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BURMET <br />REALTY <br />REAL ESTATE TRANSFER <br />DISCLOSURE STATEMENT <br />66. Address <br />67. Page 2 <br />6a unused Well: Is user, a w.,1 on Ihe prupen, which is ho longer in us,7 CV,,^^o <br />69. H yes. has it seen sealed according to State Regulations US6 156A? CYes _No <br />70. Comments: _________—----------—---------------------------- <br />n. Contaminated Well: Is there a well on the property containing conta/ninaied water? Yes. <br />72. Date well water last tested for contaminants:------------------- Comments:------------------------- <br />73. D. LAND USE AND PROPERTY CONDITION,: <br />74. Are you aware o( any of the following existing. <br />Encroachments? Yes----- Sod probtems? Yes_ <br />Diseased Trees? Yes___ No_i^ Rodent Infestation? Yes <br />Rostnctions or Reservations on the use ot the property? Yea--------- <br />75. <br />76. <br />77. <br />7B. <br />79. <br />00. <br />81. <br />82. <br />NoJ-cT <br />NO.Jeir' <br />No <br />Insect Infestabon? Yes.Noi^ <br />rtuaii I — — <br />Easwnertts other than uulity or cramage easemertts wh«fl do not mienere wrth preaemjmprwements? <br />Is the property located m a dasignaied flood plain? YIss No <br />Comments: <br />saE. INSULATION DISCLOSURE: <br />84. Does the msuleoon in the propeny contain urea lormaldehyde toam? Yes <br />05. Date insulation installed:-------------------------------- 'yP®' --------- <br />06 l Comments:____________ ___________________________ <br />Unknown <br />Company: <br />If yea, explain below: <br />87. F. OTHER KNOWN DEFECTS^ <br />88. Are there any other known defects in or on the property? <br />89. <br />90. <br />91. <br />92. <br />93. G. gpi I PR’S STATEMENT (To be signed at time of listing) <br />la !I»!w)^«’'h°: Tr»TMttr OUclOTur. Slaemehl end giv. p.rim=ion to UsOng BlcMr Id dl«os. <br />ga .his m. <br />97.1 ' / <br />^ BUYER'S ACKNOWLEDGEMENT: (To be f.gned at time of purchase agreement) <br />99. <br />100.100. 'Lknw^eS^e^Je^ei'cTo? m? r1^* Estate Transfer Disclosure Statement anO <br />ini renardina the condition of the property have been made, other than those .made above. USTING BROKCT AND <br />102! AGENTS MAKE NO REPRESENTATIONS AND ABE NOT RESPONSIBLE FOR ANY CONDITIONS EXISTING <br />101 THE PROPERTY. <br />104. ------------1 ' ' ' '' JOmm <br />105 I SELLER'S ACKNOWLEDGE.MENT: (To be signed at time of pu-xhase agreement) <br />108. on date of closing, exceci ‘or the changes indicated aPove and dated: <br />109. <br />110. MN RCTCS ISTO oniCiNAL COPT TO USTtMQ OnOKER; CCmHS TO SELUR. BUY€R. SELUNG eROKEIt c£r