01-12-2005 Council Agenda - Laserfiche WebLink

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M.S.B.A. Real Property Form No. 15 (2004) CONDITION OF THE PROPERTY PAGE 7 of9 307 NOISE POLLUTION I VIBRATION. 303 309 310 311 313 313 314 315 316 319 318 319 320 321 322 323 321 325 326 327 328 329 330 331 332 333 331 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 359 358 359 360 161 362 363 364 363 366 367 368 369 nn 3;1 Question Answer (CIRCLE ONEj Comment or Explanation Do you know if there has been any noise problems affecting property? If "Yes," please explain. YES N0 ) � the Are you aware if there has been any mold, mildew, moisture, or water inside the ceiling and roof system? Do you know if there have been any vibrations affecting the property that are not generated at the property? If "Yes," please explain. YES NO For each tank disclosed, is the tank a single wall or double wall tank? Have you ever called the police to complain about noise in the neighborhood? If "Yes," please explain. YES (NO( For each lank disclosed, is there an electronic leak monitor? MOLD. Question Answer (CIRCLE ONE) Comment or Explanation Are you aware if there has been any mold, mildew, moisture, or water inside the walls? YES (NO YES (1:1O) Are you aware if there has been any mold, mildew, moisture, or water inside the ceiling and roof system? YESCNO NO INSURANCE AND INSURABILITY. Have you made any claims against your homeowner's insurance for damage to the building or its contents? If "Yes," please explain. YES (NO) YES : For each lank disclosed, has 4 been used for the storage of petroleum products? Have you been denied homeowner's insurance for this property? If "Yes," please explain. NO YES (1:1O) For each tank disclosed, has it leaked? Have there been any liability claims made against your homeowner's insurance because of the condition of the properly? If "Yes," please explain. NO YES (NO For each tank disclosed, is the tank a single wall or double wall tank? Is the property insured through the Minnesota FAIR Plan? "Yes," please explain. If /,� YES ) For each lank disclosed, is there an electronic leak monitor? UNDERGROUND STORAGE TANKS. Are there any underground storage tanks on the properly? YES (NO) For each lank disclosed, has 4 been used for the storage of petroleum products? YES NO For each tank disclosed, has it leaked? YES NO For each tank disclosed, is the tank a single wall or double wall tank? YES NO For each lank disclosed, is there an electronic leak monitor? YES NO For each tank disclosed, do you have an owners manual or other technical data describing the tank? YES NO PART E: SELLER'S CONCLUDING DISCLOSURE. LIST HERE ANY OTHER. MATERIAL FACTS, NOT ALREADY DISCLOSED. Seller(s) signatures: (Use additional sheets if necessary] Buyer received this Disclosure on [date] Buyer(s) signatures: i 1 L s - 2 8 -