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Home My WebLink AboutAffadavit of Identity and Survivorship No delinquent taxes 1111 11111 11111 111111111 Transfer Entered 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: /''''.. '-'- '::/ifrVi Alishah S. ad Subscribed and swo to before me this J day of , 2020. —OLUILA1473 ------ Notary Public ifV.i" f ANNA MARIE CARLSON ;i . s° NOTARY PUBLIC-MINNESOTA a4 `�"-`My Commission Expires Jan.31,2025 -/lll�-�IlIIlI-�Illlllll-,1J_ 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 c.........____, " r' (STA_TE OF MINNESOTA 1^'', CERTIFICATION OF VITAL RECORD ,�I f; ,,..;,ems:: ,� :. _. o . L...� CERTIFICATE OF DEATH tea^ STATE FILE NUMBER 2017-MN-010816 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 ;j DATE OF DEATH MARCH 25,2017 PLACE OF DEATH ORONO HENNEPIN MINNESOTA • MARITAL STATUS MARRIED SPOUSE ALISHAH LAST NAME BEFORE FIRST MARRIAGE 'AAD RESIDENCE ORONO HENNEPIN' MINNESOTA PARENT GLADYS REE PARENT CLARENCE FESTE FUNERAL HOME TOTZKE FUNERAL HOME DISPOSITION BURIAL CAUSE OF DEATH IMMEDIATE OVARIAN CANCER" . - ' :.:..'! _ :� UNDERLYING �` OTHER CONTRIBUTING LICHEN PLANUS, HYPERTENSION ,' CONDITIONS , . i, MANNER NATURAL MEDICAL EXAMINER, JENNIFER L WOODLAND, M.D. CORONER OR PHYSICIAN 9750 ROCKFORD ROAD, PLYMOUTH, MINNESOTA, 55442 THIS RECORD HAS NOT BEEN AMENDED THIS IS A TRUE AND CORRECT RECORD OF DEATH REGISTERED IN THE MINNESOTA OFFICE OF VITAL RECORDS. MR&C Certificate ID 10549420 ll II II II III II III I III II FILED: MARCH 27,2017 51A-000011623 .,r , )/f-IPA.4-,Cd. 21,ttoZfra. ,,,,,............::'.,-1:.....-21'......! _:',',.,-.c n �,�,nmm�........,i f o" 'tHEg .,,, MollyMulcahy Crawford _;•••'°OF�MIN D 'o;,� STATE REGISTRAR r�P`� SQA!/ _# ✓-j - _ :%4 ISSUED: MARCH 28,2017 MURRAY COUNTY TREASURER 0 • • 4 � •t•, =A THIS CERTIFICATE IS VALID ONLY WHEN PRINTED ON OFFICIAL WATERMARKED �VGO= y�, yQ SECURITY PAPER WITH A SECURITY THREAD AND STATE SEAL OF MINNESOTA C',9 ,,- �Oi�;;18SH�,,a�``°`�:: t ; . ....: . . . . . .: . . .....:: \ ��J °i �N OF �•,,;r?� ER OR ERASURE VO R t ioM� DS THIS CERTIFICATE �.� ,i `tgA*^ 4u .m... � Y LT I\