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<br />JUL 22 ''38
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<br />03:16PM PET, BELL,CONV,JENSE
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<br />P.6/8
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<br />r,orIQHO. 282A.fWF.ll .............w.,.-.,.nl~\!!!9
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<br />YJ,'TII'""o; D.........C"" ..,1.1
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<br />MINNESOTA WELL DISCLOSURE STATEMENT
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<br />MInnP.~oIGl Law require! '''all~'nfeo I:Ignin9 "'" tlQreement to sfllI (lr Ira"sler 'eal proMrly afll-!t ,llIn... 30. 11190, Ihe
<br />~rle' m~.I disclose InrfJlmAUon in W\'.,i"'g 10 Ihe buv~' ahrlll' Iht' $t~tur. ttnd 10C<!tion ur..n k"owf\ wf!'IIO on Ine prODr.''tIly,
<br />ThIs '~auirt':l"...n( Is sal;elH:!d by deriveril'll,.J to Ihl'! t.I'.ry~r gilher "s!8lcmenl by Ihe ~elJflr Itlat Ihe ,,~rler dlk::; rlor kr'ICwOr
<br />it"Y _I~ on Ihe property. (JI a ~jl!'lr.r()~u'e I:lalcmcnl inrliva1l1 'II rl1l;l leg:!1 dflr.oriplion ~nd culm')' !!nr1 ~ r"~" ;howing
<br />tho JOc::lllon 0' eael, wP./1 In 'he disc1ot:ure sll'!ll!ITIl'" ,I II...,. ~elrer mllol irldic"'e. 'QI HHr:h w"",,, whg'hqr th~ well is in {J~H,
<br />no! in use or ~(I$lI"tI.
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<br />^ "eller ""Iu' fail\: to dh::c/m:('} (he o)\ist~llLe 01 ~ werr :lllhq'ime 01 ~(l1e 81111 knqw of, Or nod re6S0n I\J k,lI.}w nl, II,,;!
<br />ex~1t-!'w::e 0' ;II weA i:'I tisble 10 Ih~ b!lyPr fOr COl:lt rclnl;n(.Ilo Ih~ sp..,JI\9 Of rho woll !I'1d re<1"SIJfIHh'" Allornay 'get: lor
<br />collection 0' r.:osls 'tum 'h~ !:eU~r. it tkc !!clion is r;<1'nm~1cRd wi!hi" ,ix V~QI~ IIff!'!' lI'e d$llg II." b"yer <;rose,1 n,,,,
<br />purcl r<:lSe 0' 1~ rp.~1 prop,,"Y where 1I".i \YIi111 19'OCfllod.
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<br />Inslruel/on lor completion ofthle form are on Ih9 revarl!to side.
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<br />I. PROPERTY DE9CRIPTrON
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<br />SI'eef edd'(f~'S: .
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<br />,. LEGAL DESCRrPTION
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<br />3. WELL DI~ClOSURE S r A TEMENT
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<br />CCh~clo; Ih!;! flf)pr"prilile box,)
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<br />o The selli!l r:':"JIllIp.t 'I1al (he ~eller does lIul krmw or 9ny woll$ on 'he ab,~v.. ,..IIE',>crlhAd real properly,
<br />rr'h~ cpfioo ill c/1oc((ed.lhen !':kip 10 IhG I<lS! ['or: 6F'1d Siljln i!IIJU dRI!'! Ihj~ ~1:Jtgmcnl
<br />o ThfI fiener c~rliffe~ t"i:lllhFl rolloWlng wcllo ~re '1X;1"I'e(' <III thG !;It'o,,!! d~cr;b~d real lJ'Urp.rry
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<br /> MN, Uniq,,- liIIell Year 0' Well INtlSF. Nor IN SI:^lEO
<br /> WAIl NQ. (.lop," Cun!:' Type US'='
<br />Well 1 - --..'-- -- (J Ll 0
<br />w~ 2 ._~.-- ._,,---- 0 n 0
<br />Wet' 3 --",---- ,-~ ~,......_---------- D (J 0
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<br />4. SEA.LED WEll 'NFORMA TlON
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<br />r.or eacll ....ell ~sign;lIgd EI!: :JCEJled i!lbovl'!, 1:<.I"'pI~lg l111S ~r,Hon,
<br />WhH" wag I hQ well :leDled';'
<br />wno sealed 'he wen?
<br />Was e SealeLl W~l' Reporllilad wit~ Ihe Minfll-!snll'! Oep;lr,,,.,cnt 0' Hea.llh? YI:1~ .,__ No_._ A
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<br />6. MAP
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<br />Com pier!! III~ .nlecf19(! m;1p $l1Qwino lilt:! 'n~lIon 01 Oacl1 wen on I~ (e;!! pI r.'p",r.y,
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<br />6. cr::RTIFrCATION BY SELLER
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<br />'C8fUfy Ihe'lhA InlorrnatlQn r'~e...lcI8d abo"", liQ ;JOCLJraI9 andeomp1ele 10 tile 1:H;I!;1 ~I my k"o....'9dgc.
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<br />,.~ttJDt:t'ia...Il....f'r:'(1I~ltI~
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<br />(11101-:'
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<br />~oIl;1i."..,.II~1 n,:.p.I1............1)
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