Vacate 640 & 650 Kane_T. Schmitt request
DU~~E
~<k~
MEMORANDUM
December 11, 2006
TO:
The Honorable Mayor and City Council Members
FROM:
Michael C. Van Milligen, City Manager
SUBJECT: Vacating Petition - Unnamed Street between 640 and 650 Kane Street
In response to a request from Tim Schmit II to vacate an unnamed street between 640
and 650 Kane Street, City Engineer Gus Psihoyos states that the City has no plans for
the utilization of the unnamed street between 640 and 650 Kane Street and that no
public utilities exist in this parcel. City Engineer Gus Psihoyos recommends approval of
the request to vacate and that a public hearing be set for January 3, 2007. Three
abutting properties owners, Irene Schueller, Roger Lindecker and Tim Schmit II will
each purchase a portion of the property being vacated, and it is recommend that the
purchase price be established at $300 for each, plus surveying, platting, publication and
filing fees.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
(llt,A ~V~1,;lk(/
Micnael C. Van Milligen
MCVM/jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Gus Psihoyos, City Engineer
Dt;~~E
~c/k.~
MEMORANDUM
December 7,2006
FROM:
Michael C. Van Milligen, City MaC~~JY)/'"
Gus Psi hoyos, City Engineer .<J L. .
TO:
SUBJECT: Vacating Petition - Unnamed Street between 640 and 650 Kane Street
INTRODUCTION
A request has been received from Tim Schmit II for the vacating of an unnamed street
between 640 and 650 Kane Street.
DISCUSSION
The area to be vacated is divided into three lots numbered Lots 4A, 4B, and 4C of Kieffer
Place in the City of Dubuque, Dubuque County, Iowa. These lots comprise the existing 40-foot
wide right-of-way on which no public utilities exist.
Currently this right-of-way is used as a portion of a paved drive for 640 Kane, a gravel drive for
650 Kane, some lawn area, and steep wooded hillside. Irene Schueller will retain a small
triangular-shaped lot which encompasses her existing driveway. Richard Wieser, at 611
Kaufmann Avenue, was not interested in his portion of the area to be vacated. Roger
Lindecker at 615 Kaufmann Avenue will purchase half of the right-of-way abutting his lot. The
remainder will go to Mr. Schmit.
Because of the rough terrain and possible future maintenance expenses for the City, a
purchase price of $300 for each lot, plus surveying, platting, publication, and filing fees as
agreed upon with the parties involved.
RECOMMENDATION
I would recommend that this unnamed street between 640 and 650 Kane Street, as shown 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 January 3, 2007. I would further recommend that the purchase
price be established at $300 for each lot, plus surveying, platting, publication and filing fees.
ACTION TO BE TAKEN
The recommendation of the City Manager should be approved and a public hearing should be
set on the disposal of the property through the adoption of the enclosed resolution.
Prepared by Ronald J. Turner, PLS
RESOLUTION NO.
RESOLUTION OF INTENT TO VACATE AND DISPOSE OF AN
UNNAMED STREET BETWEEN 640 AND 650 KANE STREET IN THE
CITY OF DUBUQUE, DUBUQUE COUNTY, IOWA
Whereas, Tim Schmit II has requested the vacating and disposal of an
unnamed street between 640 and 650 Kane Street; and
Whereas, Buesing & Associates, Inc., has prepared and submitted to the
City Council a plat showing the vacated unnamed street between 640 and 650
Kane Street and assigned lot numbers thereto, which hereinafter shall be known
and described as Lots 4A, 4B and 4C of Kieffer Place 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 vacate and dispose of
its interest in Lots 4A, 4B and 4C of Kieffer Place in the City of Dubuque,
Dubuque County, Iowa.
Section 2. That the conveyance of Lot 4A of Kieffer Place in the City of
Dubuque, Dubuque County, Iowa to Irene H. Schueller be contingent upon the
payment of $300, plus surveying, platting, publication and filing fees.
Section 3. That the conveyance of Lot 4B of Kieffer Place in the City of
Dubuque, Dubuque County, Iowa to Timothy J. Schmit, II aka Timothy J. Schmit,
Jr., be contingent upon the payment of $300, plus surveying, platting, publication
and filing fees. .
Section 4. That the conveyance of Lot 4C of Kieffer Place in the City of
Dubuque, Dubuque County, Iowa to Roger H. Lindecker be contingent upon the
payment of $300, plus surveying, platting, publication and filing fees.
Section 5. That the City Clerk be and is hereby authorized and directed
to cause a notice of intent to vacate and dispose of said real estate to be
published in the manner as prescribed by law.
Passed, approved and adopted this
day of
,2006.
Roy D. Buol, Mayor
Attest:
Jeanne F. Schneider, CMC, City Clerk
RESOLUTION NO. 602-05
RESOLUTION OF INTENT TO VACATE AND DISPOSE OF AN
UNNAMED STREET BETWEEN 640 AND 650 KANE STREET IN THE
CITY OF DUBUQUE, DUBUQUE COUNTY, IOWA
Whereas, Tim Schmit II has requested the vacating and disposal of an
unnamed street between 640 and 650 Kane Street; and
Whereas, Buesing & Associates, Inc., has prepared and submitted to the
City Council a plat showing the vacated unnamed street between 640 and 650
Kane Street and assigned lot numbers thereto, which hereinafter shall be known
and described as Lots 4A, 4B and 4C of Kieffer Place 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 vacate and dispose of
its interest in Lots 4A, 4B and 4C of Kieffer Place in the City of Dubuque,
Dubuque County, Iowa.
Section 2. That the conveyance of Lot 4A of Kieffer Place in the City of
Dubuque, Dubuque County, Iowa to Irene H. Schueller be contingent upon the
payment of $300, plus surveying, platting, publication and filing fees.
Section 3. That the conveyance of Lot 46 of Kieffer Place in the City of
Dubuque, Dubuque County, Iowa to Timothy J. Schmit, II aka Timothy J. Schmit,
Jr., be contingent upon the payment of $300, plus surveying, platting, publication
and filing fees.
Section 4. That the conveyance of Lot 4C of Kieffer Place in the City of
Dubuque, Dubuque County, Iowa to Roger H. Lindecker be contingent upon the
payment of $300, plus surveying, platting, publication and filing fees.
Section 5. That the City Clerk be and is hereby authorized and directed
to cause a notice of intent to vacate and dispose of said real estate to be
published in the manner as prescribed by law.
Passed, approved and adopted this 18th day of December , 2006.
Roy D. Buol, Mayor
Attest:
Jeanne F. Schneider, CMC, City Clerk
VACATE UNNAMED STREET BETWEEN
~ 640 & 650 KANE ST.
NORTH VICINITY MAP
~
GRAPHIC SCALE
200 100 0 100
~I
200
I
DRAWING MAY HAVE BEEN REDUCED
1 INCH'" 200 FEET
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of Survey: LOTS 4A, 48
KIEFFER PLACE
In the City of Dubuque,
PREPARED BY: BUESING & ASSOCIATES
Plat
ADDRESS: 1212 LOCUST STREET DUBUQUE IOWA
PHONE: 563 556-4389
OF
THE VACATED 4Q-FQOT WIDE ALLEY LYING SOUTHERLY OF AND ADJACENT TO LOT 1-2 OF THE SUBDIVISION OF
1-159 & 2-2-159 OF l.H. LANG'S ADDITION IN THE CITY OF DUBUOUE. IOWA
fOUND ,. IRON PIPE
(uNLESS NOTED OTHERWISE)
fOUND 518" IRON REROD wIRED
PL....STIC CAP MARKED "9651"
PLACED 5/8" IRON REROO W!ORANG(
PLASTIC CAP MARKED "KOELKER 15487"
SURVEYED BOUNDARY LINE
PROPERTY LINE
- - - -- CENTER LINE
_ _ _R.Q!_ _ RIGHT OF WAY
() RECORD DIMENSION
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N 85"0.3'2.3" W
50.11'
lOT 4C
KIEFFER PlAC
50. OJ' (So.OO")
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SCALE: 1" = 40'
and
4C,
Iowa
LOT 1-2 OF SUB. OF 1-159 &: 2-2-159
OF L H. LANGWORTHY'S ADDITION
5 85"03'23"
E 218..3.3' (2.32.00')
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LOT 48 OF KIEFFER PLACE
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N 87"52'2r E 109.83'
57.a.' (59.72')
N 85"03'2.3" w 218.02
(217.92')
110.15' (110.00')
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lOT 4A
KIEFFER PLACE
LOT 4
KIEFFER PLACE
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ARF A SUMMARY:
lOT 4A
lOT 48
lOT 4C
TOTAL
745 SQ. FT.
6981 SQ, FT.
1 001 SQ. FT.
8727 SQ. FT
NOTES
I
80'
1. ALL MEASUREMENTS ARE IN FEET AND DECIMALS THEREOF.
2. PROPRIETOR OF LOTS: CITY OF' DUBUQUE
.3. SURVEYED REQUESTEO BY: T1I1AOTHY SCHMIT
ADDRESS: 650 KANE ST., DUBUQUE, IOWA 52001
4. THIS PLAT 15 SUBJECT TO ALL EASEMENTS OF RECORD
AND NOT OF RECORD.
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! 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 AIol A OUl Y
EO LAND VEYOR UNDER THE LAWS OF TH ST"TE OF IOWA.
/.. /I 2. D(;.
TERRY _ KOElKER (DATE)
LICENSE NUMBER 15487
WV LICENSE RENEWAL DATE IS OECEIolBER 31, 2007
alJ~~'},tilG
~IiCINI~RS AND SU/f"~J'BRS
1212lOCUSTST,OUIItIQu(.,lO.
(!I63J566-438l1
DRAWN BY: JJL CHECKED BY: TU<
SUR~Y DATE: 10/IB/06 PLOT DATE: 11/20/015
owe;. NO. 06215 01 SCALE: ," .. 40'
SHEETS COVERED BY THIS SEAL:
SHEEr 1 &: 2
SHEET 1 OF 5
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Prepared by: Ronald J. Turner, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa (563) 589-4270
Address Tax Statement: Roger H. Lindecker, 615 Kaufmann Avenue, Dubuque, IA 52001
QUIT CLAIM DEED
The City of Dubuque, Iowa, a municipal corporation of Dubuque County, Iowa, for Three Hundred
and 00/100 Dollars ($300.00) and other good and valuable consideration, does hereby Quit Claim
unto:
Roger H. Lindecker
615 Kaufmann Avenue
Dubuque, IA 52001
all its rights, title, and interest in the following described real estate situated in Dubuque County,
Iowa, to wit:
Lot4C of Kieffer Place, in the City of Dubuque, Dubuque County, Iowa
No declaration of value is required according to Iowa Code Section 428A.1.
Deeds with a consideration of $500.00 or less are exempt from transfer tax. Iowa Code Sec.
428A.1.
This deed is given pursuant to the authority of Resolution No. of the City of Dubuque,
adopted ,2007, the terms and conditions thereof, if any, having been fulfilled.
Signed this
day of
,2007.
CITY OF DUBUQUE, IOWA
By:
Roy D. Buol, Mayor
Alles!:
By:
Jeanne F. Schneider, CMC, City Clerk
STATE OF IOWA
DUBUQUE COUNTY
)
) ss
)
On this _ day of , 2007, before me, the undersigned, a Notary Public in
and for the State of Iowa, personally appeared Roy D. Buol 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 Councii under Resolution No. _ of the City Council on the _ day of
, 2007; and Roy D. Buol and Jeanne F. Schneider acknowledged the execution of
the instrument to be their voiuntary act and deed and the voluntary act and deed of the
corporation, by it voluntarily executed.
Notary Public In and For Said State
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
TRANSFEROR Name City of Dubuoue
Address 50 W. 13th Street
Number and Street or RR
Dubuaue. JA 52001
City, Town or P_O
Slale
Zip
TRANSFEREE Name R02:cr H. Lindecker
Address 615 Kaufmann A venue
NumberandStreetorRR
Duhuaue.IA 52001
City, TownorP,Q
State
Zip
Address of Property Transferred
NA
NumberandStreetorRR
CIty, lown,orP,O
State
Zip
Legal Description of Property Lot 4C of Kieffer Place in the City ofDubuaue. Dubuaue Countv.Iowa
I. 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.
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, but no notice has been received from the Department of Natural Resources that the
site is deemed to be potentially hazardous.
1 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)
X 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)
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.)
i There is an underground storage tank on this property. The type(s), size(s) and any known substance(s) contained are described below.
S. Private Burial Site (check one)
X There are no known private burial sites on this property.
1-: 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 IN 1fso, number of pages
I HEREBY DECLAR" TH~FORMA nON CONTAINED IN PART I OF THIS STATEMENT IS TRUE AND CORRECT.
Signature: j~ -~ _ Telephone Number: (563) 589-4270
Trans r or Agent us SI oyos, Ity Engmeer
______~_~~__________w__.__________~__~___~__w__w_____w__w_____________~__w__w__w____w__w____________w__~___w__w__w__w______w__w__._____~__~__w__w__w_________._______w_----
PART II - TO BE COMPLETED BY RECORDER
Date of Instrument
Book/J.D.
Page/J.D.
Date of Recording
City or Township
Deed !-
Contract I]
County
__~_____________________________~_____________________________~__w_________________________~_____w____________w__w_____________________________________.__~_________-----.-
DNR form (November 02)
FILE WITH RECORDER
542-0960
Prepared by: Ronald J. Turner, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa (563) 589-4270
Address Tax Statement: Timothy J. Schmit, II aka Timothy J. Schmit, Jr., 650 Kane Street, Dubuque, IA
52002
QUIT CLAIM DEED
The City of Dubuque, Iowa, a municipal corporation of Dubuque County, Iowa, for Three Hundred
and 00/100 Dollars ($300.00) and other good and valuable consideration, does hereby Quit Claim
unto:
Timothy J. Schmit, II aka Timothy J. Schmit, Jr.
650 Kane Street
Dubuque, IA 52002
all its rights, title, and interest in the following described real estate situated in Dubuque County,
Iowa, to wit:
Lot4B of Kieffer Place, in the City of Dubuque, Dubuque County, Iowa
No declaration of value is required according to Iowa Code Section 428A.1.
Deeds with a consideration of $500.00 or less are exempt from transfer tax. Iowa Code Sec.
428A. 1.
This deed is given pursuant to the authority of Resolution No. of the City of Dubuque,
adopted ,2007, the terms and conditions thereof, if any, having been fulfilled.
Signed this
day of
,2007.
CITY OF DUBUQUE, IOWA
By:
Roy D. Buol, Mayor
Allest:
By:
Jeanne F. Schneider, CMC, City Clerk
STATE OF IOWA
DUBUQUE COUNTY
)
) ss
)
On this _ day of , 2007, before me, the undersigned, a Notary Public in
and for the State of Iowa, personally appeared Roy D. Buol 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
, 2007; and Roy D. Buol 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
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
TRANSFEROR Name City of Dubuque
Address 50 W. 13th Street
~umberandStreelorRR
Dubunue IA 52001
City, TownorP,Q
Slate
^'p
TRANSFEREE Name Timothv J.Schmit. II aka Timothv J. Schmit. Jr.
Address 650 Kane Street
Number and Slreel or RR
Dubuque. IA 52002
City, TownorPO
State
Z'p
Address of Property Transferred
NA
Number and Street or RR
CIty, lown,orP,U
Stllte
Zip
Legal Description of Property Lot 48 of Kieffer Place in the City of Dubuaue. Dubuaue County. Iowa
1. Wells (eheek one)
X There are no known wells situated on this property.
i. 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)
X 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.
, 1 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)
X 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)
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 described 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) ofthe 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 I N If so, number of pages
I HEREBY DECLARr)~ \T'THE INF RQ^TION CONTAINED IN PART I OF THIS STATEMENT IS TRUE AND CORRECT.
Signature: '-- 7. -- - ~ Telephone Number: (563) 589-4270
\ J ranSl~or o~ gent) uus t"SlnOYos, CityJ:Oilgmeer
n_~~___n__~_~_______n_______~_~__~____________~___________~~_~_________________________~~____n_n________n________n__~__~~______________________n__~~_~~__n__n_n_
PART II - TO BE COMPLETED BY RECORDER
Date of Instrument
Book/J.D.
Page/J.D.
Date of Recording
City or Township
Deed '-I
Contract ::J
County
n_~~_~__~________________________~____________________~__~___________~____________n_______________~____________________________~________________________________~_-------
DNR form (November 02)
FILE WITH RECORDER
542-0960
Prepared by: Ronald J. Turner, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa (563) 589-4270
Address Tax Statement: Irene H. Schueller, 640 Kane Street, Dubuque, IA 52001
QUIT CLAIM DEED
The City of Dubuque, Iowa, a municipal corporation of Dubuque County, Iowa, for Three Hundred
and 00/100 Dollars ($300.00) and other good and valuable consideration, does hereby Quit Ciaim
unto:
Irene H. Schueller
640 Kane Street
Dubuque, IA 52001
all its rights, title, and interest in the fOllowing described real estate situated in Dubuque County,
Iowa, to wit:
Lot4A of Kieffer Place, in the City of Dubuque, Dubuque County, Iowa
No deciaration of value is required according to Iowa Code Section 428A.1.
Deeds with a consideration of $500.00 or less are exempt from transfer tax. Iowa Code Sec.
428A.1.
This deed is given pursuant to the authority of Resolution No. of the City of Dubuque,
adopted ,2007, the terms and conditions thereof, if any, having been fulfilled.
Signed this
day of
,2007.
CITY OF DUBUQUE, IOWA
By:
Roy D. Buol, Mayor
Allest:
By:
Jeanne F. Schneider, CMC, City Clerk
STATE OF IOWA
DUBUQUE COUNTY
)
) ss
)
On this _ day of , 2007, before me, the undersigned, a Notary Public in
and for the State of Iowa, personally appeared Roy D. Buol and Jeanne F. Schneider, to me
personally known, who being by me duiy 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 seai 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
, 2007; and Roy D. Buol 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
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
TRANSFEROR Name Citv of Dubuque
Address 50 W. 13th Street
NumberalldStreetorRR
Dubuque.IA 52001
Clly, TownorP,Q
~tate
Z'p
TRANSFEREE Name Irene H. Schueller
Address 640 Kane Street
NumberandStreetorRR
Dubuque.IA 52001
City, Town or P.O.
State
ZIp
Address of Property Transferred
NA
Number and Street or RR
Clty,lown,orP,U
State
ZIp
Legal Description of Property Lot 4A of Kieffer Place in the City ofDubuaue Dubuaue County. Iowa
I. Wells (check one)
X There are no known wells situated on this property.
I 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)
X There is no known solid waste disposal site on this property.
I' 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)
X 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)
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 described 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:
Attachment for Additional Information? Y I N If so, number of pages
I HEREBY DECLARE TJi'}if~E INFO~~T10N CONTAINED IN PART I OF THIS STATEMENT IS TRUE AND CORRECT.
Signature: , /Y'J ~ ~~ Telephone Number: (563) 589-4270
(TranslerororAgent) uusPslhoyos, CltyEngmeer
PART II - TO BE COMPLETED BY RECORDER
Date of Instrument
Bookll.D.
Page/l.D.
Date of Recording
City or Township
Deed ;J
Contract :--1
County
DNR form (November 02)
FILE WITH RECORDER
542-0960