01-12-2005 Council Agenda - Laserfiche WebLink

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WELL DISCLOSURE STATEMENT This loon approved by the Minnesota Association of REAE10E5,E which disclaims any liability arising out of use or misuse of this brio, 002000, Minnesota Association of REALTORS®, Edina, MN 1. Date January 6,2005___._. 2. Page 1 of 3 Pages•THE REQUIRED MAP IS 3. ATTACHED HERETO AND MADE A PART HEREOF 4. Minnesota Statures Sec. 1031.235 requires that before signing an agreement to sell or transfer real properly, the Seller 5. must disclose information in writing to the Buyer about the status and location of all known wells on the property. This 6. requirement is satisfied by delivering to the Buyer either a statement by the Seller that the Seiler does not know of any 7. wells on the properly, or a disclosure statement indicating the legal description and county, and a map showing the 8. location of each well. In the disclosure statement the Seller must indicate, for each well, whether the well is in use, not 9. in use or sealed. 10. Unless the Buyer and Seller agree to the contrary, in writing, before the closing of the sale, a Seller who fails to disclose 11. the existence or known status of a well at the time of sale and knew or had reason to know of the existence or known 12. status of the well, is liable to the Buyer for costs relating to sealing of the well and reasonable attorney lees for 13. collection of costs from the Seller, if the action is commenced within six years after the dale the Buyer closed the '14. purchase of the real properly where the well is located. 15. Legal requirements exist relating to various aspects of location and status of wells. Buyer is advised to contact the local 16. unit(s) of government, state agency, or qualified professional which regulates wells for further information about these 17. issues. 18. Instructions for completion of this form are on the reverse side. 19. PROPERTY DESCRIPTION 20. Street address: __ 594 E..GountvJload.62___..._Little_ Canada_._.._ 55117__ _. _.,Ramsey__. (ell» RhJ ;spiky) 21. LEGAL DESCRIPTION 22. 1110 West 9U Ieel01 IMO East 190 Ieet 01 North 289.0 feel Of BIOCI( 8, Hlleys Lake Gervais Addition 23..__._____. 24. 25. WELL DISCLOSURE STATEMENT 26. (CHECK 7 "FIE APPROPRIATE BOX.) 27.1-1 The Seller certifies that the Seller does not know of any wells on the above described real properly. 28. (11 this option is checked, Mon skip to the last line and sign and date this statement) 29.1i1 The Seller certifies that the following wells are located on the above described real property. 30. MN Unique Well Year of Well IN USE NOT IN 31. Well No. Depth Const. Type USE 32. Well 1 11.1_._ 1960 ..__ Water_Supply 33. Well 34. Well 3 n ( SEALED ✓I II 35. NOTE: See definition of teens "IN USE," "NOT IN USE," and "SEALED" on lines 82 -91. If a well is not in 36. use, it must be sealed by a licensed well contractor or a well owner must obtain a maintenance permit from the 37. Minnesota Department of Health and pay an annual maintenance fee. Maintenance permits are not transferable. If a 38. well is operable and properly maintained, a maintenance permit is not required. 39. SEALED WELL INFORMATION 40. For each well designated as sealed above, complete this section. 41. When was the well sealed? October 19,2004 42. Who sealed the well? Johnson Brothers Well Drilling company__ _ 43. Was a Sealed Well Report filed with the Minnesota Department of Health? Yes X No Unknown_.__..__ 44. MAP 45. Complete the attached MAP showing the location of each well on the real property. 46. This disclosure is not a warranty of any kind by the Seller(s) or any Agent(s) representing any Party(s) in this 47. transaction, and is not a substitute for any inspections or warranties the Party(s) may wish to obtain. 48. CERTIFICATION BY SELLER 49. I certify that the information provided above is accurate and complete to the best of any knowledge. 50. 00110 or ensanaenl ltenrescuunrvcl Dmd ISenar or nusiWminO rlJlwsvnbiiva) 51. BUYERS ACKNOWLEDGMENT / Inalel -31- 511. '.. ORIGINAL COPY TO LISTING BROKER; COPIESTO SELLER, BUYER, SELLING BROKER MN -tar S -I (9 /00) 52 It