Water Well Sewage Disclosure.P...
Reference(e,g., Sciiter& *rllrrrY)
Flenker
#
Missouri
REALTORS'
Sysem DisclosureRider WatertlUelUsewage
ffig:r*|inrmnsf frer bgnf sanse.1rrercss. tf you da not undersfandit, gongglt y9ry attamey. tt should be Dtscfo$rreSr&fetnentfq Resldentiel}+.?,pefty'?. ffufredF sg #lafgr..tdtsGffruf"$efFr's coneming the followirqproperty{the"Property'}: Tfib &isdosrseAideris m#e by fie $dersignedSet'ftsr
*-gunnseleach-- --MO- * 65q7€ ----see zpwe &
D-r---O4-S-undanoe Srso{Adfass
Camden huw
tt itry ffi #E tsot€,-Sel;er may,pt frqaenily ns dre lfals HcilffSerr4n Sy*m. F tffi, b problan free. Evenif twvily ufitffi, probHns mty srrrface&# retepredous*f rfft*|ffi6lh{m4hr :ffVc flNo (lf "Yes", complateatlof the toltowing) (3) Hm thewellbeentested?l_jYes?SNo prp|pjiltyormmmu*ty bt? ilYGsXlt|o (ai rcanypartof the welllocatedon a neighbor's propefiy(ies)? with any other lsfrE ucllshated Bfes INo {5) 'Yes', agreement? istherea recorded tf KYes ill',lo S) tlave y4nlUeennotiteOor citiO by anyarfr-orttyTitranyproblernrelatedto thewaterwelts5;!9m?lYesS,No wellsystem?[Yes^8No g4 serviceagreementooveringthe_water trerb a crrn€ntmaintenance . ' ts'Yes', urfiaris the annualcostandwhois thecurrentprwider? lf $ A* F" awareot anyptanto bringpuuiicuateril.g., Ciifwaer Dlbrrrct)@ a;i proil€rn or repair nsaded-forany part d $o ualer well slctem? I .lYe.Kfh igl t" imu arso d'Yei" a4taFtt answerabove.lnclu& all availablatest reopirtsand rapir iistory (atac# adW irieaseexptainany needlN): a phrafm' srrarddff Gcrrx.?ftEt$ !? (meaning (If 'Yes', clr..rpbteafr6he ffiw'fr|g| lift sEfion Ofter cistEmljlt Stion {.rh€r (1) CheckalI that apply:(sqdi9{ateEDagoqlt cisteln
L-rYes;Xlo tzi oo youhavea dialrat'-otthr$ury- System?
(3) tf a lagoor, is there a fenoe? fJYesjSNo
the surface?ffes f F.loAreclean{uts present?Fes [[,lo i+i ft a m!*canf, is it reaOifyaa"ceqpitfEirom Of wfratis thetankconstr@d?X$ted ilCpncretelother: Doesit discfrargeintoa jdeqlor lagoon?EYesr-:No system? Ll Yes$h ff 'Y€s , lgl.ryqy}(sl Dos anvottrer-propetry'ffiit ;fi; the-seumg€ tgi S*w p#t otttre SiwageSystemlocatedon a neigfibor'spropertyor communitylot?[-lYesffihlo 64 e trterea wellwfthin5Ofeet of the ServageSysrern?fiVes.ilr{o lUnknown (8) Doesthe Sew4e Systemhavean aerator?ilYesp$lo (e.g.,sink,tub or sfiowetitispdEeoutside$ tlF SerrageSyst"g.,[vg1$&t €i D*" anyptum6ing or discharge(efftuence)fromtheSewageSystemltrYe EQb it'O)ts therednyuntreaied-seepage yourlryperty-?fYe5l.lo (11)Doesanyeffluencefroma neigtrbo/ssystemdisperseonto (tZi l-laveyounoticedany unusualodorsfromthe ServageSystem?[-]Yes[$tS backups? slowdrainageqrdrain (13)Haveyouexperienced [Yeff]'Io serviceagreerilentcovaingthe SewageSystem?[]Yesfi ]fo therba cunentmaintenance itli ts'Ye$", wfiatis the annualcostandwfn is the currentprovider? lf SVstgq.FYes.KNo serviceagresnentf9r tle Se'arage (1Slfhc$ sny gowmmentautfnrityrquire a maintenance problern to $ewage System? ielated the lor any by irny zuthority noiified citei or tYesXNo fhury* f,sen ttei {lfl Harreyouarparde{ rpdatedor mo'difiedthe SewageSys*em?ffiYesINo ownershipoffe-Prry-rty? fiSYesLlle tt3i ibse iou dier$, psirped or servicedthe Seyrage$yst€mduring-your part $y*m! ilYes ry$b $e *rago for any of npair re*d y*r or any $f +iare in" *t*ir"t pgso arygrk a*y'Vig" pnsryerabotr'-,lncfu*al!avaibblepermifs, Sstrgggrtsand rryir history(aftachaddltional t ns*al I eL.}n Ro t S rr€lesir nilrgilerl,l:',21,&ut frrtk Buyefs tnitiafrs-
$lter'e tn*ias ."ryr/d4 -(dd4
(d#l
o/rt,
/b
Apprwed by teSalcounsel tor use exclusivelyby current msrnbarsof Mbsouri REALTORSE,Cdu"mbia,Mi$so$ri. No warrslty is mde oI iftptied ai io *e f€da vifCity or aCequacyd thts Rider,-orth* it comptiesin e*cry respect wilh theltr crthd its ese hsryprffri*F fur* sit$*ists. L€Ed law.custoni and practice,and differing circlnnstanc€sin each tran$etion, mry oacttdictate thatarendns*stcthis Ri&rbe ltEl&REALTORS@ @2016tlisqri Effectva lfillltO
Providd by: --------
*---$-hitlgJ
JOngS*
m6 friBrrd
Flenker
#
Missouri
REALTORS'
Sysem DisclosureRider WatertlUelUsewage
ffig:r*|inrmnsf frer bgnf sanse.1rrercss. tf you da not undersfandit, gongglt y9ry attamey. tt should be Dtscfo$rreSr&fetnentfq Resldentiel}+.?,pefty'?. ffufredF sg #lafgr..tdtsGffruf"$efFr's coneming the followirqproperty{the"Property'}: Tfib &isdosrseAideris m#e by fie $dersignedSet'ftsr
*-gunnseleach-- --MO- * 65q7€ ----see zpwe &
D-r---O4-S-undanoe Srso{Adfass
Camden huw
tt itry ffi #E tsot€,-Sel;er may,pt frqaenily ns dre lfals HcilffSerr4n Sy*m. F tffi, b problan free. Evenif twvily ufitffi, probHns mty srrrface&# retepredous*f rfft*|ffi6lh{m4hr :ffVc flNo (lf "Yes", complateatlof the toltowing) (3) Hm thewellbeentested?l_jYes?SNo prp|pjiltyormmmu*ty bt? ilYGsXlt|o (ai rcanypartof the welllocatedon a neighbor's propefiy(ies)? with any other lsfrE ucllshated Bfes INo {5) 'Yes', agreement? istherea recorded tf KYes ill',lo S) tlave y4nlUeennotiteOor citiO by anyarfr-orttyTitranyproblernrelatedto thewaterwelts5;!9m?lYesS,No wellsystem?[Yes^8No g4 serviceagreementooveringthe_water trerb a crrn€ntmaintenance . ' ts'Yes', urfiaris the annualcostandwhois thecurrentprwider? lf $ A* F" awareot anyptanto bringpuuiicuateril.g., Ciifwaer Dlbrrrct)@ a;i proil€rn or repair nsaded-forany part d $o ualer well slctem? I .lYe.Kfh igl t" imu arso d'Yei" a4taFtt answerabove.lnclu& all availablatest reopirtsand rapir iistory (atac# adW irieaseexptainany needlN): a phrafm' srrarddff Gcrrx.?ftEt$ !? (meaning (If 'Yes', clr..rpbteafr6he ffiw'fr|g| lift sEfion Ofter cistEmljlt Stion {.rh€r (1) CheckalI that apply:(sqdi9{ateEDagoqlt cisteln
L-rYes;Xlo tzi oo youhavea dialrat'-otthr$ury- System?
(3) tf a lagoor, is there a fenoe? fJYesjSNo
the surface?ffes f F.loAreclean{uts present?Fes [[,lo i+i ft a m!*canf, is it reaOifyaa"ceqpitfEirom Of wfratis thetankconstr@d?X$ted ilCpncretelother: Doesit discfrargeintoa jdeqlor lagoon?EYesr-:No system? Ll Yes$h ff 'Y€s , lgl.ryqy}(sl Dos anvottrer-propetry'ffiit ;fi; the-seumg€ tgi S*w p#t otttre SiwageSystemlocatedon a neigfibor'spropertyor communitylot?[-lYesffihlo 64 e trterea wellwfthin5Ofeet of the ServageSysrern?fiVes.ilr{o lUnknown (8) Doesthe Sew4e Systemhavean aerator?ilYesp$lo (e.g.,sink,tub or sfiowetitispdEeoutside$ tlF SerrageSyst"g.,[vg1$&t €i D*" anyptum6ing or discharge(efftuence)fromtheSewageSystemltrYe EQb it'O)ts therednyuntreaied-seepage yourlryperty-?fYe5l.lo (11)Doesanyeffluencefroma neigtrbo/ssystemdisperseonto (tZi l-laveyounoticedany unusualodorsfromthe ServageSystem?[-]Yes[$tS backups? slowdrainageqrdrain (13)Haveyouexperienced [Yeff]'Io serviceagreerilentcovaingthe SewageSystem?[]Yesfi ]fo therba cunentmaintenance itli ts'Ye$", wfiatis the annualcostandwfn is the currentprovider? lf SVstgq.FYes.KNo serviceagresnentf9r tle Se'arage (1Slfhc$ sny gowmmentautfnrityrquire a maintenance problern to $ewage System? ielated the lor any by irny zuthority noiified citei or tYesXNo fhury* f,sen ttei {lfl Harreyouarparde{ rpdatedor mo'difiedthe SewageSys*em?ffiYesINo ownershipoffe-Prry-rty? fiSYesLlle tt3i ibse iou dier$, psirped or servicedthe Seyrage$yst€mduring-your part $y*m! ilYes ry$b $e *rago for any of npair re*d y*r or any $f +iare in" *t*ir"t pgso arygrk a*y'Vig" pnsryerabotr'-,lncfu*al!avaibblepermifs, Sstrgggrtsand rryir history(aftachaddltional t ns*al I eL.}n Ro t S rr€lesir nilrgilerl,l:',21,&ut frrtk Buyefs tnitiafrs-
$lter'e tn*ias ."ryr/d4 -(dd4
(d#l
o/rt,
/b
Apprwed by teSalcounsel tor use exclusivelyby current msrnbarsof Mbsouri REALTORSE,Cdu"mbia,Mi$so$ri. No warrslty is mde oI iftptied ai io *e f€da vifCity or aCequacyd thts Rider,-orth* it comptiesin e*cry respect wilh theltr crthd its ese hsryprffri*F fur* sit$*ists. L€Ed law.custoni and practice,and differing circlnnstanc€sin each tran$etion, mry oacttdictate thatarendns*stcthis Ri&rbe ltEl&REALTORS@ @2016tlisqri Effectva lfillltO
Providd by: --------
*---$-hitlgJ
JOngS*
m6 friBrrd
