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Home My WebLink About9475260099430704 RECEIVED 6/2/2009 at 4:25 PM RECEIVING # 947526 BOOK: 724 PAGE: 374. JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER WY U , a C,00374 ' C7 T w ~ wi b O L 0 MANUFACTURED HOME AFFIDAVIT OF AFFIXATION ~ U a 7 Record and Return by Mail by Pickup to WFHM FINAL DOCS X2599-024 N EH 405 SW STU STRR;!T H C_ DES MOINES, IA 50309-4600 This Instrument Prepared By, CHELSIE ERICKSON Preparer's Name 2387 F ROAD, Preparer's Address 1 GRAND JUNCTION, CO 815050000 Preparer's Address 2 0099430704 Loan Number ATTENTION COUNTY CLERK:Thla Instrument covers goods that are or are to become fixtures on the Land described herein and Is to be flied for record in the records where conveyances of real estate are recorded Page 1 of 5 Initial! NMFL # 7111 (MAHA) Rev 21412008 000375 MARK E O'DRISCOLL SHEILA A O'DRISCOLL [type the name of each Homeowner signing this Affidavit] being duly sworn,. on his or her oath state as follows Homeowner owns the manufactured home ("Home") described as follows USED 1980 CENTURY HOUSING 18024 C18024DCCI 060 x 024 New/Used Year Manufacturer's Name Model Name or Model No Length x Width CHCC 0185512 CHCC 0185512 Serial No Serial No. Serial No. Serial No 2. The Home was built in compliance with the federal Manufactured Home Construction and Safety Standards Act 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 for the Home. 4 The Home is or will be located at the following "Property Address". 888 COTTONWOOD ST, LABARGE, LINCOLN, WY 83123 Street or Route, City, County, State Zip Code 5 The legal description of the Property Address ("Land") is LOT 8 BLOCK 2 OF WEST VALLEY SUBDIVISION TO THE TOWN OF LABARGE 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. TAX STATEMENTS SHOULD BE SENT TO: WELLS FARGO HOME MORTGAGE P.O. BOX 11701, NEWARK, NJ 071014701 The Homeowner Is the owner of the Land or, if not the owner of the Land, is in possession of the real property pursuant to a lease in recordable form, and the consent of the lessor is attached to this Affidavit. The Home Lj~j is U shall be anchored to the Land by attachment to a permanent foundation, 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, and permanently connected to appropriate residential 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 ATTENTION COUNTY CLERK:ThIs Instrument covers goods that are or are to become fixtures on the Land described herein and Is to be flied for record in the records where conveyances of real estate are recorded Page 2 of 6 Inlti4t'lRl NM FL # 7111 (MAHA)GG Key 2142008 0003'76 The Home shall be assessed and taxed as an improvement to the Land. 9. Homeowner agrees that as of today, or if the Horne 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 the Land, 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; and (d) The Home is (i) Permanently Affixed to a foundation, (ii) has the characteristics of site-built housing, and (iii) is part of the Land 10 If the Homeowner is the owner of the Land, any conveyance or financing 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 (1) any other claim, lien or encumbrance affecting the Home, (ii) any facts or information known to the Homeowner that could reasonably affect the validity of the title of the Home or the existence or non-existence of security Interests in it. 12. A Homeowner shall initial only one of the following, as it applies to title to the Home: (Closinttand Agent: pleasereferto the Manufactured Home and Land SupplementatClosing Instructlonsfor completioninstructionj: ] The Horne is not covered by a certificate of title. The original manufacturer's certificate of origin, duly endorsed to the Homeowner, is attached to this Affidavit, or previously was recorded in the real property records of the jurisdiction where the Home is to be located f I 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. f_] The manufacturer's certificate of origin and/or certificate of title to the Home f ] shall be f ] has been eliminated as required by applicable law. The Home shall be covered by a certificate of title. 13. This Affidavit is executed by Homeowner(s) pursuant to applicable state law. ATTENTION COUNTY CLERK:This Instrument covers goods that are or are to become fixtures on the Land described herein and Is to be filed for record in the records where conveyances of real estate are recorded Page 3 of 5 Initia' NMFL # 7111 (MAHA) Rev 214/2008 00037' IN WITNESS WHEREOF, Homeowner(s) has execut d this Affidavit in my presence and in the r ence of the~undersigned witnesses on this day of L , 42& 1 Homeowner 91 (SEAL) Witness MARK E O'DRISCOLL ~~z a, Homeowner #2 (SEAL) Witness SHEILA A O'DRISCOLL Homeowner #3 (SEAL) Witness Homeowner #4 (SEAL) Witness STATE OF V yV ) -T- O-O,IIL ) sS. COUNTY OF On the 5'- day of in the year Zml~- bejoT met tt}s I,ndersi ne¢, a_Notw PV Iic in and fqr sia44State; per,t74ly qippeared 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 instru t ~ f Notary Signature Notary Printed Name Notary Public, State of My Commission expires 7 Official Seal Qualified in the County of a c~ ' GABRIELLE BECKINGHAM Notary Public p State of Utah w My Commission Expires July 19, 2011 204 N. Main Street, Toole, UT 84074 ATTENTION COUNTY CLERK: This Instrument covers goods that are or are to become fixtures on the Land described herein and is to be filed for record in the records where conveyances of real estate are recorded Page 4 of 5 NMFL # 7111 (MAHA) Rev 214/2008