vacant land disclosure addendum
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
INSTRUCTIONS TO THE SELLER 1 2 3 4 5 6 7 8 9 10
Please complete the following form. Answer all the questions. If a question is not applicable to this Property, mark N/A. Please explain each “YES” answer at Section VII below and attach pertinent documents and information. Please refer to the section and item of the question(s) when you provide your explanation(s). Please date and sign each page of this Disclosure Addendum and each attachment. SELLER(S) AUTHORIZE(S) ALL AGENTS TO PROVIDE A COPY OF THIS VACANT LAND DISCLOSURE ADDENDUM TO OTHER REAL ESTATE AGENTS AND PROSPECTIVE BUYERS OF THE PROPERTY.
NOTICE TO BUYER THIS IS A DISCLOSURE ADDENDUM MADE BY THE SELLER CONCERNING THE PROPERTY. IT IS NOT A GUARANTY OR WARRANTY REGARDING THE CONDITION OF THE PROPERTY. BUYER SHOULD SECURE SEPARATE ADVICE FROM EXPERTS OF BUYER'S CHOICE. REAL ESTATE BROKERS ARE NOT REQUIRED TO INSPECT REAL PROPERTY, CANNOT RENDER OPINIONS ON ITS PHYSICAL CONDITION OR LEGAL STATUS, AND MAKE NO WARRANTIES REGARDING THE ACCURACY OF THE INFORMATION CONTAINED HEREIN.
I.
YES NO UNKNOWN N/A
11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
A.
X
Is this Property subject to any of the following? other listing
first right of refusal
option
lease or rental agreement
life estate
X
B.
Are there any of the following? encroachments written or oral boundary or fencing agreements boundary disputes recent boundary changes.
X
C.
Are there any of the following?
X
D.
access limitations written or oral agreements concerning the use or access to/from this property Is there a written or oral agreement for joint maintenance of an easement?
X X
E.
Any sale, transfer or reservation of development, water or drainage rights?
X
F. G.
Any sale, transfer or reservation of oil, gas, or mineral rights? Are you aware of any governmental study, survey, or notice that would affect this Property?
X
H.
Are there any pending or existing assessments against this Property (other than real property taxes for the
I.
rights of way
easements (other than normal utility easements)
J.
current year)? What is the current zoning for the Property? EFU What is the current use of the Property? Grazing/hay production
X
K. L.
Are you aware of any pending land use change? Is there a land survey for this Property?
X
M.
Is this Property subject to any Covenants, Conditions, and Restrictions?
X
If “yes” see V. COMMON INTERESTS SECTION, below.
II.
YES NO UNKNOWN N/A
30 31 32 33 34 35 36
TITLE
A. B.
X X
Has there been any settling, soil problem, standing water, flooding, or drainage problem on this Property? Does the Property contain soil used to fill, build up or level areas of the ground (fill dirt)? 1.
If yes, does the fill dirt contain foreign materials (e.g. wood, rock, debris)?
X
C.
2. If yes, was the fill dirt compacted? Has this Property been identified as “wetland”, antiquities, dunes area, or other similar designation?
X
D.
Is the Property in a designated flood or slide zone?
E.
Has there been major damage to this Property from fire, wind, flood, earth movement, or landslide?
X
Buyer Initials
GENERAL INFORMATION
/
Date
Seller Initials
/
Date
This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Mossy Oak Properties Cupper Creek Land Company, 41909 Cupper Creek Rd. Kimberly, OR 97848 Phone: 541-934-2946 Julie Mansfield-Smith Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.com
OREF 019 Page 1 of 4 Fax:
Cheri L. Heath-Rickert
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
37 38 39 40 41 42 43 44 45 46 47 48 49 50
X
F.
X
G.
Are you aware of any tanks, above ground or underground storage tanks (e.g., fuel, chemical, abandoned septic tank, etc.) currently or previously on the Property? Are you aware of any hazardous material, toxic waste, or trash dumping on this Property?
H.
Are there any structure improvements or personal property located on the Property that may be included in a sale? If “yes” list all items Above ground fuel tank and irrigation pump/big gun sprinkler 1. Are there any defects or problems with any of these items? If “yes” describe all problems and defects:
X
I.
Has this Property been used for the manufacture or distribution of illegal substances excluding marijuana? Note: Although marijuana has been legalized for medicinal and recreational use in Oregon, it remains a “Controlled Substance” under Federal Law, and is illegal. See
X
J.
X X
https://www.whitehouse.gov/ondcp/state-laws-related-to-marijuana
Has this Property been used to legally grow marijuana for either medicinal or recreational use as permitted under Oregon laws?
BUYER MAY WISH TO INVESTIGATE FURTHER ANY OF THE ISSUES MENTIONED ABOVE. III.
YES NO UNKNOWN N/A
51
A.
X
52 53 54
WATER
Is there currently a domestic water supply for this Property? 1.
If “yes”, from what source?
public utility
community water system X private well
other (specify) 2.
55
X
56
X
57
X
58
B.
X
If “no”, is a permit required and has it been applied for?
If Property is currently supplied from a well: 1.
Is there more than one well?
2.
Is (are) the well(s) on-site? (If No, attach explanation).
3.
Is (are) the well(s) shared?
59
a.
Is there an oral or written agreement for a shared well?
60
b.
Is there an easement (recorded or unrecorded) for access to and maintenance of a shared well?
61
4.
Is a copy of the well log(s) available?
62
5.
Well depth(s) is estimated to be 28.5
feet
63
6.
Well(s) supplied approximately 10
gallons per minute (GPM) of water.
X
64 65
a.
66
7.
X
67 8.
69 70 71
If “yes”, what is the capacity of the tank?
Well is 50
years old. Pump type:
gallons.
submersible X jet. Pump make
Installed by Serviced by Red's Electric 9.
X
72 73 74
a flow test of the well performed when
Is there a holding tank in addition to the pressure tank for the water system? a.
68
This figure is taken from X well log and by whom
date date of last service
Are there any known problems or have there been any repairs to the water system?
10. Has a
coliform bacteria
nitrates
domestic water supply? If “yes”, when C.
X
75
Is there a water treatment system? If “yes”, 1.
Buyer Initials
/
04/14/2016
arsenic or 4-14-16
owned or
other water quality test been performed on by whom Red's Electric
leased?
If “yes”, for what purpose was the water treatment system installed?
Date
Seller Initials
/
Date
This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026
OREF 019 Page 2 of 4 www.zipLogix.com
Cheri L.
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
76
2.
77
X
78
Is the water treatment system in good working order? (If No, attach explanation).
D.
Are there any abandoned wells on the Property?
E.
Do you have other pertinent information regarding the water supply? If “yes”, please attach an explanation.
79
X
F.
Is there an irrigation well(s)? If “yes”, how many? 1
80
X
G.
Are there water appropriation rights for this Property?
81 82 83
X
1. 2.
Have the water rights been recertified by the State of Oregon? To what body of water do the water rights pertain? North Fork John Day River
X
3.
Have the water rights been used beneficially during the last five years?
X
84
H.
X
85 86
Are there any ponds or body of water been constructed on this Property? 1.
If “yes”, is there a permit?
BUYER MAY WISH TO HAVE ANY NONPUBLIC WATER SOURCES TESTED FOR POTABILITY AND ADEQUACY OF SUPPLY. IV.
YES NO UNKNOWN N/A
87
A.
88 89 90 91 92 93 94 95 96
X X
SEWAGE
Is sanitary sewer currently available to this Property? 1.
If “yes”, where is the sewer line located?
2.
If “no”, will such service be available in the future?
B.
Are you aware of any sanitary sewer proposed for this Property?
C.
Is there a septic system on this Property? 1. 2.
cap fill sand filtration other X standard Last inspected by Don Moss Enterprised date 04/14/2016 Please attach a copy of the inspection report or invoice
3.
Date septic system was last pumped
4.
X
97
D.
98 99
If “yes”, what type of system?
by whom Don Moss Enterprises 04/14/2016 Any known problems or repairs? If “yes”, please explain on attached sheet.
If a septic system will need to be installed, is there a current governmental approval for such a system? 1.
If “yes”, what type of system?
standard
E.
X
sand filtration
other
Is there an abandoned septic system? If “yes”, where on this Property is it located?
BUYER MAY WISH TO HAVE THE SEWAGE SYSTEM INSPECTED
101
V.
YES NO UNKNOWN N/A
COMMON INTERESTS
102
X
A.
Are there CC&Rs?
103
X
B.
Is there a Home or Unit Owners' Association?
104 105 106 C.
X
108 109 110 111
cap fill
Date of approval
100
107
.
1.
If “yes” Who is the contact person?
2.
contact information: Monthly or annual dues
1. D.
X
Assessments
Is this Property in an area with a neighborhood group or community organization? If “yes”, contact information
Are there any features of this Property shared in common with adjoining landowners, such as a wall, fence,
roof, road, or driveway for which use or maintenance responsibility may affect this Property? Buyer Initials
/
Date
Seller Initials
/
Date
This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026
OREF 019 Page 3 of 4 www.zipLogix.com
Cheri L.
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
112 113 114
X X
E.
Are there any known disputes, irregularities, or other unsettled issues?
F.
Are there any “common areas” (facilities such as a pool, recreation building, tennis court, walkway, “greenbelt”, or other area) co-owned in undivided interest with others?
VI.
YES NO UNKNOWN N/A
115 116
A.
X
OTHER CONDITIONS OR DEFECTS
Are you aware of any other condition, defect, feature, problem, material fact, or issue in its immediate vicinity, affecting the buyer's use and/or enjoyment of this Property?
DOCUMENTS AND EXPLANATIONS 117 118 119 120 121 122 123 124 125 126 127 128
Please list any attached documents, reports, explanations of “Yes” answers, or those questions indicating an explanation here:
129
Seller's Signature
Pipe froze and broke in winter on well in shop. It has been repaired.
[Attach Addendum if necessary.] SELLER REPRESENTS TO BUYER THAT THE FOREGOING ANSWERS IN THIS VACANT LAND DISCLOSURE ADDENDUM, TOGETHER WITH ALL INCLUDED DOCUMENTS AND INFORMATION, IF ANY, ARE COMPLETE AND CORRECT TO THE BEST OF SELLER'S ACTUAL KNOWLEDGE, WITHOUT FURTHER INVESTIGATION OR TESTING. Date
, ________ ___ a.m. ___ p.m. ←
Date
, ________ ___ a.m. ___ p.m. ←
William Michael Heath, PR
130
Seller's Signature Cheri L. Heath-Rickert Trust
131 132 133 134 135 136 137 138 139
UNLESS PREVIOUSLY WAIVED BY BUYER IN WRITING, SELLER OR SELLER'S AGENT SHALL DELIVER A COPY OF THE COMPLETED VACANT LAND DISCLOSURE ADDENDUM TO ANY BUYER MAKING A WRITTEN OFFER TO PURCHASE THE PROPERTY. UPON RECEIPT BY BUYER OR BUYER'S AGENT, BUYER SHALL HAVE THE ABSOLUTE RIGHT TO REVOKE THEIR OFFER, FOR ANY REASON OR NO REASON, BY GIVING WRITTEN NOTICE TO SELLER OR SELLER'S AGENT WITHIN FIVE (5) BUSINESS DAYS (THE “REVOCATION PERIOD”). THE REVOCATION PERIOD SHALL COMMENCE: (A) ON THE NEXT BUSINESS DAY FOLLOWING THE DATE OF BUYER'S OR BUYER'S AGENT'S ACKNOWLEDGMENT (BELOW) OF DELIVERY OF THIS VACANT LAND DISCLOSURE ADDENDUM, OR (B) ON THE NEXT BUSINESS DAY FOLLOWING THE DATE BUYER AND SELLER HAVE SIGNED AND ACCEPTED THE SALE AGREEMENT, WHICHEVER OCCURS LAST (“THE DEADLINE”). UNLESS PREVIOUSLY WAIVED, IF BUYER'S RIGHT OF REVOCATION IS NOT TIMELY EXERCISED IN WRITING BY MIDNIGHT AT THE END OF THE LAST DAY OF THE DEADLINE, IT SHALL AUTOMATICALLY EXPIRE. IN ALL EVENTS, SAID RIGHT OF REVOCATION SHALL EXPIRE UPON CLOSING OF THE TRANSACTION.
140 141 142 143
ACKNOWLEDGMENT THE UNDERSIGNED HEREBY ACKNOWLEDGE THE DUTY TO SIGN, DATE, AND RETURN A COPY OF THIS PAGE OF THE ADDENDUM TO
144
Buyer's Signature
Date
, ________ ___ a.m. ___ p.m. ←
145
Buyer's Signature
Date
, ________ ___ a.m. ___ p.m. ←
146
Buyer's Agent Signature
Date
, ________ ___ a.m. ___ p.m. ←
SELLER OR SELLER'S AGENT PROMPTLY UPON RECEIPT FROM SELLER OR SELLER'S AGENT. A BAD FAITH REFUSAL TO DO SO COULD JEOPARDIZE BUYER'S ABILITY TO EFFECTIVELY EXERCISE THEIR RIGHT OF REVOCATION.
Julie Mansfield Smith This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026
OREF 019 Page 4 of 4 www.zipLogix.com
Cheri L.
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
INSTRUCTIONS TO THE SELLER 1 2 3 4 5 6 7 8 9 10
Please complete the following form. Answer all the questions. If a question is not applicable to this Property, mark N/A. Please explain each “YES” answer at Section VII below and attach pertinent documents and information. Please refer to the section and item of the question(s) when you provide your explanation(s). Please date and sign each page of this Disclosure Addendum and each attachment. SELLER(S) AUTHORIZE(S) ALL AGENTS TO PROVIDE A COPY OF THIS VACANT LAND DISCLOSURE ADDENDUM TO OTHER REAL ESTATE AGENTS AND PROSPECTIVE BUYERS OF THE PROPERTY.
NOTICE TO BUYER THIS IS A DISCLOSURE ADDENDUM MADE BY THE SELLER CONCERNING THE PROPERTY. IT IS NOT A GUARANTY OR WARRANTY REGARDING THE CONDITION OF THE PROPERTY. BUYER SHOULD SECURE SEPARATE ADVICE FROM EXPERTS OF BUYER'S CHOICE. REAL ESTATE BROKERS ARE NOT REQUIRED TO INSPECT REAL PROPERTY, CANNOT RENDER OPINIONS ON ITS PHYSICAL CONDITION OR LEGAL STATUS, AND MAKE NO WARRANTIES REGARDING THE ACCURACY OF THE INFORMATION CONTAINED HEREIN.
I.
YES NO UNKNOWN N/A
11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
A.
X
Is this Property subject to any of the following? other listing
first right of refusal
option
lease or rental agreement
life estate
X
B.
Are there any of the following? encroachments written or oral boundary or fencing agreements boundary disputes recent boundary changes.
X
C.
Are there any of the following?
X
D.
access limitations written or oral agreements concerning the use or access to/from this property Is there a written or oral agreement for joint maintenance of an easement?
X X
E.
Any sale, transfer or reservation of development, water or drainage rights?
X
F. G.
Any sale, transfer or reservation of oil, gas, or mineral rights? Are you aware of any governmental study, survey, or notice that would affect this Property?
X
H.
Are there any pending or existing assessments against this Property (other than real property taxes for the
I.
rights of way
easements (other than normal utility easements)
J.
current year)? What is the current zoning for the Property? EFU What is the current use of the Property? Grazing/hay production
X
K. L.
Are you aware of any pending land use change? Is there a land survey for this Property?
X
M.
Is this Property subject to any Covenants, Conditions, and Restrictions?
X
If “yes” see V. COMMON INTERESTS SECTION, below.
II.
YES NO UNKNOWN N/A
30 31 32 33 34 35 36
TITLE
A. B.
X X
Has there been any settling, soil problem, standing water, flooding, or drainage problem on this Property? Does the Property contain soil used to fill, build up or level areas of the ground (fill dirt)? 1.
If yes, does the fill dirt contain foreign materials (e.g. wood, rock, debris)?
X
C.
2. If yes, was the fill dirt compacted? Has this Property been identified as “wetland”, antiquities, dunes area, or other similar designation?
X
D.
Is the Property in a designated flood or slide zone?
E.
Has there been major damage to this Property from fire, wind, flood, earth movement, or landslide?
X
Buyer Initials
GENERAL INFORMATION
/
Date
Seller Initials
/
Date
This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Mossy Oak Properties Cupper Creek Land Company, 41909 Cupper Creek Rd. Kimberly, OR 97848 Phone: 541-934-2946 Julie Mansfield-Smith Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.com
OREF 019 Page 1 of 4 Fax:
Cheri L. Heath-Rickert
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
37 38 39 40 41 42 43 44 45 46 47 48 49 50
X
F.
X
G.
Are you aware of any tanks, above ground or underground storage tanks (e.g., fuel, chemical, abandoned septic tank, etc.) currently or previously on the Property? Are you aware of any hazardous material, toxic waste, or trash dumping on this Property?
H.
Are there any structure improvements or personal property located on the Property that may be included in a sale? If “yes” list all items Above ground fuel tank and irrigation pump/big gun sprinkler 1. Are there any defects or problems with any of these items? If “yes” describe all problems and defects:
X
I.
Has this Property been used for the manufacture or distribution of illegal substances excluding marijuana? Note: Although marijuana has been legalized for medicinal and recreational use in Oregon, it remains a “Controlled Substance” under Federal Law, and is illegal. See
X
J.
X X
https://www.whitehouse.gov/ondcp/state-laws-related-to-marijuana
Has this Property been used to legally grow marijuana for either medicinal or recreational use as permitted under Oregon laws?
BUYER MAY WISH TO INVESTIGATE FURTHER ANY OF THE ISSUES MENTIONED ABOVE. III.
YES NO UNKNOWN N/A
51
A.
X
52 53 54
WATER
Is there currently a domestic water supply for this Property? 1.
If “yes”, from what source?
public utility
community water system X private well
other (specify) 2.
55
X
56
X
57
X
58
B.
X
If “no”, is a permit required and has it been applied for?
If Property is currently supplied from a well: 1.
Is there more than one well?
2.
Is (are) the well(s) on-site? (If No, attach explanation).
3.
Is (are) the well(s) shared?
59
a.
Is there an oral or written agreement for a shared well?
60
b.
Is there an easement (recorded or unrecorded) for access to and maintenance of a shared well?
61
4.
Is a copy of the well log(s) available?
62
5.
Well depth(s) is estimated to be 28.5
feet
63
6.
Well(s) supplied approximately 10
gallons per minute (GPM) of water.
X
64 65
a.
66
7.
X
67 8.
69 70 71
If “yes”, what is the capacity of the tank?
Well is 50
years old. Pump type:
gallons.
submersible X jet. Pump make
Installed by Serviced by Red's Electric 9.
X
72 73 74
a flow test of the well performed when
Is there a holding tank in addition to the pressure tank for the water system? a.
68
This figure is taken from X well log and by whom
date date of last service
Are there any known problems or have there been any repairs to the water system?
10. Has a
coliform bacteria
nitrates
domestic water supply? If “yes”, when C.
X
75
Is there a water treatment system? If “yes”, 1.
Buyer Initials
/
04/14/2016
arsenic or 4-14-16
owned or
other water quality test been performed on by whom Red's Electric
leased?
If “yes”, for what purpose was the water treatment system installed?
Date
Seller Initials
/
Date
This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026
OREF 019 Page 2 of 4 www.zipLogix.com
Cheri L.
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
76
2.
77
X
78
Is the water treatment system in good working order? (If No, attach explanation).
D.
Are there any abandoned wells on the Property?
E.
Do you have other pertinent information regarding the water supply? If “yes”, please attach an explanation.
79
X
F.
Is there an irrigation well(s)? If “yes”, how many? 1
80
X
G.
Are there water appropriation rights for this Property?
81 82 83
X
1. 2.
Have the water rights been recertified by the State of Oregon? To what body of water do the water rights pertain? North Fork John Day River
X
3.
Have the water rights been used beneficially during the last five years?
X
84
H.
X
85 86
Are there any ponds or body of water been constructed on this Property? 1.
If “yes”, is there a permit?
BUYER MAY WISH TO HAVE ANY NONPUBLIC WATER SOURCES TESTED FOR POTABILITY AND ADEQUACY OF SUPPLY. IV.
YES NO UNKNOWN N/A
87
A.
88 89 90 91 92 93 94 95 96
X X
SEWAGE
Is sanitary sewer currently available to this Property? 1.
If “yes”, where is the sewer line located?
2.
If “no”, will such service be available in the future?
B.
Are you aware of any sanitary sewer proposed for this Property?
C.
Is there a septic system on this Property? 1. 2.
cap fill sand filtration other X standard Last inspected by Don Moss Enterprised date 04/14/2016 Please attach a copy of the inspection report or invoice
3.
Date septic system was last pumped
4.
X
97
D.
98 99
If “yes”, what type of system?
by whom Don Moss Enterprises 04/14/2016 Any known problems or repairs? If “yes”, please explain on attached sheet.
If a septic system will need to be installed, is there a current governmental approval for such a system? 1.
If “yes”, what type of system?
standard
E.
X
sand filtration
other
Is there an abandoned septic system? If “yes”, where on this Property is it located?
BUYER MAY WISH TO HAVE THE SEWAGE SYSTEM INSPECTED
101
V.
YES NO UNKNOWN N/A
COMMON INTERESTS
102
X
A.
Are there CC&Rs?
103
X
B.
Is there a Home or Unit Owners' Association?
104 105 106 C.
X
108 109 110 111
cap fill
Date of approval
100
107
.
1.
If “yes” Who is the contact person?
2.
contact information: Monthly or annual dues
1. D.
X
Assessments
Is this Property in an area with a neighborhood group or community organization? If “yes”, contact information
Are there any features of this Property shared in common with adjoining landowners, such as a wall, fence,
roof, road, or driveway for which use or maintenance responsibility may affect this Property? Buyer Initials
/
Date
Seller Initials
/
Date
This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026
OREF 019 Page 3 of 4 www.zipLogix.com
Cheri L.
DocuSign Envelope ID: 375A7104-77AE-401B-9E62-C2C41A4C6684
VACANT LAND DISCLOSURE ADDENDUM Property Address 43697 HIGHWAY 402, Kimberly, OR, OR 97848
112 113 114
X X
E.
Are there any known disputes, irregularities, or other unsettled issues?
F.
Are there any “common areas” (facilities such as a pool, recreation building, tennis court, walkway, “greenbelt”, or other area) co-owned in undivided interest with others?
VI.
YES NO UNKNOWN N/A
115 116
A.
X
OTHER CONDITIONS OR DEFECTS
Are you aware of any other condition, defect, feature, problem, material fact, or issue in its immediate vicinity, affecting the buyer's use and/or enjoyment of this Property?
DOCUMENTS AND EXPLANATIONS 117 118 119 120 121 122 123 124 125 126 127 128
Please list any attached documents, reports, explanations of “Yes” answers, or those questions indicating an explanation here:
129
Seller's Signature
Pipe froze and broke in winter on well in shop. It has been repaired.
[Attach Addendum if necessary.] SELLER REPRESENTS TO BUYER THAT THE FOREGOING ANSWERS IN THIS VACANT LAND DISCLOSURE ADDENDUM, TOGETHER WITH ALL INCLUDED DOCUMENTS AND INFORMATION, IF ANY, ARE COMPLETE AND CORRECT TO THE BEST OF SELLER'S ACTUAL KNOWLEDGE, WITHOUT FURTHER INVESTIGATION OR TESTING. Date
, ________ ___ a.m. ___ p.m. ←
Date
, ________ ___ a.m. ___ p.m. ←
William Michael Heath, PR
130
Seller's Signature Cheri L. Heath-Rickert Trust
131 132 133 134 135 136 137 138 139
UNLESS PREVIOUSLY WAIVED BY BUYER IN WRITING, SELLER OR SELLER'S AGENT SHALL DELIVER A COPY OF THE COMPLETED VACANT LAND DISCLOSURE ADDENDUM TO ANY BUYER MAKING A WRITTEN OFFER TO PURCHASE THE PROPERTY. UPON RECEIPT BY BUYER OR BUYER'S AGENT, BUYER SHALL HAVE THE ABSOLUTE RIGHT TO REVOKE THEIR OFFER, FOR ANY REASON OR NO REASON, BY GIVING WRITTEN NOTICE TO SELLER OR SELLER'S AGENT WITHIN FIVE (5) BUSINESS DAYS (THE “REVOCATION PERIOD”). THE REVOCATION PERIOD SHALL COMMENCE: (A) ON THE NEXT BUSINESS DAY FOLLOWING THE DATE OF BUYER'S OR BUYER'S AGENT'S ACKNOWLEDGMENT (BELOW) OF DELIVERY OF THIS VACANT LAND DISCLOSURE ADDENDUM, OR (B) ON THE NEXT BUSINESS DAY FOLLOWING THE DATE BUYER AND SELLER HAVE SIGNED AND ACCEPTED THE SALE AGREEMENT, WHICHEVER OCCURS LAST (“THE DEADLINE”). UNLESS PREVIOUSLY WAIVED, IF BUYER'S RIGHT OF REVOCATION IS NOT TIMELY EXERCISED IN WRITING BY MIDNIGHT AT THE END OF THE LAST DAY OF THE DEADLINE, IT SHALL AUTOMATICALLY EXPIRE. IN ALL EVENTS, SAID RIGHT OF REVOCATION SHALL EXPIRE UPON CLOSING OF THE TRANSACTION.
140 141 142 143
ACKNOWLEDGMENT THE UNDERSIGNED HEREBY ACKNOWLEDGE THE DUTY TO SIGN, DATE, AND RETURN A COPY OF THIS PAGE OF THE ADDENDUM TO
144
Buyer's Signature
Date
, ________ ___ a.m. ___ p.m. ←
145
Buyer's Signature
Date
, ________ ___ a.m. ___ p.m. ←
146
Buyer's Agent Signature
Date
, ________ ___ a.m. ___ p.m. ←
SELLER OR SELLER'S AGENT PROMPTLY UPON RECEIPT FROM SELLER OR SELLER'S AGENT. A BAD FAITH REFUSAL TO DO SO COULD JEOPARDIZE BUYER'S ABILITY TO EFFECTIVELY EXERCISE THEIR RIGHT OF REVOCATION.
Julie Mansfield Smith This form has been licensed for use solely by Julie Mansfield-Smith pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.
Copyright Oregon Real Estate Forms, LLC 2017 www.orefonline.com No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026
OREF 019 Page 4 of 4 www.zipLogix.com
Cheri L.
