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T <br />SALES DISCLOSURE FORM <br />State Form (R4/9-I PRIVACY NOTICE: The telephone Illlllllllllllllllllllllll <br />y 1 1 II{lllll� Illllll <br />,; numbers of the parties on this form are <br />nvj �� Presrnhed by Department of Local Government Finance confidential according to IC \ 6-1.1-5.5- <br />Pursuantto IC 6.1.1-5.5 <br />3(d). <br />re5e <br />Part of Parc <br />Parcel Number(s) (Show additional parcels on separate sheet if necessary,) Acreage or Lot Size (sPi <br />J�JJ° , 7 J�JJJJJJJJJJJJJ J JJ �J • <br />� 1-1 1 J_ _JJJJJJJJJJJ JJJJ J J <br />JJI JJJJJJ J <br />Address 9 of Parcels <br />4303 Technology Drive <br />City, Town, or Post Office State ZIP ��] <br />Code —� <br />LS <br />outh Bend J� 4 6 1 2 1 8Tax Billlnq Address (If other than property address) <br />M 1031 Mendota Heights Road <br />City, Town, or Post Office State ZIP Code <br />St. Paul -- — -- _ -- --- — J �J 6 I�J 2 f I Q 0 .JJJJ <br />See Attached Exhibit "A" <br />Identify all conditionslitems that apply NOTE: If items 12-21 apply, filers are not subject to disclosure <br />filing fee. <br />. 1-Buyer Is an adjacent property owner <br />• 2-Vacant Land <br />J3-F_xchange for other real property ("Trade") <br />J4-Seller Paid Points; amount If applicable <br />$JJJJJJ <br />J5-Change planned In the primary use of the property? Describe in <br />special circumstances. <br />J6-Existence of family or business relationship between buyer and seller <br />J7- Land Contract Dated: <br />0 B-Personal property included In transfer; amount if applicable <br />0 12-Security interest documents such as mortgages or trust deeds. <br />J13-Leases less than 90 years <br />O14-Document resulting from foreclosure, or express <br />threat of foreclosure, divorce court order, condemnation, <br />probate or other judicial proceedings. <br />J15-Agreements and other documents for <br />mergers, consolidations, and Incorporations <br />O16-Quitclaim deeds not serving as a source of title <br />J17-Documents Involving the partition of land between <br />tenants In common, joint tenants, or tenants by the <br />entirety. <br />❑ I' � Institution <br />to a charity, not -for -profit or government <br />�J Institution <br />J9- Significant physical changes to property between March 1 and date of sale ``J 19-Transfer for no or discounted consideration, or glft i <br />J10- Non -Warranty deed; specify type _ 20-Rerecording to correct prior recorded document it <br />J11- Partial Interest. Describe In special circumstances. i 21-Easements, Right-of-way grants <br />Contract Date (MMIDD/yYYY) Sales Price <br />1_oF� / 4% f FHLq_FoT5-] sF71. FF[4] a a s <br />Describe any unusual or special circumstances related to this sale, including the specification of any less -than -complete ownership interest and terms of seller financing. <br />Permanent Easement for Storm Sewer Installation and Maintenance <br />