HomeMy WebLinkAboutAffidavit of Identity No delinquent taxes
Transfer Entered
1111111 II I 1111 11.11111
Dec 30, 2020 8:00 AM LAND TYPE Torrens (T)
DOC NUM 5779328
Hennepin County, Minnesota Certified, filed and/or recorded on
Mark Chapin Dec 30, 2020 8:00 AM
County Auditor and Treasurer
Office of the Registrar of Titles
Hennepin County, Minnesota
Martin McCormick, Registrar of Titles
Mark Chapin, County Auditor and Treasurer
Deputy 98 Pkg ID 2140305E
Document Recording Fee $46.00
Document Total $46.00
PID(s)
05-117-23-12-0028, 05-117-23-13-0055
Existing Certs
1464737
This cover sheet is now a permanent part of the recorded document.
[Reserved for Recording Data]
AFFIDAVIT OF IDENTITY AND SURVIVORSHIP
STATE OF MINNESOTA ) NAME OF DECEDENT:
) ss Carolyn Kay Azad
COUNTY OF HENNEPIN )
I, Alishah S. Azad, residing at 200 Bederwood Drive, Orono, Minnesota 55356, being first
duly sworn on oath, state from personal knowledge:
1. That the above-named Decedent is the person named in the certified copy of the
Death Certificate attached hereto and made a part hereof.
2. That the name of the surviving fee owner is: Alishah S. Azad, spouse.
3. That on the date of death, Decedent had a marital interest in the land legally
described on Exhibit"A"attached hereto and made a part hereof as shown by instrument recorded
on November 20, 1998, as Document No. 7006826 in the office of the County Recorder of
Hennepin County, Minnesota.
197326v2
AFFIANT:
,,„i i
Alishah S. ad
Subscribed and swo to before me this
1Stk. day of , 2020.
Cljtvwx
Notary Public
t-fasaeedll
''�""'•-i ANNA MARIE CARLSON ti
41 NOTARY PUBLIC-MINNESOTA `4;
". My Commission Expires Jan.31,2025 \ .
fir irrrrrrrlir1Jr�rrrr-�rrr-i'
Tax Statements for the real property described
in this instrument should be sent to:
Alishah S. Azad
200 Bederwood Drive
Orono, Minnesota 55356
THIS INSTRUMENT WAS DRAFTED BY:
CAMPBELL KNUTSON
Professional Association
Grand Oak Office Center I
860 Blue Gentian Road,Suite 290
Eagan,Minnesota 55121
Telephone:(651)452-5000
SMM/jmo
197326v2 2
EXHIBIT "A"
Lot 34 and the North 2.00 feet of Lot 35, Auditor's Subdivision Number 203, Hennepin County,
Minnesota. ALSO all that part of Lot 37, Auditor's Subdivision Number 203, Hennepin County,
Minnesota, lying southwesterly of a line drawn parallel with and distant 100 feet at right angles
southwesterly from the center line of the main track of the Minnesota Western Railway, as
monumented, and also lying easterly, southeasterly, and easterly of a line described as follows:
Commencing at the Northwest corner of the Northeast Quarter of Section 5, Township 117, Range
23, Hennepin County, Minnesota; thence on an assumed bearing of South along the West line of
said Northeast Quarter, a distance of 1465.86 feet;thence South 89 degrees 06 minutes 38 seconds
East to the East line of the West 305.54 feet of said Northeast Quarter; thence North along said
East line a distance of 66.00 feet to a point hereinafter referred to as "Point A"; thence continuing
North along said East line a distance of 307.03 feet;thence South 66 degrees 06 minutes 50 seconds
East a distance of 130.68 feet to the East line of the West 425.04 feet of said Northeast Quarter,
said point also being the point of beginning of the line to be described; thence South along said
East line of the West 425.04 feet of said Northeast Quarter a distance of 155.97 feet to a line which
bears North 50 degrees 36 minutes 00 seconds East from said "Point A"; thence South 50 degrees
36 minutes 00 seconds West, along said line, a distance of 154.63 feet to said "Point A"; thence
on a bearing of South a distance of 4.28 feet to the Northwest corner of Lot 35, said Auditor's
Subdivision Number 203, Hennepin County, Minnesota, and said line there terminating.
Property address: 200 Bederwood Drive and unassigned address
PID No. 05-117-23-12-0028 and PID 05-117-23-13-0055
Certificate of Title No. 1464737
197326v2
STATE OF MINNESOTA
-,_� /--- (CERTIFICATION OF VITAL RECORD); -
lis - � ail
q :
Y
d.
gra _ CERTIFICATE OF DEATH _ • c,
STATE FILE NUMBER 2017-MN-010816 r
�' DECEDENT CAROLYN KAY AZAD
LAST NAME BEFORE FESTE
FIRST MARRIAGE �.
ALSO KNOWN AS
SOCIAL SECURITY NUMBER 468-86-2992
SEX FEMALE
BORN MARCH 20, 1959
PLACE OF BIRTH SLAYTON MINNESOTA
1.+ DATE OF DEATH MARCH 25,2017 .,
PLACE OF DEATH ORONO HENNEPIN MINNESOTA
MARITAL STATUS MARRIED
SPOUSE ALISHAH
LAST NAME BEFORE
FIRST MARRIAGE AZAD
`.' RESIDENCE ORONO HENNEPIN MINNESOTA
PARENT GLADYS REE
PARENT CLARENCE FESTE
of FUNERAL HOME TOTZKE FUNERAL HOME
' DISPOSITION BURIAL
CAUSE OF DEATH
IMMEDIATE OVARIAN CANCER
UNDERLYING
OTHER CONTRIBUTING LICHEN PLANUS, HYPERTENSION
CONDITIONS
MANNER NATURAL =r`
MEDICAL EXAMINER, JENNIFER L WOODLAND, M.D.
CORONER OR PHYSICIAN 9750 ROCKFORD ROAD, PLYMOUTH, MINNESOTA, 55442
u
THIS RECORD HAS NOT BEEN AMENDED
THIS ISA TRUE AND CORRECT RECORD OF DEATH REGISTERED IN THE MINNESOTA OFFICE OF VITAL RECORDS.
' MR&C Certificate ID
10549420
II II II II III II III I III II FILED: MARCH 27,2017
51A-000011623 �y(���, ,,Qtill,
°•�s�;?•.•.•ST9 ,,, Molly Mulcahy Crawford -•stio `r7•/r
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:1. "• /'� STATE REGISTRAR ���S,�P Oj,'•.�i�
=ice•- *.4741. ** et ISSUED: MARCH 28,2017 MURRAY COUNTY TREASURER Ni• •e%
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Aj THIS CERTIFICATE IS VALID ONLY WHEN PRINTED ON OFFICIAL WATERMARKED
'..,.,.. .c, �U_-
,��� �'Q�;�� SECURITY PAPER WITH A SECURITY THREAD AND STATE SEAL OF MINNESOTA � �
/--'Aryijjo'�«i at \`c f .h '-''=.�y+'"� / 1,ANY ALTERATION OR ERASURE VOIDS THIS CERTIFICATE ".• ---.....„..„,4...- / i "--;. ,,,,,.;....11141..............00.,!!,,,,,----..\ OF\ '