Approximate Agl
•
TEXAS ASSOCIATION OF REALTORS®
INf=ORMATION ABOUT ON-SITE SEWER FACILITY USE OF THIS FORM BY PERSONS
WHO ARE NOT MEMBERS ©Texas Association
OF THE TEXAS ASSOCIATION of REAL TORS®, Inc., 2004
IS NOT AUTHORIZED.
1001 COBB CREEK RD. JARRELL, TX 76537
CONCERNING THE PROPERTY AT A.
OF REAL TORS®
DESCRIPTION OF ON-SITE SEWER FACILITY ON PROPERTY: a
Unknown
a
Unknown
a
Unknown
_
a
Unknown
---~,i~r~/'~.s------------------
a
Unknown
(1) Type of Treatment System:
~ePtic
a -------------------
Tank
a Aerobic Treatment
(2) Type of Distribution System: (3) Approximate
(4) Installer: ~
B.
_
LOGation of Drain Field or Distribution System:
_
~$~ ...>.t~r_77-~~--"7~'-"'-'~-.P_
(5) Approximate Agl~: MAINTENANCE INFORMATION:
(1) Is Seller aware of any maintenance contract in effect for the on-site sewer facility? a Yes arNo If yes, name of maintenance contractor: _ Phone: contract expiration date: _ Maintenance contracts must be in effect to operate aerobic treatment and certain non-standard" on-site sewer facilities.) (2) Approximate date any tanks were last pumped?
C.
,Jt!lI>
/7tJ7/~eR-h,t::7~~
(3) Is Seller aware of any defect or malfunction in the on-site sewer facility? If yes, explain:
aVes
(4) Does Seller hav,e manufacturer or warranty information available for review?
aVes
'8No _
~No
PLANNING MA TEFUALS, PERMITS, AND CONTRACTS: (1) The following items concerning the on-site sewer facility are attached: a planning materials a permit for original installation a final inspection when OSSF was installed a maintenance contract a manufacturer information a warranty information a ------(2) "Planning materials" are the supporting materials that describe the on-site sewer facility that are submitted to the, permitting authority in order to obtain a permit to install the on-site sewer facility.
(3) .It may be nec:essary for a buyer to have the permit to operate an on-site sewer facility transferred to the buyer. (TAR-1407)
Initialed for Identification
1-7-04
ashby real estate po box 617, jarrell tx 76537 Phone: 512-746-2200 Fax: 512-746-2223 Produced
with ZipForm™
by RE FormsNet,
by Buyer
and Seller
,6jC!-
AS .zfx
Charles Ashby LLC 18025 Fifteen Mile Road, Clinton Township,
Page 1 of 2
Michigan
48035
www.zioform.com
1001 COBB CREEK RD. JARRELL, TX 76537
Information about On-Site Sewer Facility concerning
D.
INFORMATION FROM GOVERNMENTAL AGENCIES: Pamphlets describing on-site sewer facilities are available from the Texas Agricultural Extension Service. Information in the following table was obtained from Texas Commission on Environmental Quality (TCEQ) on 10/24/2002. The table estimates daily wastewater usage rates. Actual water usage data or other methods for calculating may be used if accurate and acceptable to TGEQ.
Facilitv Single Single Single Single Single Mobile Mobile
family dwelling family dwelling family dwelling family dwelling family dwelling home, condo, home, condo,
Usage (gal/day) without water-
Usage (gal/day) with water-
savina devices
savina devices
225 300
(1-2 bedrooms; less than 1,500 sf) (3 bedrooms; less than 2,500 sf) (4 bedrooms; less than 3,500 sf) (5 bedrooms; less than 4,500 sf) (6 bedrooms; less than 5,500 sf) or townhouse (1-2 bedroom) or townhouse (each add'i bedroom)
450 525 225
180 240 300 360 420 180
75
60
375
This document is not ••I substitute for any inspections or warranties. This document was completed to the best of Seller's knowledge and belief on the date signed. Seller and real estate agents are not experts about on-site!:jewer facilities. Buyer is encouraged to have the on-site sewer facility inspected by an inspector of BUYI~r'schoice.
~. Si~~el~r7~/---------'BRYCE COOPER
Date
Signature of Seller TAMMI COOPER
Date
Signature of Buyer
1(!uV~ Date
Receipt acknowledged by:
Signature of Buyer
(TAR-1407)
Page 2 of2
1-7-04
Produced
Date
with ZipForm''''
by RE FormsNet,
LLC 18025 Fifteen Mile Road, Clinton Township,
Michigan 48035
www.zipform.com
AS.zfx
TEXAS ASSOCIATION OF REALTORS®
INf=ORMATION ABOUT ON-SITE SEWER FACILITY USE OF THIS FORM BY PERSONS
WHO ARE NOT MEMBERS ©Texas Association
OF THE TEXAS ASSOCIATION of REAL TORS®, Inc., 2004
IS NOT AUTHORIZED.
1001 COBB CREEK RD. JARRELL, TX 76537
CONCERNING THE PROPERTY AT A.
OF REAL TORS®
DESCRIPTION OF ON-SITE SEWER FACILITY ON PROPERTY: a
Unknown
a
Unknown
a
Unknown
_
a
Unknown
---~,i~r~/'~.s------------------
a
Unknown
(1) Type of Treatment System:
~ePtic
a -------------------
Tank
a Aerobic Treatment
(2) Type of Distribution System: (3) Approximate
(4) Installer: ~
B.
_
LOGation of Drain Field or Distribution System:
_
~$~ ...>.t~r_77-~~--"7~'-"'-'~-.P_
(5) Approximate Agl~: MAINTENANCE INFORMATION:
(1) Is Seller aware of any maintenance contract in effect for the on-site sewer facility? a Yes arNo If yes, name of maintenance contractor: _ Phone: contract expiration date: _ Maintenance contracts must be in effect to operate aerobic treatment and certain non-standard" on-site sewer facilities.) (2) Approximate date any tanks were last pumped?
C.
,Jt!lI>
/7tJ7/~eR-h,t::7~~
(3) Is Seller aware of any defect or malfunction in the on-site sewer facility? If yes, explain:
aVes
(4) Does Seller hav,e manufacturer or warranty information available for review?
aVes
'8No _
~No
PLANNING MA TEFUALS, PERMITS, AND CONTRACTS: (1) The following items concerning the on-site sewer facility are attached: a planning materials a permit for original installation a final inspection when OSSF was installed a maintenance contract a manufacturer information a warranty information a ------(2) "Planning materials" are the supporting materials that describe the on-site sewer facility that are submitted to the, permitting authority in order to obtain a permit to install the on-site sewer facility.
(3) .It may be nec:essary for a buyer to have the permit to operate an on-site sewer facility transferred to the buyer. (TAR-1407)
Initialed for Identification
1-7-04
ashby real estate po box 617, jarrell tx 76537 Phone: 512-746-2200 Fax: 512-746-2223 Produced
with ZipForm™
by RE FormsNet,
by Buyer
and Seller
,6jC!-
AS .zfx
Charles Ashby LLC 18025 Fifteen Mile Road, Clinton Township,
Page 1 of 2
Michigan
48035
www.zioform.com
1001 COBB CREEK RD. JARRELL, TX 76537
Information about On-Site Sewer Facility concerning
D.
INFORMATION FROM GOVERNMENTAL AGENCIES: Pamphlets describing on-site sewer facilities are available from the Texas Agricultural Extension Service. Information in the following table was obtained from Texas Commission on Environmental Quality (TCEQ) on 10/24/2002. The table estimates daily wastewater usage rates. Actual water usage data or other methods for calculating may be used if accurate and acceptable to TGEQ.
Facilitv Single Single Single Single Single Mobile Mobile
family dwelling family dwelling family dwelling family dwelling family dwelling home, condo, home, condo,
Usage (gal/day) without water-
Usage (gal/day) with water-
savina devices
savina devices
225 300
(1-2 bedrooms; less than 1,500 sf) (3 bedrooms; less than 2,500 sf) (4 bedrooms; less than 3,500 sf) (5 bedrooms; less than 4,500 sf) (6 bedrooms; less than 5,500 sf) or townhouse (1-2 bedroom) or townhouse (each add'i bedroom)
450 525 225
180 240 300 360 420 180
75
60
375
This document is not ••I substitute for any inspections or warranties. This document was completed to the best of Seller's knowledge and belief on the date signed. Seller and real estate agents are not experts about on-site!:jewer facilities. Buyer is encouraged to have the on-site sewer facility inspected by an inspector of BUYI~r'schoice.
~. Si~~el~r7~/---------'BRYCE COOPER
Date
Signature of Seller TAMMI COOPER
Date
Signature of Buyer
1(!uV~ Date
Receipt acknowledged by:
Signature of Buyer
(TAR-1407)
Page 2 of2
1-7-04
Produced
Date
with ZipForm''''
by RE FormsNet,
LLC 18025 Fifteen Mile Road, Clinton Township,
Michigan 48035
www.zipform.com
AS.zfx
