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WISCONSIN REALTORS®ASSOCIATION Stark Company Realtors®(Stoughton) <br /> 4801 Forest Run Road Page 1 of 3 <br /> Madison,Wisconsin 53704 [VACANT LAND DISCLOSURE REPORT 1 <br /> DISCLAIMER <br /> A. THIS DISCLOSURE REPORT CONCERNS THE REAL PROPERTY LOCATED AT E(- i I 1 -v j.) 4.-_____ <br /> .) _ (STREET ADDRESS)IN THE - 5,( ITY) ILLAG )`(TOWN) <br /> OF r z.,,< ;,��•.,..) s COUNTY OF .n,•._ i, v —MATE OF <br /> WISCONSIN. THIS REPORT IS A DISCLOSURE OF THE CONDITION OF THAT P OPERTY IN COMPLIANCE WITH SECTION <br /> 709.02 OF THE WISCONSIN STATUTES AS OF =S«v,,..r (MONTH) I (DAY), .� u l _1 (YEAR).IT IS NOT A <br /> WARRANTY OF ANY KIND BY THE OWNER OR ANY AGENTS PRESENTING ANY PRINCIPAL IN THIS TRANSACTION AND <br /> IS NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THAT THE PRINCIPALS MAY WISH TO OBTAIN. <br /> OWNER'S INFORMATION <br /> B.1 In this form, "am aware" means have notice or knowledge. In this form, 'defect" means a condition that would have a <br /> significant adverse effect on the value of the property; that would significantly Impair the health or safety of future occupants of <br /> the property;or that if not repaired,removed or replaced would adversely affect the use of the property. <br /> B.2 The owner discloses the following information with the knowledge that, even though this is not a warranty, prospective <br /> buyers may rely on this information in deciding whether and on what terms to purchase the property. The owner hereby <br /> authorizes any agent representing any principal in this transaction to provide a copy of this statement, and to disclose any <br /> information in the statement,to any person in connection with any actual or anticipated sale of the property. <br /> 8.3 The owner represents that to the best of his or her knowledge the responses to the following statements have been <br /> accurately noted as °yes", "no" or 'not applicable° to the properly being sold. If the owner responds to any statement with "yes", <br /> the owner shall provide, in the additional information area of this form, an explanation of the reason why the response to the <br /> statement is"yes". if a statement is instead answered by a third party expert's written information, check °See Expert's Report'and <br /> attach the information.' <br /> B.4 If the transfer is of a condominium unit, the property to which this form applies is the condominium unit, the common <br /> elements of the condominium and any limited common elements that may be used only by the owner of the condominium unit <br /> being transferred. <br /> See <br /> Expert's <br /> PROPERTY CONDITION STATEMENTS* Yes No N/A Report <br /> C.1. I am aware of proposed,planned,or commenced public improvements or public L <br /> construction projects that may result in special assessments or that may otherwise <br /> materially affect the property or the present use of the property. <br /> C.2. I am aware of a government agency,court order,or federal,state,or local _ <br /> regulations requiring repair,alteration,or correction of an existing condition. <br /> C.3. I am aware of a land division or subdivision for which required state or local approvals <br /> were not obtained. <br /> C.4. I am aware that all or a portion of the property is in a floodplain,wetland,or shoreland X_. <br /> zoning area under local,state,or federal regulations. <br /> C.5. I am aware that all or part of the property is subject to,or in violation of,art agricultural _ -- <br /> conservation easement or a farmland preservation agreement with the Wisconsin <br /> Department of Agriculture,Trade and Consumer Protection(DATCP)(also see item <br /> D.2.),or under a county farmland preservation plan or enrolled in,or in violation of,a <br /> forest cropland, managed forest land(also see item D.2m.),conservation reserve, <br /> or other comparable program. <br /> C.6. I am aware of a boundary or lot dispute,an encroachment,an encumbrance,a joint > <br /> driveway,or a violation of the fence laws under ch.90,Wis.scats. <br /> C.7. I am aware of a material violation of an environmental rule or other rule or agreement <br /> — <br /> regulating the use of the property. <br /> am aware of any condition constituting a significant health risk or safety hazard for <br /> .ccupants of the property. <br /> C.9. I am aware of underground storage tanks presently or previously on the property for -7 4—storage of flammable or combustible liquids,including,but not limited to,gasoline or <br /> heating oil.(If"yes,"the owner,by law,may have to register the tanks with the Wisconsin <br /> Department of Safety and Professional Services at P.O. Box 7970, Madison,Wisconsin, <br /> 53707,whether the tanks are in use or not.Regulations of the Wisconsin Department <br /> of Safety and Professional Services may require the closure or removal of unused tanks.) <br /> Stark Company Realtors®(Stoughton)1609 Hwy 51 and 138 Stoughton,WI 53589 Untitled <br /> Fax: 608-205-3035 <br /> produced u+[h zipForrn)by zfplogc ib0r0 Fifteen%le Road.Fraser,M chigan 48026 waw zrologx corn <br />