English Mill Road_English Ridge Subd_Grant of Easement_Access and Water Main UtilityTHE CITY OF
Dui
Masterpiece on the Mississippi
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
Dubuque
band
AI -America City
r
2007 • 2012 • 2013
SUBJECT: City Acquisition of Property and Easements - Lots B and A of English
Ridge Subdivision No. 5
CIP 7402504 English Mill Water Main Extension
DATE: August 25, 2014
Larry McDermott is the owner and developer of the English Ridge Subdivision. A
request has been made to extend water utilities from the current dead end, Stone Valley
Drive, to English Mill Road and west to North Cascade Road. Typically, it would be the
developer's responsibility for an extension. The City has a need to extend water utilities
to North Cascade Road now, not in four years, when Mr. McDermott plans to develop
this section. Mr. McDermott has agreed to do this project in partnership with the City.
Water Department Manager Bob Green recommends approval of the acquisition of
Lot B of English Ridge Subdivision No. 5 and associated water main and access
easements in the amount of $47,500.00 and $8,329.00, respectively; and adoption of
the attached resolutions authorizing the City Manager to execute the Offer to Buy and
the City Council to accept the deed for such property.
Bob Green also recommends accepting the Grant of Access and Water Main Utility
Easement through and across a part of Lot A of English Ridge Subdivision No. 5, in the
City of Dubuque, Iowa.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
7.'
Mic ael C. Van Milligen
bc./1144 (4/4
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Bob Green, Water Department Manager
2
THE CITY OF
DUB1JJE
Masterpiece on the Mississippi
Dubuque
hfrd
AII•America City
hill!
2007.2012 •2013
TO: Michael C. Van Milligen, City Manager
FROM: Bob Green, Water Department Manager
DATE: August 20, 2014
SUBJECT: City Acquisition of Property and Easements — Lots B and A of
English Ridge Subdivision No. 5
CIP 7402504 English Mill Water Main Extension
Budget: $2,150,000 Current Balance: $1,924,900
INTRODUCTION
This memorandum seeks City Council approval to authorize the City Manager to
execute the Offer to Buy for the acquisition of a part of Lot A of English Ridge
Subdivision No. 4, located near the intersection of English Mill Road and the future
extension of Stone Valley Road, from English Ridge LLC for the proposed construction
of a water system pumping facility.
BACKGROUND
Larry McDermott is the owner and developer of the English Ridge Subdivision. A
request has been made to extend water utilities from the current dead end, Stone Valley
Drive, to English Mill Road and west to North Cascade Road. Typically, it would be the
developer's responsibility for an extension. The city has a need to extend water utilities
to North Cascade Road now, not in four years, when Mr. McDermott plans to develop
this section.
Discussions have taken place with Mr. McDermott in an effort to construct this water
main extension now instead of later. In an effort meet the city's needs, Mr. McDermott
and Water Department Staff have taken a partnership approach.
The proposal includes construction of approximately eight hundred (800) lineal feet of
water main, with accessories, from the existing water main near the intersection of
South Cavendish Lane and Stone Valley Drive to the west right of way of English Mill
Road in accordance with the horizontal and vertical alignment detailed in the English
Ridge Subdivision — Phase 111 Improvement Plan that has been approved by the City
through Lot A of English Ridge Subdivision No. 4. The proposal also includes the
performance of earthwork grading and erosion control construction activities related to
the construction of the water main. The horizontal alignment of said water main is
indicated on the diagram labeled Exhibit B on the attached Offer to Buy.
We propose to perform a two (2) lot subdivision of what is currently referred to as Lot A
of English Ridge Subdivision No. 4 (the plat for English Ridge Subdivision No. 4 is
shown in Exhibit A on the attached Offer to Buy). Said subdivision referred to as
English Ridge Subdivision No. 5 will divide Lot A into Lot B (shown as Lot 88 in the
English Ridge Subdivision — Phase III Improvement Plan that has been approved by the
City) and Lot A (for future development). Said proposed subdivision is shown in Exhibit
Al of the attached Offer to Buy.
We propose to acquire permanent and temporary easements created for the purpose of
constructing a water main, performing earthwork grading and erosion control
construction activities related to the construction of the water main and to provide the
City access to Lot B, the pump station lot. Said proposed easement plat is shown in
Exhibit C of the attached Offer to Buy
We propose the purchase of Lot B for the purpose of constructing a water system
pumping facility (similar to the style of the Bunker Hill pumping facility located on North
Grandview Avenue). Lot B is shown in Exhibit Al of the attached Offer to Buy.
DISCUSSION
The terms of the Offer to Buy are as follows:
• Total purchase price: $55,829.00 payable at closing, comprised of:
a. Lot B in English Ridge Sub. No. 5 (pump station lot): $47,500.00.
b. Permanent and Temporary Water Main and Access Easements:
$8,329.00.
BUDGET IMPACT
The agreed purchase price of said property, Lot B in English Subdivision No. 5 (pump
station lot), is $47,500.00; the agreed on cost for permanent and temporary water main
with access easements is $8,329.00 bringing the total expense for said agreements to
$55,829.00.
The budget fund code to support this project is CIP 7402504, English Mill Water Main
Extension. Budget Amount: $2,150,000 Current Budget Fund Balance: $1,924,900
RECOMMENDATION
I recommend approval of the acquisition of Lot B of English Ridge Subdivision No. 5
and associated water main and access easements in the amount of $47,500.00 and
$8,329.00, respectively; and adoption of the attached resolutions authorizing the City
Manager to execute the Offer to Buy and the City Council to accept the deed for such
property.
I also recommend accepting the Grant of Access and Water Main Utility Easement
through and across a part of Lot A of English Ridge Subdivision No. 5, in the City of
Dubuque, Iowa, as shown in the attached Grant of Access and Water Main Utility
Easement.
ACTION TO BE TAKEN
I request that the City Council approves the acquisition of Lot B of English Ridge
Subdivision No. 5 and associated water main and access easements in the amount of
$47,500.00 and $8,329.00, respectively; and to adopt the attached resolution
authorizing the City Manager to execute the Offer to Buy for such property and the City
Council to accept the deed for the property at such time as it is provided.
I also request adoption of the attached resolution accepting the Grant of Access and
Water Main Utility Easement from English Ridge LLC.
Prepared by: Nate Kieffer, Land Surveyor
cc: Maureen Quann, Assistant City Attorney
Gus Psihoyos, City Engineer
Jennifer Larson, Budget Director
RESOLUTION NO. 268-14
APPROVING THE ACQUISITION OF REAL ESTATE OWNED BY ENGLISH
RIDGE, LLC IN THE COUNTY OF DUBUQUE
Whereas, the City of Dubuque intends to acquire certain real estate located
in Dubuque County, Iowa for the extension of water main and the construction of a
pumping station; and
Whereas, the owner of this certain real estate and the City of Dubuque have
voluntarily negotiated that the City of Dubuque acquire the property for acquisition;
and
Whereas, the acquisition of this real estate is a voluntarily negotiated
purchase by the City of Dubuque under Section 6B.1A of the Iowa Code, and is not
an acquisition by the City of Dubuque through its exercise of the power of eminent
domain under Chapter 6B of the Iowa Code; and
Whereas, a purchase agreement has been finalized with the owner of the
real estate scheduled for acquisition and 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 approve the acquisition of
the following legally described real estate:
Lot B in English Ridge Subdivision No. 5
at a cost of forty seven thousand five hundred dollars ($47,500.00) along with
easements for the permanent water main and access easements and temporary
construction easements at a cost of eight thousand three hundred twenty nine
dollars ($8,329.00) for a total cost of fifty five thousand eight hundred twenty nine
dollars ($55,829.00).
Section 2. That the City of Dubuque be and is hereby authorized to accept
a Warranty Deed from the owner, conveying the owner's interest to the City of
Dubuque, Iowa for the herein described real estate.
Section 3. That the City Attorney 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.
Passed, approved and adopted this 2nd day
Attest:
Trish Gleason, Assistant City Clerk
September, 2014.
0
Roy D. Buol, Mayor
Prepared by: Russell N. Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, IA 52001 (563) 589-4270
Return to: Russell N. Kieffer, City of Dubuque. 50 W. 13`h Street, Dubuque. IA 52001 (563) 589-4270
RESOLUTION NO. 269 - 14
ACCEPTING THE GRANT OF AN ACCESS AND WATER MAIN UTILITY
EASEMENT THROUGH, OVER AND ACROSS A PART OF LOT A OF
ENGLISH RIDGE SUBDIVISION NO. 5, IN THE CITY OF DUBUQUE,
DUBUQUE COUNTY, IOWA
Whereas, English Ridge LLC. has executed an Easement for Access and
Water Main Utility, and Other Appurtenances through, under and across Lot A of
English Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, Iowa.
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF DUBUQUE, IOWA:
Section 1. The City Council of the City of Dubuque, Iowa, hereby approves
of, accepts and consents to the Grant of Access and Water Main Utility
Easement, and Other Appurtenances through, over and across Lot A of English
Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, Iowa from
English Ridge LLC., a copy of which is attached hereto.
Section 2. The Mayor is hereby authorized and directed to execute and
acknowledge on behalf of the City of Dubuque any instruments in connection
herewith.
Passed, approved and adopted this 2nd day of Septgnber, 2914.
Attest:
Trish L. Gleason, Assistant City Clerk
Roy D. Buol, Mayor
OFFER TO BUY REAL ESTATE AND ACCEPTANCE
TO: English Ridge, LLC (Seller)
WHEREAS, Seller is the legal owner of Lot A of English Ridge Subdivision No. 4,
which is set forth in Exhibit A; and
WHEREAS, English Ridge wishes to construct approximately eight hundred
linear feet (800 LF) of twelve inch (12") water main from the existing twelve inch (12")
water main near the intersection of South Cavendish Lane and Stone Valley Drive to the
west right of way of English Mill Road in accordance with the horizontal and vertical
alignment detailed in the English Ridge Subdivision — Phase III Improvement Plan that
has been approved by the City through Lot A of English Ridge Subdivision No. 4
including the performance of earthwork grading and erosion control construction
activities related to the construction of the water main, the horizontal alignment of said
water main as indicated on the diagram attached as Exhibit B; and
WHEREAS, City intends to perform a two (2) lot subdivision of what is currently
referred to as Lot A of English Ridge Subdivision No. 4. Said subdivision referred to as
English Ridge Subdivision No. 5 will divide Lot A into Lot B (shown as Lot 88 in the
English Ridge Subdivision — Phase 111 Improvement Plan that has been approved by the
City) and Lot A (for future development). Said proposed subdivision is set forth in
Exhibit Al; and
WHEREAS, City intends to acquire permanent and temporary easements
created for the purpose of constructing a water main, performing earthwork grading and
erosion control construction activities related to the construction of the water main and
to provide City access to Lot B. Said proposed easement plat is set forth in Exhibit C;
and
WHEREAS, City intends to purchase Lot B in English Ridge Subdivision No. 5 for
the purpose of constructing a water system pumping facility (similar to the style of the
Bunker Hill pumping facility located on North Grandview Avenue). Lot B is set forth in
Exhibit Al.
NOW THEREFORE, IN CONSIDERATION OF THE PROMISES AND THE
MUTUAL COVENANTS AND AGREEMENTS HEREIN CONTAINED, IT IS HEREBY
AGREED AS FOLLOWS:
SECTION 1. REAL ESTATE DESCRIPTION. The City of Dubuque, Iowa (Buyer)
offers to buy real estate in Dubuque County, Iowa, described as follows:
Lot B in English Ridge Subdivision No. 5
(the "Real Estate"), 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
07132014maq
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 forty seven thousand five hundred
dollars ($47,500.00) for Lot B in English Ridge Subdivision No. 5 and eight thousand
three hundred twenty-nine dollars ($8,329.00) for the permanent water main and access
easements and the temporary construction easements. The total purchase price for Lot
B in English Ridge Subdivision No. 5 and the easements described below in this Offer is
fifty five thousand eight hundred twenty nine dollars ($55,829.00), 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. Real estate taxes for fiscal
year 2014-2015 have not yet been assessed and will be prorated through the date of
closing and paid at 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. Seller shall bear the risk of loss or
damage to the Real Estate prior to closing or possession, whichever first occurs. Seller
agrees to maintain existing insurance and Buyer may purchase additional insurance. In
the event of substantial damage or destruction prior to closing, this Offer 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;
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 August 31, 2014, 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
2
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.
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 Offer, 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 Offer.
SECTION 12. REMEDIES OF THE PARTIES.
12.1 If Buyer fails to timely perform this Offer, Seller may forfeit it as provided in the
Iowa Code, 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 Offer, 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 July 31, 2014 it shall become void and all payments shall be repaid to Buyer.
3
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
Buyer, its agents, or representatives upon the 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".
SECTION 17. TWO LOT SUBDIVISION PLAT AND EASEMENTS.
17.1 Upon execution of this Offer, City agrees to perform a two (2) lot subdivision of
what is currently referred to as Lot A of English Ridge Subdivision No. 4. Said
subdivision referred to as English Ridge Subdivision No. 5 will divide Lot A into Lot B
(shown as Lot 88 in the English Ridge Subdivision — Phase III Improvement Plan that
has been approved by the City) and Lot A (for future development). Said proposed
subdivision is set forth in Exhibit Al.
4
17.2 Seller agrees to execute and deliver to City a grant of permanent easement for a
twenty foot (20') wide permanent water main easement for water main construction and
future maintenance and a temporary construction easement, as delineated in Exhibit C
for performing earthwork grading and erosion control construction activities related to
the construction of said water main as indicated on the diagram attached hereto as
Exhibit B. Said permanent easement will be vacated upon the Seller dedicating the
Stone Valley Drive right of way in future subdivisions of the English Ridge Subdivision.
Said temporary easement will terminate with City's final acceptance of the completion of
said water main construction activities.
17.3 Seller agrees to execute and deliver to City a grant of permanent easement for a
fifty foot (50') wide permanent water main and access easement that provides the City
access to Lot B of said subdivision as indicated on the diagram attached hereto as
Exhibit C. Said permanent water main and access easement will be vacated upon the
Seller dedicating the Stone Valley Drive right of way to English Mill Road in a future
subdivision of the English Ridge Subdivision.
17.4 Seller agrees to sell Lot B in English Ridge Subdivision No. 5 to the City for a
mutually agreed upon compensation between the City and the Seller.
THIS OFFER IS ACCEPTED
Dated:
Ti8/7
CITY OF DUBUQUE, IOWA
Dated: tY ` ) 3 - /
ENGLISH RIDGE LLC
By:
Michael C. an Milligen, City Manager By: itcal
arry
5
cDermott, Partner
ATTACHMENTS:
EXHIBIT A: Final Plat Exhibit of English Ridge Subdivision No. 4
EXHIBIT Al: Two (2) Lot Subdivision Plat Exhibit of English Ridge Subdivision No. 5
EXHIBIT B: Plan of Water Main Construction
EXHIBIT C: Plat of Water Main and Access Easement and Temporary Construction
Easement
EXHIBIT A
Page 1 an
1111111111111'1111
000 10: 008023003004 Type: DEN
RIS; SURVEY PLAT
Re0urded: 08/27/2014 at 03:13 40 P01
Fee Ort: *22.30 Pipe 1 or a
Dubuque
athy FlvnnRMuni!. Recorder
P11e2014-00006890
"
$
L
8le
^...3.
1
sr
> u E
sS
19'fit
sq
a
41
6.
SYa2=5
,/ RE CA
. = /
^
9 Di ..
IP
ri
No �I
0
La
"'W,y a01N
la
�e T�(
Rir J -*ft
!1-
2 `<Qg"m
9'fil
il
1 *ISA
be titi
E�i
la NM
.0 fei
��'I--__
ri < Z
C' oC
", 02
rn CA
m WQ-rl
z p fTl 0
ITI co
0 ?
-Ys}'qua
3P a
4ag5eE
F_ : IrP —st
e i
02 ¢ 2 11PV411
a �
IIm
l l
. e
s-
5
` 0 CO
2 c O
X W 0
C
' C O
n Z
g 0 0
o
m
4
B
__1.
3
R�
SHEET nRE
PROJECT ( 00. 02200
U S
3 ASS!iF5IING
..a AM
m
•n Wlmw
GATE
RENSION0
DRAWN BY:
5/39114
5/20/14
TP0
Ecom Piot oc
ENGLISH RIDGE SUBDIVISION N0. 4
x�WoLARRY ws n LL
F Rx emod11001 0
awUw4 20 VEST iA mm
SCALE'
CHECKED BY:
SEE RAR SCALE
ill(
Page 5014
PlEVARED WI: 552x2 00 8510CIT02
POOR SS: 1212 LOC
Pxb£(0555) 950-4]64
SHEET TILE
E1n01 2501 051
E540LISH RIDGE SUBDINSION
PROJECT No. 12255
PREPARED Latrny4.1[0E1-01017
LIS
BBBSIX7 4E. U 5220 0003
S4 i. IING
DATE
5125/14
SCALE
RENBIENS
5/.10/14
DRAWN EY:
CHECKED EP0m
EEE BAR WALE
T1K
r
Ne Nuu1.er.
eq: 2
Page 3 of 4
Sheet 3 of 4
Surveyor's Certificate
1, Terry L. Koelker, a Duly Licensed Land Surveyor in the State of Iowa, do hereby certify that
the following real estate was surveyed and platted by me or under my direct personal
supervision, To Wit:
Lot E of English Ridge Subdivision No. 3 in the City of Dubuque, Dubuque County, Iowa.
This survey was performed for the purpose of subdividing and platting said real estate
henceforth to be known as ENGLISH RIDGE SUBDNISION NO. 4 In the City of Dubuque,
Dubuque County, Iowa. The Total area of ENGLISH RIDGE SUBDIVISION NO. 4 is 18.211
acres. At Lot areas are more or less and all Lots are subject to easements, reservations,
restrictions, and rights-of-way of record and not of record. the plat of which Is attached hereto
and made a part of this certificate.
1 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 duly licensed
Land Surveyor under the laws of the State of Iowa.
Terry L. Koelker Date
Licensed Land Surveyor
License No. 15487 License Renewal Date 12/31/15
Owner's Consent
Dubuque, Iowa 4, 2014
The foregoing Final Plat of: ENGLISH RIDGE SUBDIVISION NO. 4, is made with the free .
consent and in accordance with the desires of the undersigned owners and proprietors of said
real estate.
State of Iowa
County ofDubuque) ss:
On this 03'a day of (J{1171 AD 2014, before me, the undersigned, A
Notary Public in and for the S to of Iowa, personally appeared Larry E. McDermott, a Partner
of English Ridge LLC, to me personally known, who being by me duly sworn, did say that he is
a Partner of said Corporation, that no seal has been procured by the said Corporation that said
instrument was signed on behalf of said Corporation by authority of its Board of Directors; and
that said Lany E. McDermott, a Partner of English Ridge LLC, acknowledged the execution of
said instrument to be the voluntary act and deed of said Corporation by it and by him voluntarily
executed.
English Ridge, LLC
Witness my hand and Notarial Seal on the date above written.
! ,r
l v
uYg an ,( %t7 to}e ono
File Number: 2014-00006890 Seq: 3
Page 4df4
Sheet 4 of 4
City of Dubuque Planning Service!,
Dubuque, Iowa CfGn2. 2 2014
The foregoing Final Plat of: ENGLISH RIDGE SUBDIVISION NO. 4, was reviewed and
approved by the City of Dubuque Planning Services Department on the date first written above.
Planning Services Department
By del-awr�
City Planner of the City of Dubuque, IA
City Assessor's Certificate
Dubuque, Iowa
l72 2014
The foregoing Final Plat of: ENGLISH RIDGE SUBDIVISION NO.4, was entered of record in
the Office of the City Assessor of the County of Dubuque, Iowa, on the date first written above.
City Assessor of the untyof Dubuque, Iowa
COUNTY AUDITOR
Dubuque, lova
.r..7 VI 2014
The foregoing Final Plat of: ENGLISH RIDGE SUBDIVISION NO. 4, was entered of record in
the office of the Dubuque County Auditor this _O 74 day of Liar 2014.
We approve of the subdivision name or title to be recorded.
-& l k:[w, 4
County Auditor of Dubuc(rie (gime
pp'• a r1
Recorder's Certificate
Dubuque, Iowa 9fa.4;> , 2014
The foregoing Final Plat of: ENGLISH RIDGE SUBDIVISION NO. 4, has been reviewed by the
Dubuque County Recorder.
Dubuq e Cou P Recorder
File Number: 2014-00006890 Seq: 4
EXHIBIT Al
PI
Pu
I
agrn
8�1@
SFP`/N°TOM
r,M
Ng
a
T.
m
mu Sx
WiCSy/RF
`
o,
o,'�..
%`.
kntiv:__
6 +"
S QORCyFy
\
5
^3.
sni.r
n
N
33... iiceyoe
v.
B rOnnoh
C
!1S
Na k __,1r
N6.00
-
r/�
r
_
—I"
Irl
o n
2Npy"s
�sAs�
firms".��3'6'
4
nc
4m:
�
F.
'�'+r.__
�$�
�g�
cNg�">
4 c�R9
n a
. m R
i G
_
W a
qG
PewyGpmp
SFS"
gap..i
4294
I'
1
1
34c2`UNER
e •o
£ ale
WW
...�
'N
5 o
o
C 70
Ca
C O 3
0 rzl o
o C n
C O
•
m C W •
Q O
x mZ
O O
m C •
m Z (l1
[' <
n _
—
O
_
—+
SHEET TIRE
PROJECT ` N0. 13200
yy,�Cp /^�
YERA NV
phurx¢ms sowsions
++
DAT
RENSIDNS
DRAWN BY:
'"
S :
Final Plot 01;
ENGLISH RIDGE SUBUMSION N0. 5
v o
�
c/o U
0000000. a naps
1/10/14
T/T/14
LPL
SCALE:
CHECKED
SEW BAR SCALE
116BY:
LLD
PREPILRED H.. RESIN* 6 6000c.2,
ADDRESS: 1212 I.
N)
e
SHEET TIOLE
Final Plot of:
ENGLISH RIDGE SUBDIVISION NO. 5
PROJECT 1 NO. 13260
PREPARE. FLARRy kIDOERUD.114407 MN YESToueuou... 52003T
akatisk§sittiG
ons -uw
DAM
1/10/14
PENSIONS
3/7/14
DRAWN BY:
TPL
SCALE:
CHECKED BY:
SEE BAN SCALE
TLI<
EXHIBIT B
66,6666-6.
itga
C S
AO
Ely
PLAN AND PROFILE
ALONG STONE VALLEY DRIVE
WY OF DUBUQUE. IOWA
ENGLISH MILL ROAD WATERMAIN EXTENSION
AND PUMPING FACILITY 2014
c
uv
Ri
S OPVEN EIEH LANE
i82
�".
R.kfv
w
24
t5
a>es
82111
ISI
I
30
R
T
Rv
SNREVSBURY LANE
I
/I
p
x
FA
1
yi
_
.k
OEB N-
ow
an 05
03 35
p
cp
$
Pz v
* Jm
TE
R
�
.
w.xaa am�vouuo.
PFPF
\
�
p€ €
3� F(P
o L 3i
€k
E
OG
5
CS R7mli
PR 3�AM'ozo
� A�4pR'a
PA'
s
'S
Mn 9
.I�.,w���
oa .�a..>a....i
-�€836+
'spa 5
E �I-
3,®mli
am
'... Nq Ppypyi
x,,,e �,.... ..
PLAN AND PROFILE
ZONE3
CITY OFEUBUOLIE.JOWA
ENGLISH MILL ROAD WATER MAIN EXTENSION
AND PUMPING. FPOI FACILITY `
'W,
#
a. ��
o o
a, LF
R3. omutmo,
wu 0r
0
C.11
Dm I.oNam NlmNM
�r d.
InGEnin, PERMITTING
nINDIERFIEVrnw
12,1047
Innandpitso
Ent
pAl
PLAN AND PROFILE
ALONG STONE VALLEY DRIVE
AND ENGLISH MILL ROAD
CID( GP DUBUQUE, lows
ENGLISH MILL ROAD' NATER MAIN JRENSON
AND PUMPING FACILITY 2010
rn.umsesFannannWin nnn nrinnn rnwn no,nosxa.n.�
EXHIBIT C
PREPARED 80 0UE5ING 555OCIATFS
e55D.P. 1550, 550_5385
II
o
LJ
SHEET 11115
Mot oz foremen
E n (50e1555,00
AMISS 13 of
N1433 5,511510on No 5
PROJECT N0. 13250
oppaco
0
5/3rtLANNNY 100' 01 L..
SWAIN°
DATE
REVSIONS
DRAWN 8?:
10/10
7/7/14
1PL
SCALE:
050(8(D SN.
SEE BAP SCALE
TLK
11
111111
11111101 III
III
11
ll
Doc ID 00809140000 Type GEN
Kind EASEMENT
Recorded: 09/17/2014 t 02:24:11 PM
Fee Amt: $37.00 Pape of 7
Dubuque County Iowa
Kathy Flynn Thurlow Recorder
Fi1e2014_00010335
Prepared by: Russell N. Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa 52001 (563)589-4270
Return to: Russell N. Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, Iowa 52001 (563)589-4270
GRANT OF EASEMENT FOR ACCESS AND WATER MAIN UTILITY
For and in consideration of the sum of Eight Thousand Three Hundred Twenty
Nine and 00/100 Dollars ($8,329.00) as provided and paid for in the Offer to Buy
Real Estate and Acceptance and other good and valuable consideration, the
receipt whereof is hereby acknowledged,
English Ridge LLC
14407 Highway 20 W
Dubuque, IA 52003
of Dubuque County, State of Iowa, for themselves, their heirs and assigns, do
hereby grant, sell and convey to the CITY OF DUBUQUE, IOWA, a municipal
corporation, its agents and contractors, from the date hereof, rights of ways and
easements through, under and across the following described real estate
situated in Dubuque, Iowa, to wit:
Lot A of English Ridge Subdivision No. 5 in the City of Dubuque, Dubuque
County, Iowa;
All as shown on Exhibit A attached hereto and by reference made a part
hereof.
Said utility easement shall be as shown on the attached Exhibit A for the purpose
of constructing and maintaining a water main and other appurtenances, along
with the right, privilege and authority to construct, reconstruct, maintain, operate,
repair, patrol and remove said improvements.
Said access easement shall be as shown on the attached Exhibit A for ingress
and egress to a proposed water system pumping facility located on Lot B of
English Ridge Subdivision No. 5.
3700
Ch/Clerk
Together with the right to enter upon said property and occupy the temporary
easement area as shown on the attached Exhibit A during the period of
construction until the project is accepted by City Council.
It is understood and agreed that the Grantee herein shall restore the disturbed
area due to maintenance or repair of said water main and other appurtenances.
Grantor shall not erect any structure over or within the easement area without
obtaining the prior written approval of the City Engineer.
Grantor shall not change the grade, elevation, and contour or perform any
construction or excavation that will diminish the lateral support or integrity of said
improvements without obtaining the prior written consent of the City Engineer.
To have and to hold unto the said City of Dubuque, Iowa, forever, and the
undersigned do hereby expressly covenant that they are the owners in fee of
said real estate and have good right to execute this agreement, and that the
Grantee, its agents or contractors, shall at all times have free access to and
egress from and over said real estate to maintain or repair said water main
thereon or therein.
Dated at Dubuque, Iowa this /S T / day of AC41/.�'7 , 2014.
By:
Larry cDermott, Partner
Eng ish Ridge LLC
NOTARY PUBLIC
STATE OF IOWA,
COUNTY OF DUBUQUE, SS:
On this 1374- day of ' i—, A.D., 2014 before me, the undersigned,
a Notary Public in and for said bounty, in said State, personally appeared Larry
McDermott, to me known to be the identical person(s) named in and who
executed the within and foregoing instrument, to which this is attached, and
acknowledged that they executed the same as their voluntary act and deed.
HERBERT W. DOLPHIN AW -21:1
Notary Public In an For Said State
Commission Number 738928
My Comm, Exp.
Page 1 of 3
PREPARED BY: BUESING & ASSOCIATES
EXHIBITA
ADDRESS: 1212 LOCUST STREET, DUBUQUE, IOWA 52001
IIIIIIIIIIIIIIIIIIIIIIIIIIII1IILI111111111111lll1III111111IIP
Doc ID: 008073700003 Type: OEN
Kand: EASEMENT PLAT
Recorded: 08/18/2014 at 04:17:57 PM
Fee Amt: $17,00 Page 1 of 3
Dubuque County Iowa
Kathy Flynn Thurlow Recorder
F1182014-00009029
PHONE: (563) 558-4385
m
O
/N/ IILSNIRE
LANE
Bj
g
W
• CA
p5
mp
N S 0676'30' W 33j.)I `-
/
/ /
/
I /
/
/ / /
/
/
m /1' /
fly
B �j�- • _ 0010/1
/ M ,4,9000 N
9K
/
8 izA
r
c.
D
A
62 MN o
m 0T
i3'Or8
6 ; W 28.32 u
_ _ 22].69• 8 N61
W
9Ir:i3'o-^ W O ENGLISH ..2.12• � m
+leo MILL RD.*. Roo
„L31VOS
S 00.03'00"W 620.00'
T$�8a4n
acM@e��
•
3 .6.£0.68 N
r^1
0 rn °
00 0
m
O5°No
`�°3• (D
(D
O G .. 3
O
0
(xi
of
SHEET TITLE
PROJECT I NO. 13280
Plat of Water Main and Access Easement
and Temporary Construction Easement:
Across Lot A of English
Ridge Subdivision No. 5
PREPARED FOR: ENGLISH RIDGE LLC
0/0 LARRY MCDERMOTT
14407 HWY 20 WEST
DUBUQUE, IA 52003
fill MEIN
ENGINEERS AND SURVEYORS
1212 LOCUST ST, DUBUQUE. N
1563) 550-6389
DATE
REVISIONS
DRAWN BY:
TPL
CHECKED BY:
SEE NAT SCALE tL _ TLK 7
�
Page 2`m3
Surveyor's Certificate
Sheet 2 of 3
1, Terry L. Koelker, a Duly LicensedLand Surveyoin the State of Iowa,do hereby certify that the plat
shown on sheet 1 of 3 hereof, is a true and correct PIat of Water Main and Access Easement and
Temporary Construction Easement: Across Lot A of English Ridge Subdivision No. 5, in the City of
Dubuque, Dubuque County, Iowa, according to the recorded plats thereof, subject to easements of
record and not of record.
1 hereby certify that this land surveyinging document was prepared and the related survey work was
performed by me or under my direct personal sunandthat|ammdu|y{icensedLandSurveyor
under the laws of the State of Iowa.
BY: (1�_
Terry L.Noeikar
Licensed Land Surveyor
License No. 15487
Dubuque, Iowa
7 ).S'
Date
License Renewal Date: 12/31/15
Owner's Consent
,2O14
The foregoing Plat of Water Main and Access Easement and Temporary Construction Easement: Acros
Lot A of English Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, Iowa, is made with
the free consent and in accordance with the desires of the undersigned owners and proprietors of said
real estate.
English Ridge, LLC
Larry E.
ermo, Partner
State of lowaCounty \
of Dubuque ) ss:
On this /57-04 day of /9 r , AD 2014, before me, the undersigned, A Notary
Public in and for the State of Iowa, personally appeared Larry E. McDermott, a Partner of English Ridge
LLC, to me personally known, who being by me duly sworn, did say that he is a Partner of said
Corporation, that no seal has been procured by the said Corporation that said instrument was signed on
behalf of said Corporation by authority of its Board of Directors; and that said Larry E. McDermott, a
Partner of English Ridge LLC, acknowledged the execution of said instrument to be the voluntary act and
deed of said Corporation by it and by him voluntarily executed.
Witness my hand and Notarial Seal on the date above written.
HERBERT W. DOLPHIN
Commission Number 738926
*°,
Notary Public in and fo the St e of Iowa
File Number: 2014-00009029 Seq: 2
Page 'of 3
Sheet 3 of 3
Citv Assessor's Certificate
Dubuque, Iowa /8 , 2014
The foregoing Plat of Water Main and Access Easement and Temporary Construction Easement: Across
Lot A of English Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, 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 Dubuque, Iowa
County Auditor's Certificate
Dubuque, Iowa .44.4.121, 2014
The foregoing Plat of Water Main and Access Easement and Temporary Co
Lot A of English Ridge Subdivision No. 5, in the City of Dubuque, Dubuque
record in the Office of the Dubuque County Auditor this 1Zr day of
We approve of the subdivision name or title to be recorded.
Dubuque, Iowa
County Auditor §f:D
Recorder's Certificate
,2014
The foregoing Plat of Water Main and Access Easement and Temporary Construction Easement: Across
Lot A of English Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, Iowa, has been
reviewed by the Dubuque County Recorder.
4'4174&
Dubuq e Co y Recorder
,p4a4ce e
File Number: 2014-00009029 Seq: 3
Prepared by: Russell N. Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, IA 52001 (563) 589-4270
Return to: Russell N. Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, IA 52001 (563) 589-4270
RESOLUTION NO. 269 - 14
ACCEPTING THE GRANT OF AN ACCESS AND WATER MAIN UTILITY
EASEMENT THROUGH, OVER AND ACROSS A PART OF LOT A OF
ENGLISH RIDGE SUBDIVISION NO. 5, IN THE CITY OF DUBUQUE,
DUBUQUE COUNTY, IOWA
Whereas, English Ridge LLC. has executed an Easement for Access and
Water Main Utility, and Other Appurtenances through, under and across Lot A of
English Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, Iowa.
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF DUBUQUE, IOWA:
Section 1. The City Council of the City of Dubuque, Iowa, hereby approves
of, accepts and consents to the Grant of Access and Water Main Utility
Easement, and Other Appurtenances through, over and across Lot A of English
Ridge Subdivision No. 5, in the City of Dubuque, Dubuque County, Iowa from
English Ridge LLC., a copy of which is attached hereto.
Section 2. The Mayor is hereby authorized and directed to execute and
acknowledge on behalf of the City of Dubuque any instruments in connection
herewith.
Passed, approved and adopted this 2nd day of Septer, 2914.
Attest:
Trish L. Gleason, Assistant City Clerk
Roy D. Buol, Mayor
STATE OF IOWA
CERTIFICATE of tfie CITY CLERK
) SS:
COUNTY OF DUBUQUE )
I, Trish L. Gleason, do hereby certify that I am the duly appointed, qualified,
Assistant City Clerkof the City of Dubuque, Iowa, in the County aforesaid, and as such
Assistant 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. 269-14 is a correct copy of the original Resolution No. 269-14 approved
and adopted by the City Council of the City of Dubuque, Iowa, at a session held by said
Council on the 2nd day of September, 2014.
In Testimony Whereof, I hereunto set my hand and official seal of the City of Dubuque,
Iowa.
Dated at Dubuque, Iowa, on this 3rd day of September, 2014.
Trish L. Gleason, Assistant City Clerk
THE CITY OF
DUB MEMORANDUM
Masterpiece an the Mississippi
TRACEY STECKLEIN
PARALEGAL
MEMO
To: Trish Gleason
Assistant City Clerk
0s1
DATE: March 26, 2015
RE: Original Recorded Documents
Trish:
I am returning to you the following original recorded documents for your file:
1. English Ridge, LLC, recorded as Instrument no. 2015-00002763 on 03/12/15
• Warranty Deed
• Groundwater Hazard Statement
2. DB&T Community Development Corp, recorded as Instrument no. 2015-00002549 on
03/09/15
• Warranty Deed
• Groundwater Hazard Statement
3. Arboretum Development LLC (Greg Adams) recorded as Instrument no. 2015-00002495
on 03/09/15
• Pre -Annexation Agreement
• Covenant Assessment of Costs of Improvements
• Covenant Pertaining to Water Service
4. Joseph & Deborah Vize recorded as Instrument no. 2015-00003136 on 03/20/15
• Pre -Annexation Agreement
• Covenant Assessment of Costs of Improvements
• Covenant Pertaining to Water Service
• Memorandum of Agreement
We will be retaining copies of these documents for our files. Thank you.
Attachment
cc: Crenna M. Brumwell, Assistant City Attorney
Maureen A. Quann, Assistant City Attorney
F:\USERS\tsteckle\Tracey\Memos\Gleason_OriginalRecordedDocs_032615.doc
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EMAIL tsteckle@cityofdubuque.org
Warranty Deed
Corporate/Business Entity Grantor)
THE IOWA STATE OAR ASSOCIATION
Official Form *336
Recorder's Covdr sheet
111111111111111111111111111111111111111111111111111111111111111111111111111111DocID. 008198490002 Type. GENKindWARRANTYDEED
Recorded: 03/12/2015 at 10:41:28 AMFeeAmt: $92.20 Page 1 of 2RevenueTax: $75.20
Dubuque County Iowa
John Murphy Recorder
F11e2015-00002763
Preparer Information; (Name, address and phone number)
David L, Clemens, 2080 Southpark Court, Dubuque, IA 52003. (563) 582-2926
Taxpayer infortnatIon: (Name and complete address)
City of Dubuque, Iowa, 50 West I ath Street, Dubuque, IA 52001
Return Document To: (N, me and complete address)
City of Dubuque, Iowa, 50 West 13th Street, Dubuque, IA 52001
Grantors: Grantees
ENGLISH RIDGE, L.L.C, CITY OF DUBUQUE, IOWA
Legal description: See Page 2
Document or instrument number of previously recorded documents:
C The Inwa State Her Aleteletlah 2E1{15
tOVVA134c$4'
500
1200
@CityClerk
Jan/30/2015 10:58:23 AM CWCM Law 5635822998 3/8
111 THE IOWA VATS MR ASSOCIATION
ONIcIAI POrm No. US David L. Cle ens
FOR THE LEEIALNFFEtly OF 'THRUM OP
THIS FORSit CONSULT YOUR LAWYER
1.41A174,
c 4
i o•
c KO
For the consider
valuable consideration,
Warranty Deed
Corporate/Business Entity Grantor)
ton ofsam_ Dollar(s) and other
a(n) 0 c I
the laws of Ja
ik i i I— organized and existing under
does hereby Convey to cuynErlamiQuE...
IOWA
the
Lot 8 of ENGLISH RIDGE
recorded Plat thereof
The grantor hereby
estate by title in fee simple;
the real estate Is free and
covenants to Warrant and
may be above stated.
Words and phrases
gular or plural number, according
Dated: _2-1 I 2-0 ((p
A,r- ionct
STATE OF
This record was acknowledged
County, Iowa:
according to the
that it holds the real
the real estate; that
be above stated; and it
alt persons, except es
construed as in the sin-
34,-14-- e-rn-an
following described real estate in DunilQuE
SUBDIVISION NO. 5, in the City of Dubuque, Iowa,
covenants with grante•.; , and successors In interest,
that it has good and lawful authority to sell and convey
clear of all liens and encumbrances, except as may
Defend the real estate against the lawful claims of
herein, including acknowledgment hereof, shall be
to the context,
NLSELRDGILL—
a(n) Jnws Uirlitcd T I ti:i
5y
L ,
By
c7ite
t i ', MEMBBR
weo
201 57beforemecinthls _i_a_ day ofR....________.
s LAI Vi 1, r.,
of ENGLISH RIDGE. L.L.C.
STEPHANIE M. OYARB/DE
NOTARY PUBLIC - ARIZONA
JV , ..,
MARICOPA COUNTY
My CornmWon Expires
June 10, 2017
ri./0•
41
i
I..* gnat re of Notary Fubllc
TM KM Stme Nar Ashadelion 2013
lOWADOCSV
5 -En
330 WARRANTY MU IUD RFORATWINISSMS Dim DEED)
Revised Augot 203
li h Iciga-Cit of Duba un Deed - 9914
Jan/30/2015 10:58'23 AM CWCM Law 5635822998 4/8
111111111111111111111011111111111111111111111111111111111111111111111111DocID: 008198500002 Type. GWHKindGROUNDWATERHAZARDRecorded: 03/12/2015 at 10:41:58 AMFeeAmt: $0.00 Page 1 of 2DubuqueCountyIowa
John Murphy Recorder
Fil e 2 0 15-000003 09
RAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT
TO EE COMPLETED BY TRANSFEROR
TRANSFEROR:
Name English Ridge„
Address 14407 H 20 West Dubu
Number and Street or RR City, Ti or P.O.
TRANSFEREE:
Name g.,_if.Tubuque, Iowa
Address 50 West I3th Street, Dubuque, IA 20'
City, Town Or P.O. Number sari ?Arent or RR
Address of Property Transferred:
Vacant Lot
Number end Street e
State Flp
State Zip
y, Town P. Stem 7—to
Legal Description of Property: (Attach if necessary) Lot B of ENGLISH RIDGE SUBDIVISION NO,
In the City of Dubuque, Iowa, aecordinto.Lier piiiThereo '
1. Wells (check one)
There are no known wells sftuatod on this property.
There is a well or w lis situated on this property. The type(s), location(s) and legal statue are
stated below or set forth on an attached separate sheet, as necessary,
2. sod Waste Disposal (check one)
V 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 N provided
in Attachment #1, attached to this document.
3. Hazardous Wastes (check one)
There is no known hazardous waste on this property.
There is hazardous waste on this property and information related thereto Is provided in
Attachment #i attached to this document.
4. UnOerground Storage Tanks (check one)
1( There are no known underground storage tanks on this property, (Note exclusions uoh as
small farm and residential rnotor fuel tanks, most heating ail 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 en attached separate sheet, as necessary.
FILE WITH RECORDER DNR form 542-0960 (July 18, 2012)
Jan/30/2015 10:58:23 AM CWCM Law 5635822998 5/8
S. Private Burial Site (check one)
There are no known private burial sites on this property.
There Is a private burial site on this property. The location(s) of the slte(s) nd 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)
I/All buildings on this property are served by a public or semi-public saw ge disposal system.
This transaction does not Involve the transfer of any building which hes or is required by law tohaveasewagedisposalsystem.
There is a building served by private sewage disposal system on this property or a building
without any lawful sewage disposal system. A certified inspectors report is attached which
doouments the condition of the prate 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 buildingio
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 fon, [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 sepa
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.
Signatur TeIephoneNo
FILE WITH RECORDER DNR form 542-0960 (July18, 2012)