~..,~

TEXAS ASSOCIATION OF REALTORS®SELLER'S DISCLOSURE NOTICE

ClTexas Association of REALTOR~,lnc.2016

Section 5.008, Property Code requires a seller of residential property of not more than one dwelling unit to deliver a Seller's DisclosureNotice to a buyer on or before the effective date of a contract. This form complies with and contains additional disclosures which

exceed the minimum disclosures required by the Code.

CONCERNING THE PROPERTY AT6930 CR 146

Bedias, TX 77831

THIS NOTICE IS A DISCLOSURE OF SELLER'S KNOWLEDGE OF THE CONDITION OF THE PROPERTY AS OF THEDATE SIGNED BY SELLER AND IS NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THE BUYERMAY WISH TO OBTAIN. IT IS NOT A WARRANTY OF ANY KIND BY SELLER, SELLER'S AGENTS, OR ANY OTHERAGENT.

Seller X- is _ is not occupying the Property. If unoccupied (by Seller), how long since Seller has occupied the Property?_ or _ never occupied the Property

Section 1. The Property has the items marked below: (Mark Yes (Y), No (N), or Unknown (U).)This notice does not establish the items to be conveyed. The contract will determine which items will & will not convey.

Item Y N UCable TV Wiring ".

Carbon Monoxide Det. VCeiling Fans tCooktop VDishwasher II'

Disposal II'

Emergency EscapeLadder(s) .IExhaust Fans 1.1Fences Iv':Fire Detection Equip. i I"French Drain ,..I •Gas Fixtures VNatural Gas Lines

Item Y N U Item Y N ULiquid Propane Gas: v' Pump: sump grinder Iv-LP Community (Captive) t/ Rain Gutters V-LP on Property tI Range/Stove Iv'Hot Tub II Roof/Attic VentsIntercom System tI Sauna VMicrowave v' Smoke Detector IvOutdoor Grill V Smoke Detector - Hearing

Impaired VPatio/Deckinq ..; Spa v:Plumbing System V Trash Compactor v'Pool v' TV Antenna V

Pool Equipment cI Washer/Dryer Hookup IvPool Maint. Accessories 1/ Window Screens IvPool Heater v' Public Sewer System 'V"

Item Y N U Additional InformationCentral NC V electric gas number of units:Evaporative Coolers V number of units:WalllWindow AC Units Iv number of units:Attic Fan(s) v' if yes, describe:Central Heat v electric .,;gas number of units: IOther Heat V if yes, describe:Oven v" number of ovens: f velectric qas other:Fireplace & Chimney Iv wood gas logs mock other:Carport " Vattached not attachedGarage Iv attached not attachedGarage Door Openers Ii number of units: number of remotes:Satellite Dish & Controls V owned v1ease from: D \ Rtrt r rVSecurity System V owned lease from:Water Heater v electric V gas other: number of units: IWater Softener .; owned lease from:Underground Lawn Sprinkler lV automatic manual areas covered:Septic / On-Site Sewer Facility V if yes, attach Information About On-Site Sewer Facility (TAR-1407)

(TAR-1406) 01-01-16 Initialed by: Buyer: and Seller: (YY)!'O , 1/.iJBrlw Land Compl'y, 116 . Mlin t. And...on. TX 77830 PhO~OOO~x: (936)873-2301Lauren Stuart Produced with zipFor~ by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 wwwzjpLogjx com

Page 1 of 5Joe :md Kay

6930 CR 146Concerning the Property at Bedias, TX 77831

Water supply provided by: _ city~ell_ Ml)D _ co-op _ unknown _ other: _Was the Property built before 1978? _ yes _Vno _ unknown

(If yes, complet~,~ig~, and attach TAR-1906 concerning lead-based paint hazards).Roof Type: ..,~ Age: _ .....d-'-=O.....I_~"'-- (approximate)Is there an overlay roof c9vering on the Property (shingles or roof covering placed over existing shingles or roofcovering)? _ yes _ no xunknown

Are you (Seller) aware of anypf the items listed in this Section 1 that are not in working condition, that have defects, orare need of repair? _ yes Xno If yes, describe (attach additional sheets if necessary): _

Section 2. Are you (Seller) aware of any defects or malfunctions in any of the following?: (Mark Yes (V) if you areaware and No (N) if you are not aware.)

Item V NBasementCeilingsDoorsDrivewaysElectrical SystemsExterior Walls

Item V NFloorsFoundation / Slab(s)Interior WallsLighting FixturesPlumbing SystemsRoof

Item V NSidewalksWalls / FencesWindowsOther Structural Components

If the answer to any of the items in Section 2 is yes, explain (attach additional sheets if necessary): _

Section 3. Are you (Seller) aware of any of the following conditions: (Mark Yes (V) if you are aware and No (N) ifyou are not aware.)

Condition V NAluminum Wiring vAsbestos Components VDiseased Trees: oak wilt vi'Endangered Species/Habitat on Property VFault Lines VHazardous or Toxic Waste ./Improper Drainage &I'Intermittent or Weather Springs VLandfill VLead-Based Paint or Lead-Based Pt. Hazards vEncroachments onto the Property vi'Improvements encroaching on others' property &I'Located in 1DO-year Floodplain vi'Located in Floodway VPresent Flood Ins. Coverage

V(If yes, attach TAR-1414)Previous Flooding into the Structures VPrevious Flooding onto the Property ~Located in Historic District v'Historic Property Designation t/Previous Use of Premises for Manufacture .;of Methamphetamine

Condition V NPrevious Foundation Repairs ifPrevious Roof Repairs ,/Other Structural Repairs v'Radon Gas vSettling VSoil Movement VSubsurface Structure or Pits VUnderground Storage Tanks v'Unplatted Easements VUnrecorded Easements IIUrea-formaldehyde Insulation IIWater Penetration ./Wetlands on Property VWood Rot VActive infestation of termites or other wood

~destroying insects (WDI)Previous treatment for termites or WDI v'Previous termite or WDI damage repaired VPrevious Fires V .Termite or WDI damage needing repair ,;Single Blockable Main Drain in Pool/Hot

ITub/Spa·

(TAR-1406) 01-01-16 Initialed by: Buyer: , and Seller: , _Produced with zipFor~ by zipLogix 18070 Fifteen Mile Road. Fraser. Michigan 48026 WWN z'pLog;x com

Page 2 of 5Jo..nd KIY

smg e oc a e mam ram may cause a suc Ion en rapmen azar or an m IVI ua.

6930 CR 146Concerning the Property at Bedias, IX 77831

If the answer to any of the items in~s, explain (attach additional sheets if necessary):~

i%;~i&OI£~~~~~~~lf ~~JO.di;U.if: t th df . dd I

Section 4. Are you (Seller) aware of any item. equipment, or system in or on the Property that is in need of repair,which has not been previously disclosed in this notice? _ yes Xno If yes, explain (attach additional sheets ifnecessary): -::- ---:--:- ----=-',.......,--,--- _

Room additions, structural modifications, or other alterations or repairs made without necessary permits or notin compliance with building codes in effect at the time.

Homeowners' associations or maintenance fees or assessments. If yes, complete the following:Name of association: -------------------=:--------------Manager's name: Phone: ----------Fees or assessments are: $ per and are: _ mandatory _ voluntaryAny unpaid fees or assessment for the Property? _yes ($ ) _ noIf the Property is in more than one association. provide information about the other associations below orattach information to this notice.

Section 5. Are you (Seller) aware of any of the following (Mark Yes (Y) if you are aware. Mark No (N) if you arenot aware.)

Y N

~

JL'

Any common area (facilities such as pools, tennis courts, walkways, or other) co-owned in undivided interestwith others. If yes, complete the following:

Any optional user fees for common facilities charged? _ yes _ no If yes, describe: _

Any notices of violations of deed restrictions or governmental ordinances affecting the condition or use of theProperty.

Any lawsuits or other legal proceedings directly or indirectly affecting the Property. (Includes, but is not limitedto: divorce, foreclosure, heirship, bankruptcy, and taxes.)

Any death on the Property except for those deaths caused by: natural causes, suicide, or accident unrelatedto the condition of the Property.

Any condition on the Property which materially affects the health or safety of an individual.

Any repairs or treatments, other than routine maintenance, made to the Property to remediate environmentalhazards such as asbestos, radon, lead-based paint, urea-formaldehyde, or mold.

If yes, attach any certificates or other documentation identifying the extent of the remediation (for example,certificate of mold remediation or other remediation).

Any rainwater harvesting system located on the Property that is larger than 500 gallons and that uses a publicwater supply as an auxiliary water source.

The Property is located in a propane gas system service area owned by a propane distribution system retailer.

Any portion of the Property that is located in a groundwater conservation district or a subsidence district.

(TAR-1406) 01-01-16 Initialed by: Buyer: , and Seller: , _Produced with zipForm4ll by zlpLoglx 18070 Fifteen Mile Road. Fraser. Michigan 48026 wwtI zlpLoglx com

Page 3 of 5Joe and Kay

6930 CR 146Concerning the Property at --'B:::..e.::..d=i:..;:;ac::.s'-,T--'X:....:..-7'-7:.....:8:.....:3:.....:1--'- _

If the answer to any of the items in Section 5 is yes, explain (attach additional sheets if necessary): _

Section 6. Seller~has _ has not attached a survey of the Property.

Section 7. Within the last 4 years, have you (Seller) received any written inspection reports from persons whoregularly provide inspections and who are either licensed as inspectors or otherwise permitted by law to performinspections? _ yes _ no If yes, attach copies and complete the following:

Inspection Date Type Name of Inspector No. of Pages

Note: A buyer should not rely on the above-cited reports as a reflection of the current condition of theProperty. A buyer should obtain inspections from inspectors chosen by the buyer.

Section 8. Check any tax exemption(s) which you (Seller) currently claim for the Property:Homestead Senior Citizen Disabled

j.(Wildlife Management _ Agricultural Disabled VeteranOther: Unknown

Section 9. Have y~ (Seller) ever filed a claim for damage to the Property with anyprovider? _ yes .uno

insurance

Section 10. Have you (Seller) ever received proceeds for a claim for damage to the Property (for example, aninsurance claim or a settlement or awcyd in a legal proceeding) and not used the proceeds to make the repairs forwhich the claim was made? _ yes ~no If yes, explain: _

Section 11. Does the property have working smoke detectors installed in accordanye with the smoke detectorrequirements of Chapter 766 of the Health and Safety Code?* _ unknown _ no 0es. If no or unknown, explain.(Attach additional sheets if necessary):

*Chapter 766 of the Health and Safety Code requires one-family or two-family dwellings to have workingsmoke detectors installed in accordance with the requirements of the building code in effect in the area inwhich the dwelling is located, including performance, location, and power source requirements. If you do notknow the building code requirements in effect in your area, you may check unknown above or contact yourlocal building official for more information.

A buyer may require a seller to install smoke detectors for the hearing impaired if: (1) the buyer or a memberof the buyer's family who will reside in the dwelling is hearing-impaired; (2) the buyer gives the seller writtenevidence of the hearing impairment from a licensed physician; and (3) within 10 days after the effective date,the buyer makes a written request for the seller to install smoke detectors for the hearing-impaired andspecifies the locations for installation. The parties may agree who will bear the cost of installing the smokedetectors and which brand of smoke detectors to install.

(TAR-1406) 01-01-16 Initialed by: Buyer: , and Seller:, Page 4 of 5Produced with zipFoflT1@byziplogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www zigloo;x com Joe and Kay

6930 CR 146Concerning the Property at -----'B=.e=-d::.;ic;:;a=-s,'-T:...:X..:......o7...:..7-=.8-=-3..:...1 _

Seller acknowledges that the statements in this notice are true to the best of Seller's belief and that no person, including

t;roker(S), p73,ucted or i;enced seller.t:;,,;;;;naccurate ;n;a;q0');;jny materia~nlormaliof,l ~

S;9n&:::tSeller ~ a, Date Si~ 01 seller~ &t 4ut ~tePrinted Name: s(t1"-} P P,/Ia hd Printed Name: SV& YY1 p¥ Ia. hd.

IADDITIONAL NOTICES TO BUYER:

(1) The Texas Department of Public Safety maintains a database that the public may search, at no cost, to determine ifregistered sex offenders are located in certain zip code areas. To search the database, visit www.txdps.state.tx.us.For information concerning past criminal activity in certain areas or neighborhoods, contact the local policedepartment.

(2) If the property is located in a coastal area that is seaward of the Gulf Intracoastal Waterway or within 1,000 feet of themean high tide bordering the Gulf of Mexico, the property may be subject to the Open Beaches Act or the DuneProtection Act (Chapter 61 or 63, Natural Resources Code, respectively) and a beachfront construction certificate ordune protection permit may be required for repairs or improvements. Contact the local government with ordinanceauthority over construction adjacent to public beaches for more information.

(3) If you are basing your offers on square footage, measurements, or boundaries, you should have those itemsindependently measured to verify any reported information.

(4) The following providers currently provide service to the property:

Electric: mtel So e.t+h S'i n l rs'iSewer: _Water:Cable: D I r -le..-t TOTrash:Natural Gas:-------------------Phone Company:Propane: ~S~~--'13~ _

phone #: q,l, Kq..~", 5"100phone #: _phone #: _phone #: _phone #: _phone #: _

phone #: -----...-=--r----:-:"'"'"..,-,,,--------;:;;-;-;,,-=--phone #: q2(; ~ ?J qJt ... S" if/;~

(5) This Seller's Disclosure Notice was completed by Seller as of the date signed. The brokers have relied on this noticeas true and correct and have no reason to believe it to be false or inaccurate. YOU ARE ENCOURAGED TO HAVEAN INSPECTOR OF YOUR CHOICE INSPECT THE PROPERTY.

The undersigned Buyer acknowledges receipt of the foregoing notice.

DateDate Signature of Buyer

Printed Name: _

Signature of Buyer

Printed Name:----------------

(TAR-1406) 01-01-16 Page 5 of 5

Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www zlpLoojx.com Joe. and Kay

~~TEXAS ASSOCIATION OF REALTORS®

INFORMATION ABOUT SPECIAL FLOOD HAZARD AREASUSE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS«> IS NOT AUTHORIZED.

ClTexas Association of REALTORS«>,lnc., 2014

CONCERNING THE PROPERTY AT

A. FLOOD AREAS:

6930 CR 146Bedias, TX 77831

(1) The Federal Emergency Management Agency (FEMA) designates areas that have a high risk of floodingas special flood hazard areas.

(2) A property that is in a special flood hazard area lies in a "V-Zone" or "A-Zone" as noted on floodinsurance rate maps. Both V-Zone and A-Zone areas are areas with high risk of flooding.

(3) Some properties may also lie in the "floodway" which is the channel of a river or other watercourse andthe adjacent land areas that must be reserved in order to discharge a flood under FEMA rules.Communities must regulate development in these floodways.

B. AVAILABILITY OF FLOOD INSURANCE:

(1) Generally, flood insurance is available regardless of whether the property is located in or out of a specialflood hazard area. Contact your insurance agent to determine if any limitations or restrictions apply tothe property in which you are interested.

(2) FEMA encourages every property owner to purchase flood insurance regardless of whether the propertyis in a high, moderate, or low risk flood area.

(3) A homeowner may obtain flood insurance coverage (up to certain limits) through the National FloodInsurance Program. Supplemental coverage is available through private insurance carriers.

(4) A mortgage lender making a federally related mortgage will require the borrower to maintain floodinsurance if the property is in a special flood hazard area.

C. GROUND FLOOR REQUIREMENTS:

(1) Many homes in special flood hazard areas are built-up or are elevated. In elevated homes the groundfloor typically lies below the base flood elevation and the first floor is elevated on piers, columns, posts,or piles. The base flood elevation is the highest level at which a flood is likely to occur as shown on floodinsurance rate maps.

(2) Federal, state, county, and city regulations:

(a) restrict the use and construction of any ground floor enclosures in elevated homes that are in specialflood hazard areas.

(b) may prohibit or restrict the remodeling, rebuilding, and redevelopment of property and improvementsin the floodway.

(3) The first floor of all homes must now be built above the base flood elevation.

(a) Older homes may have been built in compliance with applicable regulations at the time ofconstruction and may have first floors that lie below the base flood elevation, but flood insurancerates for such homes may be significant.

(TAR 1414) 01-01-14

Brazos Land Company, t 16 •Main SL nd,rson, TX 77830 Phone: (936)87l-4000 Fax: (936)873-2301Lauron Stuart Produced with zjpFo~ by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 wwwzjoLoojx com

Page 1 of 3

Joe and Kay

6930 CR 146Information about Special Flood Hazard Areas concerning B"--'-e..:....d..:....ia..:....s-'-,..:....T..:....X---'-7_78..:....3..:....1 _

(b) It is possible that modifications were made to a ground floor enclosure after a home was first built.The modifications mayor may not comply with applicable regulations and mayor may not affectflood insurance rates.

(c) It is important for a buyer to determine if the first floor of a home is elevated at or above the baseflood elevation. It is also important for a buyer to determine if the property lies in a f1oodway.

(4) Ground floor enclosures that lie below the base flood elevation may be used only for: (i) parking; (ii)storage; and (iii) building access. Plumbing, mechanical, or electrical items in ground floor enclosuresthat lie below the base flood elevation may be prohibited or restricted and may not be eligible for floodinsurance coverage. Additionally:

(a) in A-Zones, the ground floor enclosures below the base flood elevation must have flow-through ventsor openings that permit the automatic entry and exit of floodwaters;

(b) in V-Zones, the ground floor enclosures must have break-away walls, screening, or lattice walls; and

(c) in f1oodways, the remodeling or reconstruction of any improvements may be prohibited or otherwiserestricted.

D. COMPLIANCE:

(1) The above-referenced property mayor may not comply with regulations affecting ground floorenclosures below the base flood elevation.

(2) A property owner's eligibility to purchase or maintain flood insurance, as well as the cost of the floodinsurance, is dependent on whether the property complies with the regulations affecting ground floorenclosures.

(3) A purchaser or property owner may be required to remove or modify a ground floor enclosure that is notin compliance with city or county building requirements or is not entitled to an exemption from suchrequirements.

(4) A flood insurance policy maintained by the current property owner does not mean that the property is incompliance with the regulations affecting ground floor enclosures or that the buyer will be able tocontinue to maintain flood insurance at the same rate.

(5) Insurance carriers calculate the cost of flood insurance using a rate that is based on the elevation of thelowest floor.

(a) If the ground floor lies below the base flood elevation and does not meet federal, state, county, andcity requirements, the ground floor will be the lowest floor for the purpose of computing the rate.

(b) If the property is in compliance, the first elevated floor will be the lowest floor and the insurance ratewill be significantly less than the rate for a property that is not in compliance.

(c) If the property lies in a V-Zone the flood insurance rate will be impacted if a ground floor enclosurebelow the base flood elevation exceeds 299 square feet (even if constructed with break-away walls).

(TAR 1414) 01-01-14

Produced with zipForTn«l by zipLogix 18070 Fifteen Mile Road, Fraser. Michigan 48026 WWN zjpLoojx com

Page 2 of 3

Joeaod Kay

~~TEXAS ASSOCIATION OF REALTORS®

INFORMATION ABOUT ON-SITE SEWER FACILITYUSE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS4llIS NOT AUTHORIZED.

@TexasAssoclatlon of REALTORS4ll,lnc., 2004

CONCERNING THE PROPERTY AT6930 CR 146

Bedias, TX 77831

A. DESCRIPTION OF ON-SITE SEWER FACILITY ON PROPERTY:

(1) 8pe of Treatment System: ~ePtic Tank 0 Aerobic Treatment

(2) Type of Distribution System: _

(3) Approximate Location of Drain Field or Distribution System: _

oUnknown

~nknown

oUnknown

oUnknown

oUnknown

OVes ONo

(4) Installer:~~

(5) Approximate Age: _---''tL.-...:-I=-?~-_=.d&=_..::O_LL_{ __....!Ot---'?~"_6_'_r=.s---------

B. MAINTENANCE INFORMATION:

(1) Is Seller aware of any maintenance contract in effect for the on-site sewer facility? 0 Ves ~oIf yes, name of maintenance contractor: ----:-----:-_--,--- _Phone: contract expiration date: ,--------,---,----__-,-------,-----:::,--------,---,----Maintenance contracts must be in effect to operate aerobic treatment and certain non-standard" on-sitesewer facilities.)

(2) Approximate date any tanks were last pUmped? t+p--'--f.l"'-'r'---'-'.:...I__---"'#e-....:..J--''7 _

(3) Is Seller aware of any defect or malfunction in the on-site sewer facility?If yes, explain: _

(4) Does Seller have manufacturer or warranty information available for review?

C. PLANNING MATERIALS, PERMITS, AND CONTRACTS:

OVes [Y-f<Jo

(1) ~hollowing items concerning the on-site sewer facility are attached:planning materials 0 permit for original installation 0 final inspection when OSSF was installedmaintenance contract 0 manufacturer information 0 warranty information 0 _

(2) "Planning materials" are the supporting materials that describe the on-site sewer facility that aresubmitted to the permitting authority in order to obtain a permit to install the on-site sewer facility.

(3) It may be necessary for a buyer to have the permit to operate an on-site sewer facilitytransferred to the buyer.

(TAR-1407) 1-7-04 . Initialed for Identification by Buyer__ ' __ and Seller__ •__ Page 1 of 2

Brazos Land Company, 116 S. Main St. Anderson, TX 77830 Phone: (936)873-4000 Fax: (936)873-2301Lauren Stuart Produced with zjpFor~ by zlpLogix 18070 Fifteen Mile Road. Fraser, Michigan 48026 WWtI zlgLog;x com

Jue and Kay

Information about On-Site Sewer Facility concerning

6930 CR 146

Bedias, TX 77831

D. INFORMATION FROM GOVERNMENTAL AGENCIES: Pamphlets describing on-site sewer facilities areavailable from the Texas Agricultural Extension Service. Information in the following table was obtainedfrom Texas Commission on Environmental Quality (TCEQ) on 10/24/2002. The table estimates dailywastewater usage rates. Actual water usage data or other methods for calculating may be used if accurateand acceptable to TCEQ.

Usage (gal/day)without water-

Facility saving devices

Single family dwelling (1-2 bedrooms; less than 1,500 sf) 225Single family dwelling (3 bedrooms; less than 2,500 sf) 300Single family dwelling (4 bedrooms; less than 3,500 sf) 375Single family dwelling (5 bedrooms; less than 4,500 sf) 450Single family dwelling (6 bedrooms; less than 5,500 sf) 525Mobile home, condo, or townhouse (1-2 bedroom) 225Mobile home, condo, or townhouse (each add'i bedroom) 75

Usage (gal/day)with water­

saving devices

18024030036042018060

This document is not a substitute for any inspections or warranties. This document was completed tothe best of Seller's knowledge and belief on the date signed. Seller and real estate agents are notexperts about on-site sewer facilities. Buyer is encouraged to have the on-site sewer facility inspectedby an inspector of Buyer's choice.

~'~S~-:fr4Joe M. Pyland

Receipt acknowledged by:

'fua I~~~s;gnatu'f:::.t.,P4;~ ~ /f.t:o fJKay P. Pyland

Signature of Buyer

(TAR-1407) 1-7-04

Date Signature of Buyer Date

Page 2 of2

Produced with zipFo~ by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 WtrW zipLoojx com Joe and Kay

6930 CR 146Information about Special Flood Hazard Areas concerning =B-=.e.=d;:.::ia;:.::s"-,....:.T.::..cX:........:...7..:....7:::....83:::....1-=---- _

E. ELEVATION CERTIFICATE:

The elevation certificate is an important tool in determining flood insurance rates. It is used to provideelevation information that is necessary to ensure compliance with floodplain management laws. Todetermine the proper insurance premium rate, insurers rely on an elevation certificate to certify buildingelevations at an acceptable level above flood map levels. If available in your area, it is recommended thatyou obtain an elevation certificate for the property as soon as possible to accurately determine future floodinsurance rates.

You are encouraged to: (1) inspect the property for all purposes, including compliance with any groundfloor enclosure requirement; (2) review the flood insurance policy (costs and coverage) with yourinsurance agent; and (3) contact the building permitting authority if you have any questions aboutbuilding requirements or compliance issues.

Receipt acknowledged by:

Signature

(TAR 1414) 01-01-14

Date Signature Date

Page 3 of 3

Produced with zipForrmll by zlpLoglx 18070 Fifteen Mile Road, Fraser, Michigan 48026 WNW zjpLoolx com Joe lad KIY

.~

Locatlot\ t)ftwo 1011 burlnp Of two exca"ated bIcktIoc pita (thaw location wUh rellpect to. known rcferClnl ;1 point).IndlCllte 1I,lope or provldo eomo vr Un•• ft't1m the .~~,.. to thu fvthllllt location of the propoud 11011 .bliorpl 'Dr! or lrriptlonarDL

LOOItton IJfnaUJrll, COI\IQ'UClUlcI, or fn'OPl.seci drlll\IIt WI)'I. (Itt1lInla, ponds. lakes, "vue, hlah tide ofIAlt WlI l llr bodie.) waterImpoundlltclflt II'eU, cut or flll hank, lha!'ll' .Iopoa and break&. Nobl proaonoe of )00 year flood zone,location of exllt1nl or propoled l(ijlount Itrata, propeIt.)' linea. pmporty dlmonalonl, l~.tlon of butldll18l. ouemcnta,.",Imrnmlll pool.. publlo' WIIter wolls IIld lin... private WIder weill Wliinel. and other lb'UCtlnS whore knt II"" on lCtiaccntpropertllili. . .

Site Dnwla.:lcalCl: I inch ~ ..

(INe.# ~/aOI(~~/

.<3~ .6 J'tJ/lAJSo ttl, Wll.lJr,(.·()w4~ T/fllCe r'~A1C!.-€

rll4!',,*8fI)~1J,I)'S", 1"'.. 7 7" gG.2'fl14ll' $'-10 'le.

-----_..--------_._---...,L Z/II/ 7b fi'1l ~'8~

I!~

...-<---_....-..._........ ",/ '-_."\:::l.. ...

....... ..···v . /fUIIlPoA.~ \_'"'/ S-"-o"

I'(

0.£,14:/ ._.....,, .. " \ .•.., ~.. '. __ -

i;.

)

.-_..........

....

ToTIl' B-plJ· 3DO (Jilt.J()()(;,jJ())<./,fc ~ ./2,;/faxJ sa;JFTET

Aj'EZ)

~ )/fJ5~W/iC£ II,Af jJWITH O/£cK IIAI.. ~.

Cert. No.

Id WdlS:L0 100c PC '~ON 'ON XtlJ