HomeMy WebLinkAbout925727
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1'his document is being recorded by
Alliance Title and Escrow of Wyoming, LLC
as a courtesy only.
OOO~1,9
Record and Return to:
WELLS FARGO BANK, N.A.
FINAL DOCUMENTS X9999-01M
1000 BLUE GENTIAN ROAD
EAGAN, MN 55121-1663
RECEIVED 12/29/2006 at 4:38 PM
RECEIVING # 925727
BOOK: 645 PAGE: 219
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
MANUFACTURED HOME
AFFIDAVIT OF AFFIXATION
0157455171
BEFORE ME, the undersigned notary public, on this day personally appeared
(type the name(s) of each Homeowner signing this Affidavit):
\)
known to me to be the person(s) whose name(s) is/are subscribed below (each a "Homeowner"), and
who, being by me first duly sworn, did each on his or her oath state as follows:
I. Homeowner owns the manufactured home ("Home") described as follows:
USED
New/Used
1996
Year
MODULlNE INDUSTRIES
Manufacturer's Name
ARDMOREI
Model Name / Model No.
66 X 27
Lenght/ Width
115888A
Serial No. 1
115888B
Serial No.2
Serial No.3
Serial No.4
2. The Home was built in compliance with the federal Manufactured Home construction and Safety
Standards Act.
3. If the Homeowner is the first retail buyer of the Home, Homeowner is in receipt of (i) the
manufacturer's warranty for the Home, (ii) the consumer Manual for the Home, (iii) the Insulation
Disclosure for the Home, and (iv) the formaldehyde health notice.
4. The Home is or will be located at the following "Property Address":
1133 WEST 8TH STREET, LA BARGE. WY 83123
(property Address)
5. The legal description of the real property where the Home is or will be permanently affixed ("Land")
IS:
See Attached Lel:al Description
6. The Homeowner is the owner of the Land or, if not the owner of the land, is in possesion of the
real property pursuant to a lease in recordable form, and the consent of the lessor is attached to this
Affidavit.
(Page 1 of 5) EC228A REV. 12/22/05
0925727
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0157455171
7. The Home Is anchored to the Land by attachment to a permanent foundation,
constructrd in accordance with applicable state and local building codes and manufactures's specifications
in a manner sufficient to validate any applicable manufacturer's warranty, and permanently connected to
appropriate resindential utilities (e.g., water, gas, electricity, sewer) ("permanently affixed"). The
Homeowner intends that the Home be an immoveable fixture and a permanent improvement to the
Land.
8. The Home shall be assessed and taxed as an improvement to the Land
9. Homeowner agrees that as of today, or if the Home is not yet located at the Property Address, upon
the delivery of the Home to the Property Address:
(a) All permits required by governmental authorities have been obtained;
(b) The foundation system for the Home was designed by an engineer to meet the soil conditions of
Property Address. All foundations are constructed in accordance with applicable state and local building
codes, and manufacturer's specifications in a manner sufficient to validate any applicable manufacturer's
warranty.
(c) The wheels, axles, towbar or hitch were removed when the Home was, or will be, placed on the
Property Address;
(d) The Home is (i) permanently affixed to a foundation, (ii) has the characteristic of site-built housing,
and (iii) is part of the Land; and
(e) The Home is permanently connected to a septic tank or sewage system and other utilities such as
electricity, water and natural gas.
10. Ifthe Homeowner is the owner of the Land, any conveyance or fmancing of the Home and the
Land shall be a single transaction under applicable state law.
11. Other than those disclosed in this Affidavit, the Homeowner is not aware of (i) any other claim, lien
or encumbrance affecting the Home, (ii) any facts or information known to the applicant that could
reasonably affect the validity of the title of the Home or the existence or non-exixtence of security
interests in it.
12. A release of lien from each of the lien holders identified in paragraph 11 of this Affidavit _ has
been shall be delivered to the commissioner of motor vehicles.
13. A homeowner shall initial only one of the following, as it applies to title to the Home:
_ The Home is not covered by a certificate of title. The original manufacturer's certificate of origin,
duly endosed to the Homeowner, is attached to this affidavit.
_ The Home is not covered by a certificate of title. After diligent search and inquiry, the Homeowner
is unable to produce the original manufacturer's certificate of origin.
_ The certificate of title to the Home _shall be _ has been eliminated as required by applicable
law.
_ The Home shall be covered by a certificate of title.
14. The Homeowner designates the following person to record this Manufactured Home Affidavit of
Affixation and upon its recording it shall be returned by the recording officer in the real property records
where the home is to be located to same:
Name:
Address:
15. The Affidavit executed by Homeowner(s) pursuant to applicable state law.
(Page 2 of 5) EC228C Rev. 12/22/05
09ZSI-}Z?
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0157455171
IN WI1NESS WHEREOF, Homeowner(s) has executed this Affida'g in my presence and in the
presence of the undersined witne es on this -:Z.C? day of ¿e...- ..:L0c6 -,
Witness
Witness
STATE OF flA}-r
COUNTY OF t?(~
)
) ss.:
)
On the & q day of (J.J..e.... in the year 62 0 0 (o
~~si~,.a ~~ and for said State, personally appeared
personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)
whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument,
the individual(s), or the person on behalf of which the individual(s) acted, executed the instrument.
before
~~ 'B.d~
No~ature
0f l\ l~. d!. ~ 0 't\.
Notary Printed Name
Notary Public; State of I1AJ ~
Qualified in the County of 1-.' ru..t '-- t\..
My commission expires t, . [:)...0 - i- (). 7
JILL H, LARSON· NOTARY PUBLIC
COUNTY OF
UNCOlN ~Wj~,~
MY COMMISSION EXPIRES JUNE 20, 2007
(Page 3 of 5)
EC228E Rev. 12/22/05
09ZS727
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EXHIBIT A
0157455171
PROPERTY DESCRIPTION
The legal description of the Property Address ("Land") is typed below or please see attached
legal description:
Lots 12 and 13 of Block 3 of West Valley Subdivision, Lincoln County, Wyoming as described
on the official plat filed on June 30, 1981 as instrument No. 560645 of the records of the Lincoln
County Clerk.
(Page 5 of 5) EC2281 REv. 12/20/05