passed, approved and adopted this 1st day of July, 2002. Terrance M. Duggan, Mayor Attest: Jeanne F. Schneider, City Clerk day of July , T~rr~nce M. Dug~y~, Mayor Plat of Survey: for Rigt~t of Way Vacation, described as LOT 119A OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CIT' OF DUBUQUE, IOWA. DETAIL - NO SCALE -OT 120 TO THE WEST ! LO'I' 122 LOT2 OF LOT /~ LOT1,8 /~o~ LOT124 ~ LOT 117 LOT125 I LOT 126 ~ 9.50' FROM BOC TO PROPER'~Y LINE NEW ROW LINE DETAIL - NO SCALE 9.50' FROM BOC TO PROPERTY LiNE LOT 1 LOT 116 LEGEND CURVE DATA: C-1 25 50 100 SCALE IN FEET EUESING & f'-SSOCIATES CONSULTING ENGINEERS ORDINANCE NO. 54-02 ORDINANCE VACATING A PORTION OF VAN BUREN STREET (FORMERLY LENOX AVENUE) Whereas, Michael W. and Sally A. Basten have requested the vacating of a portion of Van Buren Street (formerly Lenox Avenue); and Whereas, Buesing & Associates has prepared and submitted to the City Council a plat showing a vacated portion of Van Buren Street (formerly Lenox Avenue) and assigned a lot number thereto, which hereinafter shall be known and described as Lot 119A of Lenox Addition, in the City of Dubuque, Dubuque County, Iowa; and Whereas, the City Council of the City of Dubuque, Iowa has determined that a portion of Van Buren Street (formerly Lenox Avenue) is no longer required for public use, except for utility easements as noted, and vacating of said portion of Van Buren Street (formerly Lenox Avenue) known as Lot 119A of Lenox Addition, in the City of Dubuque, Dubuque County, Iowa should be approved. NOW, THEREFORE, BE IT RESOLVED BYTHE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the real estate described as Lot 119A of Lenox Addition in the City of Dubuque, Iowa, be and the same is hereby vacated. Section 2. The City of Dubuque reserves unto itself a perpetual easement including the right of ingress and egress thereto, for the purpose of erecting, installing, constructing, reconstructing, repairing, owning, operating, and maintaining water, sewer, drainage, gas, telephone, television cable, fiber optics, and electric lines as may be authorized by the City of Dubuque, Iowa, as shown on the Plat of Survey of Lot 119A of Lenox Addition in the City of Dubuque, Iowa. Passed, approved and adopted this 1 st Attest: day of July, 2002. Terrance M. Duggan, Mayor Jeanne F. Schneidler, CMC, City Clerk RESOLUTION NO. 345-02 RESOLUTION OF INTENT TO DISPOSE OF CITY INTEREST IN LOT 119A OF LENOX ADDITION IN THE CITY OF DUBUQUE, IOWA Whereas, Michael W. and Sally A. Basten have requested the vacating of a portion of Van Buren Street (formerly Lenox Avenue); and Whereas, Buesing & Associates has prepared and submitted to the City Council a plat showing the vacated portion of Van Buren Street (formerly Lenox Avenue) and assigned lot number thereto, which hereinafter shall be known and described as Lot 119A of Lenox Addition in the City of Dubuque, Iowa; and Whereas, the City Council of the City of Dubuque, Iowa has determined that this portion of Van Buren Street (formerly Lenox Avenue) is no longer required for public use, except for utility easements as noted, and vacating and sale of said portions of Van Buren Street known as Lot 119A of Lenox Addition in the City of Dubuque, Dubuque County, Iowa should be approved. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the City of Dubuque intends to dispose of its interest in Lot 119A of Lenox Addition in the City of Dubuque, Iowa. Section 2. That the conveyance 'of Lot 119A of Lenox Addition in the City of Dubuque, Iowa to Michael W. and Sally A. Basten be contingent upon the payment of $573.78, plus platting, publication and filing fees. Section 3. The City of Dubuque reserves unto itself a perpetual easement including the right of ingress and egress thereto, for the purpose of erecting, installing, constructing, reconstructing, repairing, owning, operating, and maintaining water, sewer, drainage, gas, telephone, television cable, fiber optics, and electric lines as may be authorized by the City of Dubuque, Iowa, as shown on the Plat of Survey of Lot 119A of Lenox Addition in the City of Dubuque, Iowa. Section 4. That the City Clerk be and is hereby authorized and directed to cause a notice of intent to dispose of said real estate to be published in the manner as prescribed by law. Passed, approved and adopted this 1st day of July, 2002. Terrance M. Duggan, Mayor Attest: Jeanne F. Schneider, CMC, City Clerk Prepared by: Ronald J. Tumer, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa (563) 589-4270 RESOLUTION NO. RESOLUTION DISPOSING OF CiTY INTEREST IN LOT 119A OF LENOX ADDITION IN THE CITY OF DUBUQUE, IOWA Whereas, pursuant to resolution and published notice of time and place of headng, published in the Telegraph Herald, a newspaper of general circulation published in the City of Dubuque, Iowa on this day of ,2002, the City Council of the City of Dubuque, Iowa met on the day of ., 2002, at 6:30 p.m. in the Public Library Auditorium, 360 West 11 Street, Dubuque, Dubuque County, Iowa to consider the proposal for the sale of real estate described as: Lot 119A of Lenox Addition in the City of Dubuque, Dubuque County, Iowa Whereas, the City Council of the City of Dubuque, Iowa overruled any and all objections, oral or written to the proposal to sell such real estate, except for easement as noted. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the sale of City of Dubuque real property described as Lot 119A of Lenox Addition in the City of Dubuque, Iowa to Michael W. and Sally A. Basten be and the same is hereby approved for the sum of $573.78 plus cost of publication, platting and filing fees. Conveyance shall be by Quit Claim Deed. Section 2. The City of Dubuque reserves unto itself a perpetual easement including the right of ingress and egress thereto, for the purpose of erecting, installing, constructing, reconstructing, repairing, owning, operating, and maintaining water, sewer, drainage, gas, telephone, television cable, fiber optics, and electric lines as may be authorized by the City of Dubuque, Iowa, as shown on the Plat of Survey of Lot 119A of Lenox Addition in the City of Dubuque, Iowa. Section 3. That the Mayor be authorized and directed to execute a Quit Claim Deed, and the City Clerk be and is hereby authorized and directed to deliver said deed of conveyance to Michael W. and Sally A. Basten upon receipt of the purchase price in full. Section 4. That the City Clerk be and is hereby authorized and directed to record a certified copy of this resolution in the offices of the City Assessor, Dubuque County Recorder and Dubuque County Auditor. Passed, approved and adopted this day of ,2002. Terrance M. Duggan, Mayor Attest: Jeanne F. Schneider, CMC, City Clerk PREPARED BY: BUESING & ASSOCIATES ADDRESS: 1212 LOCUST STREET, DUBUQUE, IOWA PHONE: 563 556-4389 Plat of Survey: for Right of Way Vacation, described as LOT 1 19A OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CITY OF DUBUQUE, IOWA. EXISTING SAN.SEWER ~ MANHOLE % 9.50' FROM BOC TO PROPERTY LINE ,P x LOT 121 N10°55'36"[ ~ ~/4, 13.32' DETAIL - NO SCALE 2.23'(12.2').. LOT 120 LOT 122 [~r~rH~EOs%ER~"~,J%., LOT20P LOT 123 I. OT 124 LOT 126 %~ 219.( LOT 1 OF 119 LOT 118 LEGEND IRON PiPE - SIZE AS NOTED (FOUND) 5/8" IRON ROD (FOUND) 5/8" IRON ROD W/YELLOW CAP RLS# 4016 (PLACED) RECORDED PROPERTY LiNE SURVEYED PROPERTY LiNE LOT 117 NEW ROW LINE LOT116 LOT 115 UTILITY EASEMENT LINE --6HT--BHT -- EXISTING OVERHEAD UTIUTY LINE -- SAN -- SAN -- EXISTING SANITARY SEWER LINE ( ) RECORDED DIMENSION P.O.B. POINT OF BEGINNING BOC BACK OF CURB ROW RIGHT OF WAY NOTES (1) ALL MEASUREMENTS ARE IN FEET AND DECIMALS THEREOF. (2) PROPRIETOR: CITY OF DUBUQUE. (3) DATE OF FIELD SURVEY: JUNE 17, 2002 (4) TOTALED SURVEYED AREA = 2000 SQ. FT. (5) IF THiS PLAT DOES NOT HAVE AN EMBOSSED SEAL AND SURVEYOR'S SIGNATURE IN PURPLE INK, IT IS A COPY THAT MAY CONTAIN UNAUTHORIZED ALTERATIONS. THE CERTIFICATION CONTAINED ON THIS PL&T SHALL NOT APpLy TO ANY COPIES. BHE TI E t PRO, EOT I NO. 02113 PLAT OF SURVEY ""~"~ ~°I%HAEL W BASTEN for Right of Way Vacation I 2804 VAN BUREN STRE~ DUBUQU~ IA 52001 PLOT DATE: 6-1~02 DETAIL - NO SCALE 9.50' FROM BOC TO PROPERTY LINE PUBLIC UTILITY EASEMENT 17.69' ~ EXISTING SAN.SEWER MANHOLE S 11 °22'56"W/ 22.72' //~ P.O.B. CURVE DATA: C-1 DELTA- 14°33't6" ARC - 101.63' CHORD- 101.36 RADIUS - 400.09' TANGENT - 51.09' CHORD BEARING - S51°12'00"E 0 25 50 10( SCALE IN FEET DATE JU~-"'~, 2002 REVISIONS JLW _~ DRAWN BY: TLK CHECKED BY: BUESING & ASSOCIATES CONSULTING ENGINEERS 1212 LOCUST STREET DUBUQUE, IOWA 52001 (563) 556-4389 I HEREBY CERTIFY THAT THIS LAND SURVEYING DOCUMENT WAS PREPARED AND THE RELATED SURVEY WORK WAS PERFORMED BY ME OR UNDER MY DIRECT PERSONAL SUPERVISION AND THAT I AM A Y LICENSED LAND SURVEYOR UNDER THE LAWS OF THE OF IOWA. JOHN L. WHITE (DATE) CENSE NUMBER 4016 MY LICENSE RENEWAL DATE iS DECEMBER 31, 2002 SHEETS COVERED BY THIS SEAL: ~'~ ~-- Surveyors Certificate Sheet 2 of 4 Dubuque, Iowa /~'--v/~,, -- ,2002 I hereby certify that the plat shown on SHEET 1 OF 4 hereof, is a true and correct Plat of Survey: for Right of Way Vacation, described as LOT 'I'IgA OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CITY OF DUBUQUE, IOWA. The perimeter of LOT 119A OF LENOX ADDITION, was surveyed by me and is more particularly described as follows: LOT 119A OF LENOX ADDITION Commencing at the Southeast corner of Lot 115 of Lenox Addition in the City of Dubuque; Thence North 11 o 22' 56" East ((his is an assumed beadng for the purposes of this survey only) along the West R.O.W. (Right of Way) line of Isborn Avenue a distance of 214.98 feet to the Northeasterly corner of Lot I of 119 of Lenox Addition, the Point of Beginning; Thence North 43° 21' 14" West along the Northeasterly line of said Lot I of 119, a distance of 122.35 feet to the Northeasterly comer of Lot 2 of 119 of Lenox Addition; Thence North 10° 55' 36" East, a distance of 13.32 feet; Thence Southeasterly a distance of 101.63 feet along the Arc of a 400.09 foot radius curve to the left, of which the chord distance is 101.36 feet and a chord bearing of South 51° 12' 00" East; Thence South 23° 10' 36" East, a distance of 17.69 feet to the West R.O.W. line of Isborn Avenue extended Northerly; Thence South 11 ° 22' 56" West along said West R.O.W. line of said Avenue extended Northerly, a distance of 22.72 feet to the Point of Beginning; The TOTAL AREA of LOT 119A OF LENOX ADDITION is 2000 Square feet and is subject to all easements of record and not of record. I hereby certify that this land surveying document was prepared and the related survey work was pe~.m, ed by me or under my direct personal supervision and that I am ~_de~.~ lawS of the State of Iowa. a duly licensed Land Surveyor J~-IN L. WHITE DATE /LICENSED LAND SURVEYOR / REGISTRATION # 4016 REG. RENEWAL 12/31/02 Owner's Consent Sheet 3 of 4 Dubuque, Iowa ,2002 The foregoing Plat of Survey: for Right of Way Vacation, described as LOT 'I'IgA OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CITY OF DUBUQUE, IOWA, is made with the free consent and in accordance with the desires of the undersigned owners and proprietors of said real estate. City of Dubuque Mayor Terrance M. Duggan City of Dubuque Clerk Jeannie Schneider State of Iowa ) ) County of Dubuque ) ss: On this.day of , A.D. 2002, before me, the undersigned, a Notary Public in and for the State of Iowa, personally appeared Terrance M. Duggan and Jeannie Schneider to me personally known, who, being duly sworn did say that are the Mayor and City Clerk, respectively, of the City of Dubuque, Iowa, a municipal corporation, executing the within and foregoing instrument and acknowledged that they executed the same as a voluntary act and deed of the City of Dubuque, by it and by them voluntarily executed. Witness my hand and Notarial Seal on the date above written Notary Public in and for the State of Iowa City of Du~ Sheet 4 of 4 Dubuque, Iowa ,2002 The undersigned, Terrance M. Duggan, Mayor and Jeanne Schneider, Clerk of the City of Dubuque, Iowa, do hereby certify that the foregoing Plat of Survey: for Right of Way Vacation, described as LOT 119A OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CITY OF DUBUQUE, IOWA, as appears heretofore has been filed in the office of the City Clerk of Dubuque Iowa, and that by Resolution No. the City Council of the City of Dubuque, Iowa approves said plat. Mayor of the City of Dubuque, IA Terrance M. Duggan Clerk of the City of Dubuque, IA Jeannie Schneider City Assessor's Certificate Dubuque, Iowa ,2002 The foregoing Plat of Survey: for Right of Way Vacation, described as LOT 1 "19A OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CITY OF DUBUQUE, IOWA, was entered of record in the Office of the City Assessor of the City of Dubuque, Iowa, on the date first written above. City Assessor of the City of Dubuque, IA .County Auditor's Certificate Dubuque, Iowa ,2002 I, the undersigned, Denise M. Dolan, Dubuque County Auditor have reviewed and examined the Plat of Survey: for Right of Way Vacation, described as LOT 119A OF LENOX ADDITION, AS COMPRISED OF A VACATED PORTION OF VAN BUREN STREET (formerly Lenox Avenue) RIGHT OF WAY IN THE CITY OF DUBUQUE, IOWA. The foregoing Plat of Survey was entered of record in the Office of the County Auditor of Dubuque County, Iowa, on the date first written above. County Auditor of Dubuque County, Iowa Prepared by: Rona[d J. Turner, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa (319) 589-4270 Address Tax Statement: Michael W. & Sally A. Basten, 2804 Van Buren Street, Dubuque, IA 52001 QUIT CLAIM DEED The City of Dubuque, Iowa, a municipal corporation of Dubuque County, Iowa, for Five Hundred Seventy Three and 78/00 Dollars ((;573.78) does hereby Quit Claim unto: Michael W. & Sally A. Basten 2804 Van Buren Street Dubuque, IA 52001 all its rights, title, and interest in the following described reat estate situated in Dubuque County, Iowa, to wit: Lot 119A of Lenox Addition in the City of Dubuque, Dubuque County, Iowa The City reserves unto itself a perpetual easement including the right of ingress and egress thereto, for the purpose of erecting, installing, constructing, reconstructing, repairing, owning, operating, and maintaining water, sewer, drainage, gas, telephone, television cable, fiber optics, and electric lines as may be authorized by the City of Dubuque, Iowa, as shown on the plat of said Lot 119A of Lenox Addition. No declaration of value is required according to Iowa Code Section 428A.1. This deed is given pursuant to the authority of Resolution No. of the City of Dubuque, adopted , 2002, the terms and conditions thereof, if any, having been fulfilled. Signed this day of , 2002. CITY OF DUBUQUE, IOWA By: Terrance M. Duggan, Mayor Attest: By: Jeanne F. Schneider, City Clerk STATE OF IOWA DUBUQUE COUNTY ) ) ss ) On this day of , 2002, before me, the undersigned, a Notary Public in and for the State of Iowa, personally appeared Terrance M. Duggan and Jeanne F. Schneider, to me personally known, who being by me duly sworn, did say that they are the Mayor and City Clerk, respectively, of the City of Dubuque, Iowa, a municipal corporation; that the seal affixed to the foregoing instrument is the corporate seal of said corporation, by the authority of its City Council, as contained in Ordinance No. 2-5 of the City of Dubuque Code of Ordinances, passed by Resolution of the City Council under Resolution No. __ of the City Council on the day of , 2002; and Terrance M. Duggan and Jeanne F. Schneider acknowledged the execution of the instrument to be their voluntary act and deed and the voluntary act and deed of the corporation, by it voluntarily executed, Notary Public In and For Said State. TR. AxNSFEROR Name REAL ESTATE TRANSFER - GROUNDWATER HAZARD 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) Address TRANSFEREE Name 50 W. 13th Street Dubuque IA 52001-4864 Michael W. & Sally A. Basten Address 2804 Van Buren SLTeet Dubuque IA 52OO1 ZIp Address of Property Trausfe~ed Legal Description of Property Lot'119A of Lenox Addition in the City of Dubuque, D4buque County, Iowa 1. Wells (check one) ~I There are no kno,am wells situated on this property. [1 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 NaturaI Resources. The location(s) of the site(s) is stated below. 3. Hazardous Wastes (check one) ~ There is no known hazardous waste on this properly. [] There is hazardous waste on ttMs property and it is being managed in accordance with Department of Natural Resources roles. 4. Underground Storage Tan'ks (check one) I~ There are no known underground storage tanks on this proper~y. (Note exclusions such as small farm and residential motor fuel -tanks, most heating oil tanks, cisterns and septic tanks, in instmctious.) [] There is an underground storage tamk or tamlcs on this property. The type(s), size(s) and any known substance(s) contained are d~crihet below. 5. Private Burial Site (check one) [X 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: Anachment for Additional Information? Y/{~ number of pages Michael A. Koch PART II - TO BE COMPLETED BY RECOILDER Date o£ InsWament Boo'k/I.D. Page/I.D. Date of Recording City or Township Deed [] Contract [] County DNR form (July 99) FILE ~VITH RECORDER (See Instruction #6) INSTRUCTIONS FOR COMPLETING GROUNDWATER HAZARD STATEM2ENT The transferor of real property is required to complete Part I of this form. The purpose of the statement is to satisfy legal requirements for filing instruments of conveyance of real property with the county recorder (Iowa Code Section 558.69). The Department of Natural Resources does not approve or disapprove of property transfers based on these statements. The statement must be signed by one of the persons transferring the property interest or that person's agent. An agent signing this form represents the information from transferor to be correct. For the most part the information requested is clear (name, address, etc.). One statement under each of the numbered items (1, 2, 3, 4 and 5) must be checked, and if one or more of the statements checked requires the transferor to provide additional information, that information is to be provided in part I. Relate the additional information to the specific category of facility (well, etc.) by numbering it with the .corresponding number (1, 2, 3, 4, 5). If additional space is needed, type or print it legibly on a separate sheet or sheets, complete the statements at the end of Part i and attach the additional information to ali copies of the form. x,¥~en describing the location of a facility on the property, be reasonably precise, such as a specific distance and general direction from a landmark or comer of the property. A professional survey is not necessary. The following del'tuitions are for use in completing the form. 1. Wells - A "well" is any excavation that is drilled, cored, bored, au'gered,' washed, driven, dug, jetted or otherwise constructed for accessing groundwater or for diverting surface water into the ground, including abandoned wells. "Well" does not include an open ditch or drainage tiles which discharge to the surface. If a well is an "abandoned well" or an "agricultural drainage well," this must be identified and the status of the well with respect to Iowa Code sections 455B. 190 and I59.29, respectively, must be stated. An "abandoned ~vell" is a well no longer in use or in such state of disrepair that continued use is unsafe or kmpracticable. Abandoned wells are to be properly plugged in accordance with chapter 39 of the rotes of the Department of Natural Resources. (567 Iowa Administrative Code, Chapter 39) 3. Hazardous Wastes - "Hazardous waste" is def'me~l in Iowa Code section 455B.411, 567--141.2 (455B), I.A.C., and federal regulations referenced therein. It is generally de£med as waste that poses a threat to human health or the environment. It includes wastes which are ignitable, corrosive, toxic, explosive, violetuly reactive, or specifically listed as hazardous in the Code of Federal Regulations (40 CFR 261). EXCLUDED are household wastes, agricultural wastes retrained to the so~. as fertilizers or soil conditioners, agricultural chemicals applied or disposed of by a farmer in accordance with the manufacturer's instructions, triple-rinsed agricultural chemical containers disposed of by farmers (where the rinsate is used as makeup water in the tankrnix and applied at appropriate rates), and other specific materials. Persons are legally required to be aware of hazardous waste laws. 4. Underground Storage Tan'ks - "Underground storage tank' means one or a combination of tanks, including tmdergrotmd piping connected to the tanks, used to contain an accumulation of regulated substances, and the volume of which is I0 percen.: or more beneath the surface of the ground. "Regulated substances" include petroleum products and hazardous or toxic rn2teffaLs identified in 567-I35.2(455B), I.A.C. Underground storage tank does not include: a. Farm or residential tanks of 1,100 gallons or less capa~w used for storing motor fuel for noncommercial purposes. But See 455B.473(4)) b. Tares used for storing heating oil for consumptive use on the premises where stored. c. Residential septic tanks. d. Pipeline facilities regulated by state or federal law. e. A surface impoundment, pit pond, or lagoon. f. A storm water or wastewater collection system. g. A rmv-through process tank. h. 'A liquid trap or associated gathering lines directly related to oil or gas production and gather/rig operations. i. A tank in an underground area such as a basement or m/ne, ir' the tank is on or above the surface of the floor. j. Pipes cormected to the above exclusions. An "agricultural drainage well" is a well consUmcted for the purpose of draining, or which drains, water from agricultural land to an aquifer (underground), excluding drainage file intakes which outlet to the surface. Agricultural drainage wells are required to be registered with the department by September 30, 1988, and the owner of the well and of the land drained by the well are to develop a plan proposing alternatives to the use of the well by July 1, 1998 (See Iowa Code Section 159.29.) 2. Solid Waste - "Solid waste" means garbage, refuse, rubbish and other similar discarded solid or semisolid material. It does not include dirt, stone, brick, or similar inorganic material used for fill, as long as no other solid waste is included. See 567--I00.2(455B), Iowa Administrative Code (I.A.C.) for further definitions. A "disposal site" is any area on the proper~y on, in, or under which solid waste has t~een disposed, whether or not the disposal is or was regulated by the deparmaent. If the transferor or agent has not received notice from the Department of Natural Resources that the disposal site has been deemed to be potentially hazardous, there is no duty to inquire to the department. "Tank type" means the material of construction (steel, fiber~ reinforced plastic [FPP], or other [specify]), and any internal or external protection such as a protective coating or wrapping, nr cathodic protection. Identify the capacity in gallons and the substance stored La cch tank. 5. Private Burial Sites - "Private Burial Site" means one or more graves containing human remains. For each site the transferor shall state the Iocatiun of the site. For each decedem buried on the property the transferor shall state all lcno;~-a identifying information of that decedent including name, dete of death, and date of bLrth. 6. Filing - The original of this form must be presented to r2ne county recorder when the document to be recorded is filed. ~ne Recorder shall forward the original to the transferee when the recorded instrument is returned. The recorder is not required to keep any copies. -- *Note The land application of s!udges or soils resulting from the remediatinn of underground storage tank releases accomplished in compliance with Department of Natural Resources roles without a permit is not required to be reported as the disposal of solid waste or hazardous waste. (See Iowa Code Section 558~69) DNR form (July 99)