Septic Sysem Disclosure Transfer Agreement printable pdf download

SEPTIC SYSTEM DISCLOSURE / TRANSFER AGREEMENT

LAKE COUNTY, MN

LAKE COUNTY ORDINANCE #11 REQUIRES A COMPLIANCE INSPECTION OF SUBSURFACE SEWAGE TREATMENT SYSTEMS (SSTS)

PRIOR TO PROPERTY TRANSFER (POINT OF SALE) BY A LICENSED SEPTIC INSPECTOR. THE STATUS OF THE SSTS MUST BE

DISCLOSED BY THE PROPERTY OWNER(S) (“SELLER”) BEFORE THE SALE OR TRANSFER OF THAT PROPERTY TO ANOTHER

INDIVIDUAL(S) (“BUYER”). THE FOLLOWING ARE CONDITIONS OF WHICH THE BUYER NEEDS TO BE AWARE.

TODAY’S DATE:_________________________ PROPERTY TRANSFER DATE:_____________________

PARCEL #____ ____ - ____ ____ ____ ____ - ____ ____ ____ ____ _____

PROPERTY ADDRESS: ______________________________________________________________

CITY:________________________________________ ZIP:_________________TSP:___________

SSTS INFORMATION

CHECK

To the best of my knowledge, this transfer is EXEMPT for the following reason(s):

The system has been installed in the last twelve (12) years with a valid SSTS permit or a passing Compliance Inspection has

been completed within the last eight (8) years.

A signed disclosure statement is presented indicating that no SSTS exists nor is one required on the property.

Court rulings for wills, probate actions, divorce, estate settlements.

The affected tract of land is without buildings or contains no dwellings or other buildings with plumbing fixtures.

The transfer does not require the filing of a Certificate of Real Estate Value, as described in Minnesota Statutes, Section

272.115, subdivision 1.

The sale or transfer completes a contract for deed or purchase agreement entered into prior to the effective date of this

Ordinance. This subsection applies only to the original vendor and vendee on such a contract.

Any dwellings or other buildings that are connected exclusively to a municipal wastewater treatment system; any dwellings

or other buildings that are located within the jurisdiction of a County approved agreement requiring exclusively connection

to the wastewater treatment system of any municipality; or, and dwellings or other buildings that are connected exclusively

to an approved wastewater treatment facility other than an individual sewage treatment system.

SSTS INFORMATION

CHECK

Status of the SSTS is determined to be:

COMPLIANT: The septic system meets all current standards. The Seller must provide the Buyer a Certificate of Compliance.

A valid Certificate of Compliance issued by the Planning and Zoning Department (Department) for a system built within 12

years or a passing Compliance issued within 8 years for systems older than 12 years.

OPERATING PERMIT REQUIREMENTS: Operating permits are not transferable. A new operating permit must be issued in

the name of the new owner. At time of property transfer, the buyer shall complete and submit to the Department an

application for transfer of an SSTS operating permit.

NONCOMPLIANT: SSTS found not to be in compliance with MN Rules, Ch. 7080.1500, Subp. 4A or 7081.0080, Subp. 3 must

be repaired or replaced within 10 months or as directed under MS. Ch. 145A. The seller or buyer must provide sufficient

security in the form of an escrow or trust agreement to assure the installation of a complying SSTS per Lake Co Ordinance

#11 Article VIII, Sec. 1.03, 1. c.

IMMINENT THREAT TO PUBLIC HEALTH: The septic system is identified as an Imminent Threat to Public Health and

immediate action is required. The Seller must provide the Notice of Imminent Threat to Public Health to the Buyer. Buyer

and Seller must complete the Transfer Agreement on the back of this form and submit to the Department an application,

permit fee and design within 30 days; or by June 1

, if frozen soil conditions exist. Refer to Article IV, Sec. 2.0, 2.02, for

potential holding tank use.

To the best of my knowledge this information is correct (please print names).

Seller name:

Buyer Name:

Signature:

Seller Name:

Buyer Name:

Signature:

Reminder:

If the system has NOT been inspected, or if the system is classified as Noncompliant or an Imminent Threat to

Public Health, the Buyer and Seller must complete the back of this form and submit it to the Planning & Zoning Department

within the respective time lines identified above.

INCOMPLETE FORMS WILL BE RETURNED

Septic Sysem Disclosure Transfer Agreement

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