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• <br /> MAIM.Reit Preperllr Poem No.14(1691,Nov.axon . - . . <br /> SURE OF • <br /> 0 SEWAGE TREA7MEN1'SYSTEM. <br /> - A�2ef6 <br /> ABANDONED ONED SUBSURFACE ON.SITE'SEWAGE TREATMENT.SYSTEM:iCheckeNher 6 Of 7:) • . <br /> CI Seiler/Traneferor has no knowledge Whether there is an abandoned <br /> .subsurface sewage treatment system on the <br /> • J$ knows 1.7. Selier/Tramisror that there(a dki.note . .., <br /> subsurface sewage treatment systems on the:. •._: •:lac/Transferor . . <br /> disdoses the existents of en abandoned subsurface flowage haohnoM <br /> . system on the properly,then Minnesota law requires that the location of the. <br /> . system be disclosed to BuyedTransfereemith a map.(Complete the map <br /> . below In Seoton.C.J .: • : .: - <br /> C.'. SUBSURFACE SewA©E TREATMENT SYSTEMS(IN-USE ORABANOONED)ON THE • <br /> PROPERTY. Describe all Iroise aad.abandoned systems on the property. <br />• <br /> • 1. For each sewage.tr eatrlent system in aloe,state the bAni of 8yeteRh: <br /> =Septic.Tank with:j,standehd dralnfleid =moon=system drainfleld <br />• <br /> =1.Sealed System(holding tank or contabad camped) . <br /> f=0ih.sr(deealbe )mSeepege lank©pesepooi= <br /> dry well=Poaching pit <br /> 2 SKETCH MAP Sketch the location of.the house,garage;accessory bdidirhgs,well,septic . <br />• <br /> .tank,drainled,mound,or other components•of the sewer system. Also show the location <br /> . of the components of any abandoned sewage treatment systems(tanks,pipes.dratntlalds, <br />• pits,etc.) Include estimated distances from all roads,streets and buildings. Use'additional <br /> sheets of paper,If necessary. , <br /> ...-- <br /> gz.'T.--- .. <br /> 8 SELLER/TRANSFEROR DISCLOSURE:Pursuentto MMnesote Maul. es Section 115.55, <br /> Subdivision 6,the 3eller/iransferor shall disclose to the Buyerlirinsferee what the <br /> Seiler/Transferor has Imowledge of relative to the Compliance status of the subsurface <br /> treatment system,and whether,to the best-of the Seller's/Transferor's knowledge,a <br /> straight-pips system eodsts..A Seller/Transferor who hes in that possession a previous <br /> inspection report completed by a licensed inspection business or certified local governnwrt <br /> inspector in accordance with Section 115.55,.Subdivision 5 or 5e,shall attach a copy'lathe <br /> dildosure statement that is provided te.the Buyer/Ttarheferee. . <br /> STATEMENT SY SELLERRRANSFEROR: lb my knowledge,the property Mae oneJ� <br /> . fan compliance with all applicable sewage ,. , _nt laws and rules. To the but of or t <br /> • <br /> knowledge,a straight-pipe s e..;,, f! ma), damns exist. A previous Inspection <br /> repot( oneJ s/ eili''�"' and if. - ,i sts,it Ii attached te this Disclosure. •• <br /> n: bit none of fa Ilds teals, <br /> SAY c.irrslum Ina Woos dlti[NK 1 Vadp„bggf a fblRbMn tleNrd or slum me*es hI liuid bYMr4!WR W by <br /> Nurof!mirror oft <br /> iii.MO 01.1.If FiettHOrN /2—/4.1? <br /> Signs ra of SoieriTtonshror • • ' Ptd Nara of sellogrtahsferar ., pate - <br /> Sloneker,of adierlflinehwr . PWM Name of Nr/itenHsnor Date <br /> • 4 ACKNOWLEDOENT AND RECEIPT BY BUYERITRANSFEREE: I have received this <br /> disclosure on(datej �' l Co/Y t <br /> i <br /> ; <br /> ateree _ Sete OBUepteeae <br />