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Purchase of 427-429 Rhomberg Avenue_Junnie and Rich's Coin
Masterpiece on the Mississippi Dubuque band AI- America City IIIii! 2007 • 2012 • 2013 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Bee Branch Creek Restoration - Property Acquisition of 427 -429 Rhomberg Avenue DATE: November 12, 2013 In December of 2004, the City Council established the alignment for the Bee Branch Creek Restoration Project, from 15th and Sycamore Streets to 24th and Washington Streets, establishing the properties to be acquired for the Bee Branch Creek Restoration Project. Civil Engineer Deron Muehring recommends the City Council approve the purchase of 427 -429 Rhomberg Avenue for the purchase price of $130,000, and authorize acceptance of the Warranty Deed and any other related steps necessary to carry out the terms of the offer. The primary benefit of purchasing 427 -429 Rhomberg for the Bee Branch Creek Restoration is that it would allow the City control over the building before, during, and after construction of the proposed Rhomberg Avenue Bridge. This would enable the City to take any and all necessary steps to stabilize and protect the building from damage. It would also allow the City to repair any damage to the building that might occur as a result of the bridge construction without involving a third party. If any damage results, discussions would be limited to the City and the City's construction contractor. I concur with the recommendation and respectfully request Mayor and City Council approval. Michael C. Van Milligen MCVM:jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Teri Goodmann, Assistant City Manager Deron Muehring, Civil Engineer Gus Psihoyos, City Engineer 2 THE CITY OF Dui Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Deron Muehring, Civil Engineer bl4A/ DATE: November 13, 2013 SUBJECT: Bee Branch Creek Restoration, Property Acquisition Dubuque bitil ca City 2007.2M2•2013 INTRODUCTION The purpose of this memorandum is to seek authorization to acquire 427 -429 Rhomberg Avenue, Dubuque, Iowa (the Property) for the Bee Branch Creek Restoration Project. BACKGROUND In December of 2004, the City Council established the alignment for the Bee Branch Creek Restoration Project, from 15th and Sycamore Street to 24th and Washington Street, establishing the properties to be acquired for the Bee Branch Creek Restoration Project. DISCUSSION John P. Mihalakis and Richard L. Billmeyer, partners in Junnie & Rich's Coin Partnership and owners of the Property, voluntarily approached the City in September, 2013 and proposed to sell the Property to the City for one hundred thirty thousand dollars ($130,000.00). The building and associated property is currently vacant. The Bee Branch Creek Restoration includes the construction of a bridge to carry Rhomberg Avenue traffic over the proposed creek just north of Kniest Street. The Property (427 -429 Rhomberg) is located within 50 feet of the proposed bridge. Attachment A shows location of the property while Attachment B shows the building in relationship to the proposed bridge. In September of 2013 it was communicated to the Bee Branch engineering design team that the third story of 427 -429 Rhomberg had partially collapsed into the second floor of the brick building. City staff approached the owners of the property to try and determine the stability of the building. If the building is unstable, and appropriate steps are not taken during construction of the Rhomberg Avenue Bridge, additional damage to the building could result. Through discussions with the property owner, City staff learned that the building was for sale. The primary benefit of purchasing 427 -429 Rhomberg for the Bee Branch Creek Restoration is that it would allow the City control over the building before, during, and after construction of the proposed Rhomberg Avenue Bridge. This would enable the City to take any and all necessary steps to stabilize and protect the building from damage. It would also allow the City to repair any damage to the building that might occur as a result of the bridge construction without involving a third party. If any damage results, discussions would be limited to the City and the City's construction contractor. Based on the City's cost to acquire similar property, $130,000.00 is appropriate compensation for 427 -429 Rhomberg Avenue. Enclosed are the Offer to Buy Real Estate and Acceptance (the Offer) signed by John P. Mihalakis and Richard L. Billmeyer, partners in Junnie & Rich's Coin Partnership., the Acknowledgment of Voluntary Negotiation, and the proposed Resolution approving the Offer to Buy Real Estate and Acceptance. RECOMMENDATION I recommend acquiring 427 -429 Rhomberg Avenue per the terms outlined in the attached Offer to Buy Real Estate and Acceptance for the Bee Branch Creek Restoration Project. BUDGET IMPACT The acquisition will be funded through the FY2013 Capital Improvement Program Budget appropriation of $2,723,388 for Bee Branch Creek Restoration property acquisitions. REQUESTED ACTION I respectfully request that the City Council adopt the attached Resolution approving the Offer and authorizing acceptance of the Warranty Deed and any other related steps necessary to carry out the terms of the Offer. Attach. cc: Barry Lindahl, City Attorney Maureen Quann, Assistant City Attorney Gus Psihoyos, City Engineer Jenny Larson, Budget Director Steve Brown, Project Manager 2 Attachment A Address: Legal Description: 427 -429 Rhomberg Avenue LOTS 9 AND 10 of SMEDLEY'S SUBDIVISION LOT 8 OF SMEDLEY'S SUBDIVISON LOT 7 AND THE NE 1. OF LOT 6 OF SMEDLEY'S SUBDIVISION AND THE NE 14' 8" OF LOT 2 OF LOT 1 OF LOT 5 OF LOT 9 OF KNIEST'S SUBDIVISION Attachment B Location of 429 Rhomberg Avenue in relation to the proposed Rhomberg Avenue Bridge to be constructed as part of the Upper Bee Branch Creek Restoration Project. RESOLUTION NO. 327 -13 RESOLUTION APPROVING THE ACQUISITION OF REAL ESTATE OWNED BY JOHN P. MIHALAKIS AND RICHARD L. BILLMEYER, D /B /A JUNNIE & RICH'S COIN PARTNERSHIP, IN THE CITY OF DUBUQUE Whereas, the City of Dubuque intends to acquire certain real estate located immediately adjacent to the area of the Bee Branch Creek Restoration Project for stormwater mitigation activities as recommended in the 2001 "Drainage Basin Master Plan "; and Whereas, this certain real estate is not currently part of or located within the Bee Branch Creek Restoration Project; and Whereas, the owners of this certain real estate approached the City of Dubuque voluntarily and proposed that the City of Dubuque acquire the property for possible future addition to, but not currently as part of, the Bee Branch Creek Restoration Project; and Whereas, the acquisition of this real estate is a voluntarily negotiated purchase by the City of Dubuque under Section 6B.1A of the Code of Iowa, and is not an acquisition by the City of Dubuque through its exercise of the power of eminent domain under Chapter 6B of the Code of Iowa; and Whereas, a purchase agreement has been finalized with the owners of the real estate scheduled for acquisition and an Acknowledgment of Voluntary Negotiation has been executed by the owner. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the City of Dubuque, Iowa hereby approves the acquisition of the following legally described real estate: LOTS 9 AND 10 of SMEDLEY'S SUBDIVISION LOT 8 OF SMEDLEY'S SUBDIVISON LOT 7 AND THE NE '/ OF LOT 6 OF SMEDLEY'S SUBDIVISION AND THE NE 14' 8" OF LOT 2 OF LOT 1 OF LOT 5 OF LOT 9 OF KNIEST'S SUBDIVISION at the cost of One Hundred Thirty Thousand and 00/100 Dollars ($130,000.00). Section 2. That the City of Dubuque be and is hereby authorized to accept a Warranty Deed from the owners, conveying the owner's interest to the City of Dubuque, Iowa for the herein described real estate. Section 3. That the City Clerk be and is hereby authorized and directed to cause said Warranty Deed to be recorded in the office of the Dubuque County Recorder, together with a certified copy of this Resolution. Section 4. That the City Clerk be and is hereby directed to forward a copy of this Resolution to the Dubuque County Assessor and the Dubuque County Auditor. Passed, approved and adopted this 18th day of November, 2013. Roy D. (aol, Mayor Attest: Kevin 8/' irnstahl, City Cler 11 11 1 11 1 1 11 REAL ESTATE TRANSFER - DECLARATION OF VALUE Please read the instructions on the reverse side BEFORE completing and filing this form. Part I - TO BE COMPLETED BY BUYER, SELLER OR AGENT SELLER: John P. Mihalakis and Richard L. Billmeyer SSN or FEIN: 42-0866803 A Seller Address: 2095 Kerper Boulevard Dubuque Iowa 52001 e -mail /phone: BUYER: City of Dubuque, Iowa SSN or FEIN 42- 6004596 • Buyer Address: 50 West 13th Street Dubuque Iowa 52001 e-mail/phone: Address of Property Conveyed • 427 -429 Rhomberg Avenue Dubuque Iowa 52001 Date of Instrument. • ® Deed 1 ❑ Contract 2 • Legal Description: Lots 9 and 10 in Smedley's Subdivision, being a Subdivision of Lots 6, 7 and 8 and the South 100 feet of Lot 5 Kniest's Subdivision in the City of Dubuque, Iowa Type of Sale (check all that apply): ❑ Fulfillment of prior year(s) contract ® Sale to /by Exempt Organization ❑ Auction Sale ❑ Corporate merger or reorganization ❑ Purchase of adjoining land ❑ Transfer of partial interest ❑ Quit Claim Deed ❑ Sale between family members or related parties ❑ Foreclosure, forfeitures, or transfers arising from default; forced sale Was this a sale of AG LAND to: ❑ Corporation ❑ Trust ❑ Alien ❑ Non- Resident Alien ❑ Limited Partnership A 1. Total Amount Paid DECLARATION OF VALUE STATEMENT $ 65,000.00 $ 65,000.00 - 2. Amount Paid for Personal Property (see instructions) 3. Amount Paid for Real Property Only (1 minus 2) Contract Sale Information: Down Payment $ Interest Rate % Monthly Payment $ Length of Contract years Balloon Payment Date (if applicable) I HEREBY DEC )' ".A/RR�J THAT THE I FORMATION CONTAINS PA VI OF THJS F RM IS TRUE AND CORR (CCT s N Tj DE ED, f�1�ASiK / HIS FORM . Printed Name. �lC� G/►d /�; /1"J , / E not ✓ ❑ Buyer or ❑ Sell r ❑ Agent or ❑ Attorney re PART II - TO BE COMPLETED BY THE ASSESSOR Classification of Property: ❑ Res _4_ ❑ Com _5_ ❑ Ind _2_ ❑ Ag _1_ • Deeded Acres: • OCC Primary Parcel Number • ( attach list of additional parcels) • TLA/G BA • Tax District • Full Assessed Value January 1 of Year of Sale Land Building Dwelling Total Good for study? ❑ Yes ❑ No NUTC • If No, give reason. A Effective Date of Form 09/30/12 Iowa Department of Revenue ISBA 57006a (03/23/12) SPECIAL INSTRUCTIONS Visit our web site at www.iowa.gov /tax. See more detailed instructions online at www.iowa.gov /tax /forms /DOVdetails.pdf FILING INSTRUCTIONS: Iowa law requires that a "Declaration of Value" statement reflecting the full consideration paid in certain nonexempt real estate conveyances be submitted to the county recorder at the time a deed, contract, instrument, or other writing is presented for recording. Part I of this form is the prescribed "Declaration of Value" statement that must be completed by the buyer or seller or either's agent for nonexempt transactions. Part II of this form is to be completed only by the assessor. The blank area at the top of the form is for use by the county recorder. In this area the recorder will provide the following information: Date of Recording, Book and Page Number or Instrument Number, County, Real Estate Transfer Tax, Deed or Contract. IMPORTANT: This form does not have to be completed for any document presented for recording which clearly indicates on such document that it is an exempt transaction. Refer to Iowa Administrative Code 701 -79.5. If the transaction is exempt, but the reason for exemption is not stated on the actual document presented for recording, Part I of this form must be completed. If this form is not completed accurately and completely for nonexempt transactions by the buyer or seller or either's agent, the county recorder is required by law to refuse to record the contract, deed or other instrument conveying the affected property. Social Security Numbers (SSNs) and Federal ID Numbers (FEINs) are required by 701 IAC 79.5(5), pursuant to Iowa Code sections 428A.1 and 428A.7, as authorized by 42 U.S.C. §405(c)(2)(C)(i). All Social Security Numbers and Federal ID Numbers must be redacted prior to release to the public. TYPE OF SALE: Check all box or boxes that designate conditions that apply to the sale on the front section of the form. For purposes of indicating a "Sale Between Family Members" only the following relationships are to be considered: Mother Daughter Sister Sister -in -law Stepsister Mother -in -law Daughter -in -law Niece Foster Child Foster parent Foster brother Foster sister Father Son Brother Brother -in -law Stepbrother Father -in -law Son -in -law Nephew Grandson Granddaughter Grandfather Grandmother Stepmother Uncle Stepfather Aunt Stepson Stepdaughter DECLARATION OF VALUE STATEMENT: Total Amount Paid — Enter the entire and full purchase price of the property transferred, including down payment. Reporting of personal property should conform to the transfer document and any related income tax filings. Amount Paid for Personal Property — Enter the amount of the purchase price that was paid for personal property. For residential sales, personal property includes items that are not attached ( "built in ") to the home that are normally removed by the owner, when he or she vacates. This includes, but is not limited to items such as washers, dryers, drapes, stoves, refrigerators, and portable dishwashers. Personal property for commercial or industrial sales includes inventories, as well as equipment and fixtures classified and assessed as personal property. Reporting of personal property should conform to the transfer document and any related income tax filings. Amount Paid for Real Property Only — Subtract Line 2 from Line 1 and enter the difference here. IF THIS TRANSACTION IS EXEMPT FROM THE TRANSFER TAX, you may not be required to complete this form UNLESS you are claiming exemption number 1, 6,14, or 15, which require a Declaration of Value Statement. Exceptions Iowa Code 428A.2 1. (DOV required) Any executory contract for the sale of land under which the vendee is entitled to or does take possession thereof, or any assignment or cancellation thereof. 2. Any instrument of mortgage, assignment, extension, partial release, or satisfaction thereof. 3. Any will. 4. Any plat. 5. Any lease. 6. (DOV required for federal agency or instrumentality) Any deed, instrument, or writing in which the United States or any agency or instrumentality thereof or the state of Iowa or any agency, instrumentality, or governmental or political subdivision thereof is the grantor, assignor, transferor, or conveyor; and any deed, instrument or writing in which any of such unit of government is the grantee or assignee where there is no consideration. 7. Deeds for cemetery lots. 8. Deeds which secure a debt or other obligation, except those included in the sale of real property. 9. Deeds for the release of a security interest in property excepting those pertaining to the sale of real estate. 10. Deeds which, without additional consideration, confirm, correct, modify or supplement a deed previously recorded. 11. Deeds between husband and wife, or parent and child, without actual consideration. A cancellation of indebtedness alone which is secured by the property being transferred and which is not greater than the fair market value of the property being transferred is not actual consideration within the meaning of this subsection. 12. Tax deeds. 13. Deeds of partition where the interest conveyed is without consideration. However, if any of the parties take shares greater in value than their undivided interest a tax is due on the greater values, computed at the rate set out in section 428A.1. 14. (DOV required)The making or delivering of instruments of transfer resulting from a corporate merger, consolidation, or reorganization or a merger, consolidation, or reorganization of a limited liability company under the laws of the United States or any state thereof, where such instrument states such fact on the face thereof. 15. (DOV required) Deeds between a family corporation, partnership, limited partnership, limited liability partnership, or limited liability company and its stockholders, partners, or members for the purpose of transferring real property in an incorporation or corporate dissolution or the organization or dissolution of a partnership, limited partnership, limited liability partnership, or limited liability company under the laws of this state, where the deeds are given for no actual consideration other than for shares or for debt securities of the corporation, partnership, limited partnership, limited liability partnership, or limited liability company. For purposes of this subsection, a family corporation, partnership, limited partnership, limited liability partnership, or limited liability company is a corporation, partnership, limited partnership, limited liability partnership, or limited liability company where the majority of the voting stock of the corporation, or of the ownership shares of the partnership, limited partnership, limited liability partnership, or limited liability company is held by and the majority of the stockholders, partners, or members are persons related to each other as spouse, parent, grandparent, lineal ascendants of grandparents or their spouses and other lineal descendants of the grandparents or their spouses, or persons acting in a fiduciary capacity for persons so related and where all of its stockholders, partners, or members are natural persons or persons acting in a fiduciary capacity for the benefit of natural persons. 16. Deeds for the transfer of property or the transfer of an interest in property when the deed is executed between former spouses pursuant to a decree of dissolution of marriage. 17. Deeds transferring easements. 18. Deeds giving back real property to lienholders in lieu of forfeitures or foreclosures. 19. Deeds executed by public officials in the performance of their official duties. 20. Deeds transferring distributions of assets to heirs at law or devisees under a will. 21. Deeds in which the consideration is five hundred dollars or less. 57006b (03/23/12) City of Dubuque CHECK NO 398217 AMOUNT $103.20 VENDOR 1688 DUBUQUE COUNTY RECORDER CHECK DATE 11/19/2013 Activity /Project Account Purchase Order Invoice No Amount Description 7201654 73111 427- 429RHOM $103.20 TRANSFER TAX FOR TENANTS IN COMMON PARCEL 427 -429 RHOMBER ZZZZ TOTAL $103.20 THE CITY OF DUB, E City Hall 50 West 131h Street Masterpiece on the Mississippi Dubuque, Iowa 52001 DUBUQUE BANK & TRUST Check No. 398217 DUBUQUE, IOWA PAY ONE HUNDRED THREE DOLLARS AND TWENTY CENTS * * * * * * * * * * * * * * * * * * * * * * * * * * ** TO THE DUBUQUE COUNTY RECORDER ORDER 720 CENTRAL AVE OF DUBUQUE IA 52001 Date 11/19/2013 Amount $103.20 * * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** "3982L?" I:073900535i: 00 OL3 211' OFFER TO BUY REAL ESTATE AND ACCEPTANCE TO: John P. Mihalakis and Richard L. Billmeyer, d /b /a Junnie & Rich's Coin Partnership. SECTION 1. REAL ESTATE DESCRIPTION. The City of Dubuque, Iowa (Buyer) offers to buy real estate in Dubuque County, Iowa, described as follows: Parcel Number 1024216010: LOTS 9 AND 10 OF SMEDLEY'S SUBDIVISION Parcel Number 1024216011: LOT 8 OF SMEDLEY'S SUBDIVISON Parcel Number 1024216012: LOT 7 AND THE NE 'A OF LOT 6 OF SMEDLEY'S SUBDIVISION AND THE NE 14' 8" OF LOT 2 OF LOT 1 OFLOT5OFLOT9OF KNIEST'S SUBDIVISION legal description to be confirmed per continued abstract per Section 9, with any easements and appurtenant servient estates, but subject to the following: a) any zoning and other ordinances; b) any covenants of record; and c) any easements of record for public utilities, roads and highways. SECTION 2. PRICE. The purchase price shall be one hundred thirty thousand dollars ($130,000.00), payable in cash at the Closing. SECTION 3. REAL ESTATE TAXES. Seller shall pay any unpaid real estate taxes payable for fiscal year 2012 -2013 and prior years. Seller shall also pay real estate taxes for fiscal year 2013 -2014 prorated through the date of closing. Buyer shall pay all subsequent real estate taxes after the date of closing. SECTION 4. SPECIAL ASSESSMENTS. Seller shall pay all special assessments, if any, which are a lien as of the date of closing, prorated to the date of closing. SECTION 5. RISK OF LOSS AND INSURANCE. Sellers shall bear the risk of loss or damage to the Real Estate prior to closing or possession, whichever first occurs. Sellers agree to maintain existing insurance and Buyer may purchase additional insurance. In the event of substantial damage or destruction prior to closing, this Agreement shall be null and void; provided, however, Buyer shall have the option to complete the closing and receive insurance proceeds regardless of the extent of damages. The Real Estate shall be deemed substantially damaged or destroyed if it cannot be restored to its present condition on or before the closing date. SECTION 6. CARE AND MAINTENANCE. The Real Estate shall be preserved in its present condition and delivered intact at the time possession is delivered to Buyer, 09182013maq provided, however, if there is loss or destruction of all or any part of the Real Estate from causes covered by the insurance maintained by Seller, Buyer agrees to accept such damaged or destroyed Real Estate together with such insurance proceeds in lieu of the Real Estate in its present condition and Seller shall not be required to repair or replace same. SECTION 7. POSSESSION. If Buyer timely performs all obligations, possession of the Real Estate shall be delivered to Buyer by December 31, 2013, or such earlier date as the parties may agree in writing, with any adjustments of rent, insurance, and interest to be made as of the date of transfer of possession. SECTION 8. FIXTURES. All property that integrally belongs to or is part of the buildings on the Real Estate, whether attached or detached, such as light fixtures, shades, rods, blinds, awnings, windows, storm doors, screens, plumbing fixtures, water heaters, water softeners, automatic heating equipment, wall -to -wall carpeting, built -in items and electrical service cable, outside television towers and antenna, fencing, gates and landscaping shall be considered a part of Real Estate and included in the sale, EXCEPT Seller may keep and remove from the Real Estate the following: (1) The front and back bars located in the tavern area; and (2) The two (2) cast iron bath tubs located in the upstairs apartments. If the buildings located on the Real Estate are deconstructed or demolished, the Seller may keep and remove from the Real Estate the following: (1) The two (2) furnaces located in the tavern area; and (2) The air conditioner located in the tavern area. SECTION 9. ABSTRACT AND TITLE. Seller shall promptly obtain an abstract of title to the Real Estate. At Buyer's expense, the abstract will be continued through the date of acceptance of this offer, and delivered to Buyer for examination. It shall show merchantable title in Seller in conformity with this agreement, Iowa law and Title Standards of the Iowa State Bar Association. The abstract shall become the property of the Buyer when the purchase price is paid in full. Seller shall pay the costs of any additional abstracting and title work due to any act or omission of Seller, including transfers by or the death of Seller or its assignees. SECTION 10. DEED. Upon payment of the purchase price, Seller shall convey the Real Estate to Buyer, by Warranty Deed, free and clear of all liens, restrictions, and encumbrances except as provided in 1(a) through 1(c). Any general warranties of title shall extend only to the time of acceptance of this offer, with special warranties as to acts of Seller continuing up to time of delivery of the deed. SECTION 11. TIME IS OF THE ESSENCE. Time is of the essence in this contract. 2 SECTION 12. REMEDIES OF THE PARTIES. 12.1 If Buyer fails to timely perform this Offer, Seller may forfeit it as provided in the Code of Iowa, and all payments made shall be forfeited or, at Seller's option, upon thirty (30) days written notice of intention to accelerate the payment of the entire balance because of such failure (during which thirty (30) days such failure is not corrected) Seller may declare the entire balance immediately due and payable. Thereafter this Offer may be foreclosed in equity and the Court may appoint a receiver. 12.2 If Seller fails to timely perform this contract, Buyer has the right to have all payments made returned to it. 12.3 Buyer and Seller also are entitled to utilize any and all other remedies or actions at law or in equity available to them and shall be entitled to obtain judgment for costs and attorney fees as permitted by law. SECTION 13. CONTRACT BINDING ON SUCCESSORS IN INTEREST. This Offer shall apply to and bind the successors in interest of the parties. SECTION 14. CONSTRUCTION. Words and phrases shall be construed as in the singular or plural number, and as masculine, feminine or neuter gender, according to the context. SECTION 15. TIME FOR ACCEPTANCE. If this Offer is not accepted by Seller on or before November 18, 2013 it shall become void and all payments shall be repaid to the Buyer. SECTION 16. OTHER PROVISIONS. 16.1 The Offer is subject to final approval of the City Council of the City of Dubuque, Iowa in its sole discretion. If the City Council of the City of Dubuque, Iowa does not approve this Offer, it shall become automatically void and neither party shall be bound by the terms and conditions set forth herein. 16.2 After execution of this Offer by Seller and Buyer and final approval of the City Council of the City of Dubuque, Iowa, Buyer shall deliver a copy of the executed Offer to Buy Real Estate and Acceptance executed by Michael C. Van Milligen, City Manager, along with a copy of the Resolution of the City Council authorizing the purchase of this Real Estate. 16.3 Buyer, its counsel, accountants, agents and other representatives, shall have full and continuing access to the Real Estate and all parts thereof, upon reasonable notice to Seller for the purpose of inspecting, surveying, engineering, test boring, performance of environmental tests and such other work as Buyer shall consider appropriate, provided that Buyer shall hold Seller harmless and fully indemnify Seller against any damage, claim, liability or cause of action arising from or caused by the actions of 3 Buyer, its agents, or representatives upon the Real Estate or the Donated Real Estate (except for any damage, claim, liability or cause of action arising from conditions existing prior to any such entry upon the Real Estate), and shall have the further right to make such inquiries of governmental agencies and utility companies, etc. and to make such feasibility studies and analyses as Buyer considers appropriate. 16.4 Seller warrants that the rights of all tenants shall be terminated by Seller prior to closing and that there will be no tenants whose rights in the Real Estate survive the closing. This covenant shall survive the closing. 16.5 Until ten (10) days prior to closing, Buyer shall have the right to terminate this Offer if environmental issues exist on the Real Estate that Buyer determines in its sole discretion do not permit Buyer to use the Real Estate for its intended use. Prior to terminating this Offer pursuant to this Section, Buyer shall offer Seller the opportunity to remediate the Real Estate to the satisfaction of Buyer in its sole discretion and at Seller's sole cost. 16.6 The Real Estate is sold /purchased "as is" and "with all faults ". THIS OFFER IS ACCEPTED Dated: l�llb /l3 CITY OF DUBUQUE, IOWA By: Micha6l C. Van Milligen City Manager 4 Dated: // By: ohn P. Mihalakis Junnie & Rich's Coin Partnership By: Richard L. Billmeyer Junnie & Rich's Coin Partnership ACKNOWLEDGMENT OF VOLUNTARY NEGOTIATION AND PURCHASE OF PROPERTY Project: Bee Branch Restoration and Gateway Project Parcel Numbers: 1024216010, 1024216011, and 1024216012 As owner(s) of real estate needed for the above referenced project and parcel, we acknowledge this is a voluntarily negotiated purchase by the City of Dubuque, Iowa under Section 6B.1A of the Code of Iowa, and is not an acquisition by the City of Dubuque, Iowa through an exercise of the power of eminent domain under Chapter 6B of the Code of Iowa. This voluntarily negotiated sale to the City of Dubuque, Iowa was made without any coercive action of any nature. Joh . Mihalakis, Junnie &.Rich's Coin Partnership Date ichard L. Billlmeyer, Junnie HELEN A. G!LE T ? Commission Number 760388 My Comm. Exp. lD I3 090/. ch's Coin Partnership Date CLi Notary Public in and for Du p que County, Iowa Closing Statement Buyer: The City of Dubuque, Iowa Seller: Junnie and Rich's Coin Partnership John P. Mihalakis and Richard L. Billmeyer Property: 427 -429 Rhomberg Avenue, Dubuque, IA 52001 Closing Date: 11/20/2013 Purchase Price Down Payment Balance Due at Closing Seller's Expenses: Transfer Tax: Corporation Parcel Tenants in Common Parcel Real Estate Taxes: P.I.N. 1024216011 1st 1/2 2012 -2013 2nd 1/2 2012 -2013 1st 1/2 2013 -2014 (7/1/2013 - 11/20/2013) ($138.00/365 days = $0.38 *143 days) P.I.N. 1024216012 1st 1/2 2012 -2013 2nd 1/2 2012 -2013 1st 1/2 2013 -2014 (7/1/2013 - 11/20/2013) ($192.00/365 days = $0.53 *143 days) P.I.N. 1024216010 1st 1/2 2012 -2013 2nd 1/2 2012 -2013 1st 1/2 2013 -2014 (7/1/2013 - 11/20/2013) ($2,762.00/365 days = $7.65 *143 days) Total Seller's Expenses: Net Proceeds to Seller from sale of 427 -429 Rhomberg Avenue Checks from Buyer for Closing: Dubuque County Recorder's Office Real Estate Transfer Taxes Corporation Parcel Tenants in Common Parcel Check payable to Junnie & Rich's Coin Partnership have reviewed the Closing Statement and agree to the above disbursements. $130,000.00 $0.00 $130,000.00 $103.20 $103.20 $69.00 $69.00 $54.07 $96.00 $96.00 $75.22 $1,381.00 $1,381.00 $1,094.09 $4,521.78 $125,478.22 $103.20 $103.20 $125,478.22 ,,P , L 4 c z , .,' ' John P. Mihala is ichard L. Billmeyer it/24/2015 Date Date City of Dubuque CHECK NO 398219 AMOUNT $125,478.22 VENDOR 7900 JUNNIE & RICH'S COIN PARTNERSHIP CHECK DATE 11/19/2013 Activity /Project Account Purchase Order Invoice No Amount Description 7201654 73111 427 -429 RHO $125,478.22 PURCHASE OF 427 -429 RHOMBERG ZZZZ TOTAL $125,478.22 THE CITY OF DUB Masterpiece on the Mississippi PAY ONE HUNDRED TWENTY FIVE THOUSAND FOUR HUNDRED SEVENTY EIGHT DOLLARS AND 22/100 * * * * * * ** DUBUQUE BANK & TRUST DUBUQUE, IOWA City Hall 50 West 13th Street Dubuque, Iowa 52001 Check No. 398219 Date 11/19/2013 Amount $125,478.22 TO THE JUNNIE & RICH'S COIN PARTNERSHIP ORDER 2095 KERPER BLVD OF DUBUQUE IA 52001 -3669 Security feature a 03982190 I:07390053Si: 00 OL3 2u' 111111 ruuii lllIlIl IIIIOIIII IIIII11I'V Ni Doc ID: 007857110004 Type: GEN Kind DEED WITH RESOLUTION Recorded: 11/26/2013 at 02:34 :43 PM Fee Amt: $135.20 Pape 1 of 4 Revenue Tax: $103.20 Dubuque County Iowa Kathy Flynn Thurlow Recorder F11e2013- 00018323 ©THE IOWA STATE BAR ASSOCIATION Official Form No. 101 - August 2013 Maureen A. Quann FOR THE LEGAL EFFECT OF THE USE OF THIS FORM, CONSULT YOUR LAWYER Return To: Maureen A. Quann, Suite 330 300 Main Street, Dubuque. IA 52001 (563) 589 -4381 Preparer: Maureen A. Quann. Suite 330 300 Main Street. Dubuque. IA 52001 (563) 589 -4381 Taxpayer: City of Dubuque, Iowa, 50 West 1_3th Street Dubuque, IA 52001 5TA1-, WARRANTY DEED ociA18.° For the consideration of Sixty -five thousand ($652000.00) Junnie & Rich's Coin Partnership, a Partnership Dollar(s) and other valuable consideration, do hereby Convey to City of Dubuque, Iowa the following described real estate in Dubuque County, Iowa: Northeasterly 1/2 of Lot 6, lot 7, and Lot 8, in Smedley's Subdivision; and the Northeasterly 14 feet 8 inches of Lot 2 of Lot 1 of Lot 5 of Lot 9 in Kniest's Subdivision of Part of Mineral Lot 314; in the City of Dubuque, Iowa, according to the recorded plats thereof Grantors do Hereby Covenant with grantees, and successors in interest, that grantors hold the real estate by title in fee simple; that they have good and lawful authority to sell and Convey the real estate; that the real estate is free and clear of all liens and encumbrances except as may be above stated; and grantors Covenant to Warrant and Defend the real estate against the lawful claims of all persons except as may be above stated. 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 numbe , and as masculine or feminine gender, according to the context. Dated: 20 2013 Richard L. Billmeyer, STATE F IOWA , COUNTY OF Dubuque Thi record was acknowledged before me this day of , by John P. Mihalakis, A Partner, and Richard L. Billmeyer, A Partner rantor) MAUREEN A. QUANN Commission Numb g r 765 My Comm. Exp. Signature of No y Public (This form of acknowledgment for individual grantor(s) only) RESOLUTION NO. 327 -13 RESOLUTION APPROVING THE ACQUISITION OF REAL ESTATE OWNED BY JOHN P. MIHALAKIS AND RICHARD L. BILLMEYER, D /B /A JUNNIE & RICH'S COIN PARTNERSHIP, IN THE CITY OF DUBUQUE Whereas, the City of Dubuque intends to acquire certain real estate located immediately adjacent to the area of the Bee Branch Creek Restoration Project for stormwater mitigation activities as recommended in the 2001 "Drainage Basin Master Plan "; and Whereas, this certain real estate is not currently part of or located within the Bee Branch Creek Restoration Project; and Whereas, the owners of this certain real estate approached the City of Dubuque voluntarily and proposed that the City of Dubuque acquire the property for possible future addition to, but not currently as part of, the Bee Branch Creek Restoration Project; and Whereas, the acquisition of this real estate is a voluntarily negotiated purchase by the City of Dubuque under Section 6B.1A of the Code of Iowa, and is not an acquisition by the City of Dubuque through its exercise of the power of eminent domain under Chapter 6B of the Code of Iowa; and Whereas, a purchase agreement has been finalized with the owners of the real estate scheduled for acquisition and an Acknowledgment of Voluntary Negotiation has been executed by the owner. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the City of Dubuque, Iowa hereby approves the acquisition of the following legally described real estate: LOTS 9 AND 10 of SMEDLEY'S SUBDIVISION LOT 8 OF SMEDLEY'S SUBDIVISON LOT 7 AND THE NE % OF LOT 6 OF SMEDLEY'S SUBDIVISION AND THE NE 14' 8" OF LOT 2 OF LOT 1 OF LOT 5 OF LOT 9 OF KNIEST'S SUBDIVISION at the cost of One Hundred Thirty Thousand and 00/100 Dollars ($130,000.00). Section 2. That the City of Dubuque be and is hereby authorized to accept a Warranty Deed from the owners, conveying the owner's interest to the City of Dubuque, Iowa for the herein described real estate. Section 3. That the City Clerk be and is hereby authorized and directed to cause said Warranty Deed to be recorded in the office of the Dubuque County Recorder, together with a certified copy of this Resolution. Section 4. That the City Clerk be and is hereby directed to forward a copy of this Resolution to the Dubuque County Assessor and the Dubuque County Auditor. Passed, approved and adopted this 18th day of November, 2013. 1 di Attest: Kevin S(Firnstahl, City Cler Roy D. iol, Mayor STATE OF IOWA CERTIFICATE of the CITY CLERK SS: COUNTY OF DUBUQUE ) I, Kevin S. Firnstahl, do hereby certify that I am the duly appointed, qualified, City Clerk of the City of Dubuque, Iowa, in the County aforesaid, and as such City Clerk, I have in my possession or have access to the records of the proceedings of the City Council. I do further state that the hereto attached Resolution No. 327 -13 is a true and correct copy of the original. In Testimony Whereof, I hereunto set my hand and official seal of the City of Dubuque, Iowa. Dated at Dubuque, Iowa, on this 19th day of November, 2013. Kev S. Firnstahl, CMS;, City Clerk n V III 11 11 I II r11i 11 1111 11 Doc ID 007857120002 Type: GWH Kind GROUNDWATER HAZARD Recorded: 11/26/2013 at 02:35:05 PM Fee Amt: $0.00 Page 1 of 2 Dubuque County Iowa Kathy Flynn Thurlow Recorder Fi1e2013- 00002056 REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name Junnie & Rich's Coin Partnership, A Partnership Address 2095 Kerper Boulevard Dubuque Iowa 52001 Number and Street or RR City, Town or P.O. State Zip TRANSFEREE: Name City of Dubuque, Iowa Address 50 West 13th Street Dubuque Iowa 52001 Number and Street or RR City, Town or P.O. State Zip Address of Property Transferred: 427 -429 Rhomberg Avenue Dubuque Iowa 52001 Number and Street or RR City, Town or P.O. State Zip Legal Description of Property: (Attach if necessary) Northeasterly 1/2 of Lot 6, Lot 7, and Lot 8, in Smedley's Subdivision; and the Northeasterly 14 feet 8 inches of Lot 2 of Lot 1 of Lot 5 of Lot 9 in Kniest's Subdivision of Part of Mineral Lot 314; in the City Of Dubuque, Iowa, according to the recorded plats thereof 1. Wells (check one) X 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) X 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) X 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) X 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) 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) 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. _ 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 AND THAT THE INFORMATION STATED ABOVE IS TRUE AND CORRECT. Signature: ransferor or Agen FILE WITH RECORDER Telephone No.: 3'7 42 / 3 DNR form 542 -0960 (July 18, 2012) in 11 IIMII 111 111 111111 uii Doc ID. 007857130005 Type GEN Kind DEED WITH RESOLUTION Recorded: 11/26/2013 at 02 :35:37 PM Fee Amt: $135.20 Page 1 of 5 Revenue Tax: $103.20 Dubuque County Iowa Kathy Flynn Thurlow Recorder F11e2013- 00018324 t. ST^r� WARRANTY DEED O (Several Grantors) THE IOWA STATE BAR ASSOCIATION t Official Form No. 102 sOcp :Is- Recorder's Cover Sheet Preparer Information: (Name, address and phone number) Maureen Q. Quann, 300 Main Street, Ste 330„ Dubuque, IA 52001, Phone: (563) 589 -4381 Taxpayer Information: (Name and complete address) City of Dubuque, Iowa, 50 West 13th Street, Dubuque, IA 52001 Return Document To: (Name and complete address) City of Dubuque, Iowa, 50 West 13th Street, Dubuque, IA 52001 Grantors: John P. Mihalakis Richard L. Billmeyer Grantees: City of Dubuque, Iowa Legal description: See Page 2 Document or instrument number of previously recorded documents: © The Iowa State Bar Association 2005 IOWADOCSO THE IOWA STATE BAR ASSOCIATION Official Form No. 102 Maureen A. Quann FOR THE LEGAL EFFECT OF THE USE OF THIS FORM, CONSULT YOUR LAWYER 5TArF N A • 0 1;1 O(I For the consideration of Sixty -five thousand ($65,000.00) Dollar(s) and other valuable consideration, John P. Mihalakis, an undivided 3 /5th interest, and Richard L. Billmeyer, an undivided 2 /5th interest, as tenants in common WARRANTY DEED (Several Grantors) do hereby Convey to City of Dubuque, Iowa the following described real estate in Dubuque County, Iowa: Lots 9 and 10 in Smedley's Subdivision, being a Subdivision of Lots 6, 7 and 8 and the South 100 feet of Lot 5 of Kneist's Subdivision in the City of Dubuque, Iowa, according to the recorded plat thereof Grantors do Hereby Covenant with grantees, and successors in interest, that grantors hold the real estate by title in fee simple; that they have good and lawful authority to sell and convey the real estate; that the real estate is free and clear of all liens and encumbrances except as may be above stated; and grantors Covenant to Warrant and Defend the real estate against the lawful claims of all persons except as may be above stated. 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: November 20, 2013 (Grantor) (Grantor) (Grantor) (Grantor) (Grantor) STATE OF IOWA , COUNTY OF DUBUQUE This instrument was acknowledged before me on November 20 , 2013 by John P. Mihalakis, owner of an undivided 3 /5th interest, and Richard L. Billmeyer, owner of an undivided 2 /5th interest, as tenants in common MAUREEN A_ QUANN Commission Number 769401 My Comm. Exp. _ Maureen A. Quann , Notary Public © The Iowa State Bar Association 2005 IOWADOCS® 102 WARRANTY DEED (SEVERAL GRANTORS) Revised June 2005 RESOLUTION NO. 327-13 RESOLUTION APPROVING THE ACQUISITION OF REAL ESTATE OWNED BY JOHN P. MIHALAKIS AND RICHARD L. BILLMEYER, D /B /A JUNNIE & RICH'S COIN PARTNERSHIP, IN THE CITY OF DUBUQUE Whereas, the City of Dubuque intends to acquire certain real estate located immediately adjacent to the area of the Bee Branch Creek Restoration Project for stormwater mitigation activities as recommended in the 2001 "Drainage Basin Master Plan "; and Whereas, this certain real estate is not currently part of or located within the Bee Branch Creek Restoration Project; and Whereas, the owners of this certain real estate approached the City of Dubuque voluntarily and proposed that the City of Dubuque acquire the property for possible future addition to, but not currently as part of, the Bee Branch Creek Restoration Project; and Whereas, the acquisition of this real estate is a voluntarily negotiated purchase by the City of Dubuque under Section 6B.1A of the Code of Iowa, and is not an acquisition by the City of Dubuque through its exercise of the power of eminent domain under Chapter 6B of the Code of Iowa; and Whereas, a purchase agreement has been finalized with the owners of the real estate scheduled for acquisition and an Acknowledgment of Voluntary Negotiation has been executed by the owner. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. That the City of Dubuque, Iowa hereby approves the acquisition of the following legally described real estate: LOTS 9 AND 10 of SMEDLEY'S SUBDIVISION LOT 8 OF SMEDLEY'S SUBDIVISON LOT 7 AND THE NE 1/ OF LOT 6 OF SMEDLEY'S SUBDIVISION AND THE NE 14' 8" OF LOT 2 OF LOT 1 OF LOT 5 OF LOT 9 OF KNIEST'S SUBDIVISION at the cost of One Hundred Thirty Thousand and 00 /100 Dollars ($130,000.00). Section 2. That the City of Dubuque be and is hereby authorized to accept a Warranty Deed from the owners, conveying the owner's interest to the City of Dubuque, Iowa for the herein described real estate. Section 3. That the City Clerk be and is hereby authorized and directed to cause said Warranty Deed to be recorded in the office of the Dubuque County Recorder, together with a certified copy of this Resolution. Section 4. That the City Clerk be and is hereby directed to forward a copy of this Resolution to the Dubuque County Assessor and the Dubuque County Auditor. Passed, approved and adopted this 18th day of November, 2013. Roy D. oI, Mayor Attest: e'r} rffffl; AtIPispitfr Kevin S /rirnstahl, City Cler STATE OF IOWA CERTIFICATE of the CITY CLERK SS: COUNTY OF DUBUQUE ) I, Kevin S. Firnstahl, do hereby certify that I am the duly appointed, qualified, City Clerk of the City of Dubuque, Iowa, in the County aforesaid, and as such City Clerk, I have in my possession or have access to the records of the proceedings of the City Council. I do further state that the hereto attached Resolution No. 327 -13 is a true and correct copy of the original. In Testimony Whereof, I hereunto set my hand and official seal of the City of Dubuque, Iowa. Dated at Dubuque, Iowa, on this 21st day of November, 2013. Kevi(i S. 'Firnstahl, CM ,-City Clerk 1111 i i i 111111111111111111111111111111111111111111111111111111111111111111111111 Doc ID. 007857140002 Type GWH Kind GROUNDWATER HAZARD Recorded: 11/26/2013 at 02:35:49 PM Fee Amt: $0.00 Pape 1 of 2 Dubuque County Iowa Kathy Flynn Thurlow Recorder Fi1e2013- 00002057 REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name John P. Mihalakis and Richard P. Billmeyer Address 2095 Kerper Boulevard Dubuque Iowa 52001 Number and Street or RR City, Town or P.O. State Zip TRANSFEREE: Name City of Dubuque, Iowa Address 50 West 13th Street Dubuque Iowa 52001 Number and Street or RR City, Town or P.O. State Zip Address of Property Transferred: 427 -429 Rhomberg Avenue Dubuque Iowa 52001 Number and Street or RR City, Town or P.O. State Zip Legal Description of Property: (Attach if necessary) Lots 9 and 10 in Smedley's Subdivision, being a Subdivision of Lots 6, 7 and 8 and the South 100 feet of Lot 5 Kniest's Subdivision in the City of Dubuque, Iowa 1. Wells (check one) X 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) X 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) X 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) X 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) 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) 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) X All buildings on this property are served by a public or semi - public sewage disposal system. _ 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 AND THAT THE INFORMATION STATED ABOVE IS TRUE AND CORRECT. Signature: g .:la Telephone No.: e' (Transferor or Ag^ FILE WITH RECORDER DNR form 542 -0960 (July 18, 2012)