Pr oudly Pr esent s:
18 32 SE B l u e Sk i es L an e | Pr i n ev i l l e | O R 9 7 75 4 N at alie N olt e Pr ivat e Of f ice A dvisor N at alieNolt e624@gmail.com +1 (541) 50 8-9581
PEACE, TRANQUILITY & PRIVACY AWAIT IN THIS STUNNING CUSTOM HOM E 3 BED | 5 BATH | 3,106 SQUARE FEET | 1.58 ACRE | 40' x 50' AIRCRAFT HANGAR Built wit h met iculous at t ent ion t o det ail and breat ht aking views at t he end of a cul-de-sac in Dry Creek Airpark. This gorgeous home is filled wit h abundant nat ural light . The chef ?s kit chen includes everyt hing on t he most discerning cook?s list , while bot h casual and formal dining areas make ent ert aining a breeze. French doors open t o a beaut iful deck wit h panoramic views, and t he great room feat ures vault ed ceilings, a fireplace, and incredible windows. The main level boast s a luxurious primary suit e wit h a t wo-sided fireplace, a guest room, and a den. Upst airs, you'll find an addit ional privat e suit e wit h it s own balcony. The home also includes an at t ached, oversized t hree-car garage and a 40' x 50' aircraft hangar wit h an office, half bat h, and 220 square feet of finished st orage. Lovingly landscaped grounds offer comfort able out door living spaces. Dry Creek Airpark feat ures a privat e, paved 3,000' x 35' airst rip at 3,620 ft elevat ion wit h pilot -cont rolled light ing, all wit hin a gat ed communit y t hat also offers t ennis court s. This could be your piece of paradise!
Crook County Property Summary Report Report Date: 2/5/2025 4:50:11 PM
Disclaimer The information and maps presented in this report are provided for your convenience. Every reasonable effort has been made to assure the accuracy of the data and associated maps. Crook County makes no warranty, representation or guarantee as to the content, sequence, accuracy, timeliness or completeness of any of the data provided herein. Crook County explicitly disclaims any representations and warranties, including, without limitation, the implied warranties of merchantability and fitness for a particular purpose. Crook County shall assume no liability for any errors, omissions, or inaccuracies in the information provided regardless of how caused. Crook County assumes no liability for any decisions made or actions taken or not taken by the user of this information or data furnished hereunder.
Account Summary Account Information PETER JUTEAU AND ELISE BURNHAM JUTEAU RL Map and Taxlot: 161609C0-01800-15688
Ownership
PETER JUTEAU AND ELISE BURNHAM JUTEAU RL
Account:
15688
1832 SE BLUE SKIES LANE
Tax Status:
Taxable 1832 SE BLUE SKIES LN, PRINEVILLE OR 97754
PRINEVILLE, OR 97754-8630
Mailing Address:
Mailing Name:
Situs Address:
Valuation Real Market Values as of Jan. 1, 2025
Property Taxes Current Tax Year: 2024 Tax Code Area:
0021
Assessment
Land
$111,290
Structures
$1,461,340
Total
$1,572,630
Subdivision: DRY CREEK AIRPARK PUD
Current Assessed Values:
Lot:
Maximum Assessed
$652,350
Assessed Value
$652,350
20
Block: 0 Assessor Acres: 1.58 Property Class: 101
Veterans Exemption
Warnings, Notations, and Special Assessments
Valuation History All values are as of January 1 of each year. Tax year is July 1st through June 30th of each year. Real Market Value - Land Real Market Value - Structures Total Real Market Value Maximum Assessed Value Total Assessed Value Exemption Value
Property Information Report, page 1
2014 - 2015 $51,180 $540,350 $591,530
2015 - 2016 $60,700 $587,810 $648,510
2016 - 2017 $60,700 $680,050 $740,750
2017 - 2018 $62,700 $718,000 $780,700
2018 - 2019 $62,700 $772,110 $834,810
$476,302 $476,302 $22,802
$490,591 $490,591 $23,486
$505,309 $505,309 $24,190
$520,468 $520,468 $24,916
$536,082 $536,082 $25,664
2019 - 2020 $66,000 $802,030 $868,030
2020 - 2021 $70,000 $854,790 $924,790
2021 - 2022 $76,900 $1,019,860 $1,096,760
2022 - 2023 $111,290 $1,366,610 $1,477,900
2023 - 2024 $111,290 $1,385,560 $1,496,850
2024 - 2025 $111,290 $1,461,340 $1,572,630
$552,164 $552,164 $26,434
$568,729 $568,729 $27,227
$597,000 $597,000 $28,045
$614,910 $614,910 $28,886
$633,350 $633,350 $0
$652,350 $652,350 $0
Property Information Report, page 2 (For Report Disclaimer see page 1)
Tax Payment History Year
Date Due
Transaction Type
Transaction Date
As Of Date
Amount Received
Tax Due
Discount Amount
Interest Charged
Refund Interest
2024
11/15/2024
PAYMENT
11/12/2024
11/12/2024
$7,727.76
($7,966.76)
$239.00
$0.00
$0.00
2024
11/15/2024
IMPOSED
10/03/2024
11/15/2024
$0.00 Total:
$7,966.76 $0.00
$0.00
$0.00
$0.00
2023
11/15/2023
PAYMENT
11/06/2023
11/06/2023
$7,461.82
($7,692.60)
$230.78
$0.00
$0.00
2023
11/15/2023
IMPOSED
10/10/2023
11/15/2023
$0.00 Total:
$7,692.60 $0.00
$0.00
$0.00
$0.00
2022
11/15/2022
PAYMENT
11/09/2022
11/09/2022
$6,889.65
($7,102.73)
$213.08
$0.00
$0.00
2022
11/15/2022
IMPOSED
10/12/2022
11/15/2022
$0.00 Total:
$7,102.73 $0.00
$0.00
$0.00
$0.00
2021
11/15/2021
PAYMENT
11/04/2021
11/04/2021
$6,889.25
($7,102.32)
$213.07
$0.00
$0.00
2021
11/15/2021
IMPOSED
10/12/2021
11/15/2021
$0.00 Total:
$7,102.32 $0.00
$0.00
$0.00
$0.00
2020
11/15/2020
IMPOSED
11/15/2020
11/15/2020
$0.00
($283.66)
$0.00
$0.00
$0.00
2020
11/15/2020
PAYMENT
11/15/2020
11/10/2020
($6,566.72)
$6,700.73
($134.01)
$0.00
$0.00
2020
11/15/2020
IMPOSED
11/15/2020
11/15/2020
$0.00
($56.73)
$0.00
$0.00
$0.00
2020
11/15/2020
PAYMENT
11/15/2020
11/15/2020
$6,566.72
($6,769.81)
$203.09
$0.00
$0.00
2020
11/15/2020
PAYMENT
11/10/2020
11/10/2020
$6,566.72
($6,700.73)
$134.01
$0.00
$0.00
2020
11/15/2020
IMPOSED
11/05/2020
11/15/2020
$0.00
$340.39
$0.00
$0.00
$0.00
2020
11/15/2020
IMPOSED
10/16/2020
11/15/2020
$0.00 Total:
$6,769.81 $0.00
$0.00
$0.00
$0.00
2019
11/15/2019
IMPOSED
11/15/2019
11/15/2019
$0.00
$6,530.20
$0.00
$0.00
$0.00
2019
11/15/2019
PAYMENT
11/14/2019
11/15/2019
$6,334.29 Total:
($6,530.20) $0.00
$195.91
$0.00
$0.00
2018
11/15/2018
IMPOSED
11/15/2018
11/15/2018
$0.00
$6,365.47
$0.00
$0.00
$0.00
2018
11/15/2018
PAYMENT
11/14/2018
11/15/2018
$6,174.51 Total:
($6,365.47) $0.00
$190.96
$0.00
$0.00
2017
11/15/2017
IMPOSED
11/15/2017
11/15/2017
$0.00
$6,269.13
$0.00
$0.00
$0.00
Property Information Report, page 3 (For Report Disclaimer see page 1)
Year
Date Due
Transaction Type
Transaction Date
As Of Date
Discount Amount
Interest Charged
Refund Interest
2017
11/15/2017
PAYMENT
11/14/2017
11/15/2017
$188.07
$0.00
$0.00
2016
11/15/2016
IMPOSED
11/15/2016
11/15/2016
$0.00
2016
11/15/2016
PAYMENT
11/15/2016
11/15/2016
$5,801.83 Total:
$5,981.27
$0.00
$0.00
$0.00
($5,981.27) $0.00
$179.44
$0.00
$0.00
2015
11/15/2015
PAYMENT
11/16/2015
11/15/2015
$5,549.01
($5,720.63)
$171.62
$0.00
$0.00
2015
11/15/2015
IMPOSED
11/15/2015
11/15/2015
$0.00 Total:
$5,720.63 $0.00
$0.00
$0.00
$0.00
2014
11/15/2014
IMPOSED
11/15/2014
11/15/2014
$0.00
$5,478.33
$0.00
$0.00
$0.00
2014
11/15/2014
PAYMENT
11/12/2014
11/15/2014
$5,313.98 Total:
($5,478.33) $0.00
$164.35
$0.00
$0.00
2013
11/15/2013
IMPOSED
11/15/2013
11/15/2013
$0.00
$5,441.70
$0.00
$0.00
$0.00
2013
11/15/2013
PAYMENT
11/13/2013
11/15/2013
$5,278.45 Total:
($5,441.70) $0.00
$163.25
$0.00
$0.00
2012 2012
11/15/2012
IMPOSED
11/15/2012
11/15/2012
$0.00
$4,623.56
$0.00
$0.00
$0.00
11/15/2012
PAYMENT
11/14/2012
11/15/2012
$4,484.85 Total:
($4,623.56) $0.00
$138.71
$0.00
$0.00
2011
11/15/2011
PAYMENT
04/27/2012
11/15/2011
$1,802.03
($1,802.03)
$0.00
$0.00
$0.00
2011
11/15/2011
PAYMENT
02/08/2012
11/15/2011
$1,802.03
($1,802.03)
$0.00
$0.00
$0.00
2011
11/15/2011
IMPOSED
11/15/2011
11/15/2011
$0.00
$5,406.10
$0.00
$0.00
$0.00
2011
11/15/2011
PAYMENT
11/14/2011
11/15/2011
$1,802.04 Total:
($1,802.04) $0.00
$0.00
$0.00
$0.00
2010
11/15/2010
PAYMENT
05/13/2011
11/15/2010
$1,833.07
($1,833.07)
$0.00
$0.00
$0.00
2010
11/15/2010
PAYMENT
02/14/2011
11/15/2010
$1,833.07
($1,833.07)
$0.00
$0.00
$0.00
2010
11/15/2010
PAYMENT
11/15/2010
11/15/2010
$1,833.07
($1,833.07)
$0.00
$0.00
$0.00
2010
11/15/2010
IMPOSED
11/15/2010
11/15/2010
$0.00 Total:
$5,499.21 $0.00
$0.00
$0.00
$0.00
2009
11/15/2009
PAYMENT
05/04/2010
11/15/2009
$1,786.19
($1,786.19)
$0.00
$0.00
$0.00
2009
11/15/2009
PAYMENT
02/11/2010
11/15/2009
$1,786.19
($1,786.19)
$0.00
$0.00
$0.00
2009
11/15/2009
IMPOSED
11/15/2009
11/15/2009
$0.00
$5,358.58
$0.00
$0.00
$0.00
2009
11/15/2009
PAYMENT
11/12/2009
11/15/2009
$1,786.20 Total:
($1,786.20) $0.00
$0.00
$0.00
$0.00
2008
11/15/2008
PAYMENT
05/15/2009
11/15/2008
$1,935.23
($1,935.23)
$0.00
$0.00
$0.00
2008
11/15/2008
PAYMENT
11/17/2008
11/15/2008
$3,793.06
($3,870.47)
$77.41
$0.00
$0.00
2008
11/15/2008
IMPOSED
11/15/2008
11/15/2008
$0.00 Total:
$5,805.70 $0.00
$0.00
$0.00
$0.00
2007
11/15/2007
PAYMENT
05/06/2008
11/15/2007
$1,816.16
($1,816.16)
$0.00
$0.00
$0.00
2007
11/15/2007
IMPOSED
11/15/2007
11/15/2007
$0.00
$5,448.47
$0.00
$0.00
$0.00
2007
11/15/2007
PAYMENT
11/15/2007
11/15/2007
$3,559.66 Total:
($3,632.31) $0.00
$72.65
$0.00
$0.00
2006
11/15/2006
IMPOSED
11/15/2006
11/15/2006
$0.00
$5,311.63
$0.00
$0.00
$0.00
2006
11/15/2006
PAYMENT
11/09/2006
11/15/2006
$5,152.28 Total:
($5,311.63) $0.00
$159.35
$0.00
$0.00
2005
11/15/2005
PAYMENT
05/15/2006
11/15/2005
$5,127.12
($5,127.12)
$0.00
$0.00
$0.00
2005
11/15/2005
IMPOSED
11/15/2005
11/15/2005
$0.00 Total:
$5,127.12 $0.00
$0.00
$0.00
$0.00
2004
11/15/2004
IMPOSED
11/15/2004
11/15/2004
$0.00
$1,943.48
$0.00
$0.00
$0.00
Property Information Report, page 4 (For Report Disclaimer see page 1)
Amount Received
Tax Due
$6,081.06 Total:
($6,269.13) $0.00
Year
Date Due
Transaction Type
Transaction Date
As Of Date
Amount Received
Tax Due
Discount Amount
Interest Charged
Refund Interest
2004
11/15/2004
PAYMENT
11/09/2004
11/15/2004
$1,885.18 Total:
($1,943.48) $0.00
$58.30
$0.00
$0.00
2003
11/15/2003
IMPOSED
11/15/2003
11/15/2003
$0.00
2003
11/15/2003
PAYMENT
11/12/2003
11/15/2003
$696.32 Total:
$717.86
$0.00
$0.00
$0.00
($717.86) $0.00
$21.54
$0.00
$0.00
2002
11/15/2002
PAYMENT
11/21/2002
11/15/2002
$682.68
($703.79)
$21.11
$0.00
$0.00
2002
11/15/2002
IMPOSED
11/15/2002
11/15/2002
$0.00 Total:
$703.79 $0.00
$0.00
$0.00
$0.00
2001
11/15/2001
PAYMENT
11/20/2001
11/15/2001
$670.22
($690.95)
$20.73
$0.00
$0.00
2001
11/15/2001
IMPOSED
11/15/2001
11/15/2001
$0.00 Total:
$690.95 $0.00
$0.00
$0.00
$0.00
2000
11/15/2000
PAYMENT
11/21/2000
11/15/2000
$651.36
($671.51)
$20.15
$0.00
$0.00
2000
11/15/2000
IMPOSED
11/15/2000
11/15/2000
$0.00 Total:
$671.51 $0.00
$0.00
$0.00
$0.00
Sales History Sale Date Seller 07/20/2020 08/27/1999
Sale Amount
Buyer
GLIVINSKI MICHELLE D TRUST/TRUSTEE DRY CREEK AIRPARK LLC
PETER JUTEAU AND ELISE BURNHAM JUTEAU RL
Sale Type
$650,000 $51,900
Recording 2020-301394
WARRANTY DEED
2001-151042
Code Area
Year Built
Eff Year Built
Total Sq Ft
0021
2003
2003
2000
Code Area
Year Built
Eff Year Built
Total Sq Ft
0021
2003
2003
3106
Structures Stat Class/Description
Improvement Description
FARM BLDG - : GP BUILDING
GP BUILDING
Stat Class/Description
Improvement Description
RESIDENCE - : RES Two story
RES Two story
Land Characteristics Land Description
Acres
Land Classification
Market
1.58
Mrkt
OSD
0.00
1ST OSD
Related Accounts Related accounts apply to a property that may be on one map and tax lot but due to billing have more than one account. This occurs when a property is in multiple tax code areas. In other cases there may be business personal property or a manufactured home on this property that is not in the same ownership as the land. No Related Accounts found.
Ownership Name Type
Name
OWNER
JUTEAU ELISE BURNHAM TRUSTEE
Property Information Report, page 5 (For Report Disclaimer see page 1)
Ownership Type ,
Percentage 100.00%
_D4
15688
JULY 1, 2024 TO JUNE 30, 2025 CROOK COUNTY TAX COLLECTOR 200 NE 2nd St Prineville, OR 97754
PROPERTY DESCRIPTION CODE: 0021 MAP: 161609-C0-01800 ACRES: 1.58 SITUS: 1832 SE BLUE SKIES LN PRINEVILLE
LAST YEAR
ACCOUNT NO: 15688
2024 - 2025 CURRENT TAX BY DISTRICT
PETER JUTEAU AND ELISE BURNHAM JUTEAU RL 1832 SE BLUE SKIES LANE PRINEVILLE OR 97754-8630
VALUES:
REAL PROPERTY TAX STATEMENT
THIS YEAR
HIGH DESERT ESD CROOK COUNTY SCHOOL DIST CENTRAL OR COMM COLLEGE EDUCATION TOTAL:
62.89 3,121.89 404.72 3,589.50
CROOK COUNTY GENERAL FUND AG EXTENSION SERVICE CROOK CO HISTORICAL FUND CROOK CO FIRE & RESCUE CEMETERY DISTRICT GENERAL GOVT TOTAL:
2,524.72 78.74 39.14 1,037.24 64.84 3,744.68
REAL MARKET (RMV) LAND STRUCTURES
111,290 1,385,560 1,496,850
111,290 1,461,340 1,572,630
TOTAL ASSESSED VALUE
633,350
652,350
ASSESSED VALUE
633,350
652,350
TOTAL PROPERTY TAX:
7,692.60
7,966.76
TOTAL RMV
If your Assessed Value has grown by more than 3% from last year and you have any questions, please contact the Assessor's office at (541) 447-4133.
CC JAIL BOND CC SCHOOL BOND COCC BOND & INTEREST BONDS - OTHER TOTAL:
122.90 456.32 53.36 632.58
2024 - 2025 TAX ( Before Discount )
7,966.76
TOTAL DUE (After Discount )
7,727.76
THIS IS NOT A TAX BILL IF... Your mortgage company is reponsible for paying for taxes. Keep this statement for your records. WELLS FARGO BANK 936 Crook County Website - www.co.crook.or.us
Tax Collector (541) 447-6554 or Assessor (541) 447-4133
TAX PAYMENT OPTIONS
PAYMENT OPTIONS FULL PAYMENT 2/3 PAYMENT 1/3 PAYMENT
↑
8-22-22_v2
Tear Here
Discount Allowed 239.00 106.22
Date Due Nov 15, 2024 Nov 15, 2024 Nov 15, 2024
Amount 7,727.76 5,204.95 2,655.59
3% Discount .... 2% Discount .... No Discount ....
*COURTESY STATEMENT IF LENDER IS SCHEDULED TO PAY. CALL LENDER TO VERIFY IF NECESSARY* Tear Here
2024 - 2025 PROPERTY TAXES PAYMENT OPTIONS
CROOK COUNTY TAX COLLECTOR 200 NE 2nd St Prineville, OR 97754
Full Payment Enclosed or 2/3 Payment Enclosed or 1/3 Payment Enclosed
MAILING ADDRESS CHANGES ON BACK
ACCOUNT NO. 15688
PETER AND ELISE BURNHAM JUTEAU RL 1832 SEJUTEAU BLUE SKIES LANE 1832 SE BLUE SKIES LANE PRINEVILLE OR 97754-8630 PRINEVILLE OR 97754-8630
Amount
Discount
Date Due
3%
11/15/24
2% 0%
11/15/24
7,727.76 5,204.95
11/15/24
2,655.59
DISCOUNT IS LOST & INTEREST $ APPLIES AFTER DUE DATE
PETER JUTEAU AND ELISE BURNHAM JUTEAU RL 5298*19**G50**0.766**1/2*********AUTO**5-DIGIT 97754
↑
Enter Payment Amount
MAKE PAYMENT TO: CROOK COUNTY TAX COLLECTOR CROOK COUNTY TAX COLLECTOR 200 NE 2ND ST 200 NE 2nd St PRINEVILLE, OR 97754-1996 Prineville, OR 97754
07100000156880000265559000052049500007727765 Property Information Report, page 7 (For Report Disclaimer see page 1)
1/1 5298
(See back of statement for instructions)
_D _
15688
Payment instructions Please send only a check or money order with your payment stub. DO NOT mail cash. Your cancelled check is proof of payment. Property tax payments MUST be credited to the earliest year that taxes are due. Tax statements for less than $40 must be paid in full.
Discounts/payment schedule (choose one) To receive a discount, payments MUST be delivered, U.S. postmarked, or transmitted by private express carrier on or before November 15. Returned checks may cause a loss of the discount. To receive any applicable discount you MUST make: • Full payment—Receive a three percent (3%) discount on the amount of current year tax, as shown on your tax statement, if full payment is delivered, U.S. postmarked, or transmitted by private express carrier by November 15. • Two-thirds payment—Receive a two percent (2%) discount on the amount of current year tax paid, as shown on your tax statement, if two-thirds payment is delivered, U.S. postmarked, or transmitted by private express carrier by November 15. Pay the final one-third (with no discount) by May 15 to avoid interest charges. • One-third payment—No discount allowed. Pay one-third by November 15, followed by another one-third payment by February 15. Pay the final one-third balance by May 15. Interest is charged at a rate of 1.333% monthly, 16% annually. Interest is accrued on past due installment payments accordingly: • First one-third installment payment, interest begins accruing on December 16. • Second one-third installment payment, interest begins accruing February 16. • Remaining one-third payment, interest begins accruing on May 16. If the 15th falls on a weekend or legal holiday, the due date will be extended to the next business day.
Delinquent taxes and lien dates All personal property tax is delinquent when any installment is not paid on time. The responsible taxpayer can be served with a warrant 30 days after delinquency. Personal property can be seized and other financial assets can be garnished.
Real property tax is delinquent if not paid by May 15. Foreclosure proceedings on real property begin when taxes have been delinquent for three years.
(*) Accounts subject to foreclosure Real property tax accounts with an unpaid balance for any tax year marked with an (*) on the front of this statement are subject to foreclosure if not paid on or before May 15. Payments MUST be applied to the oldest tax first.
Review your value If you think your property value is incorrect or if there has been a change to the value that you did not expect or understand, review it with the county assessor’s office. Many assessors provide value information online. Visit your county assessor’s website or call them for more details.
Appeal rights If you think the VALUE of your property as shown on this statement is too high, you can appeal. Your appeal is to the county board of property tax appeals (BOPTA), except for state appraised industrial property. To appeal industrial property appraised by the Department of Revenue, you must file a complaint in the Magistrate Division of the Oregon Tax Court. If you disagree with a PENALTY assessed for late filing of a real, personal, or combined property return, you may ask the county BOPTA to waive all or a portion of the penalty. See www.oregon.gov/dor/ programs/property/pages/property-appeals.aspx.
When and where to appeal to BOPTA File your petition by December 31 with the county clerk in the county where the property is located. You can get petition forms and information from your county clerk, or at www.oregon.gov/ dor/forms.
What to pay if you appeal Follow the payment schedule to avoid interest charges and to receive applicable discounts. If your tax is reduced after appeal, any overpayment of property tax will be refunded. Tax statement information is available in alternate formats, in compliance with the Americans with Disabilities Act (ADA). Contact your county tax collector.
8-22-22_v2
Mailing address change request (Mailing address changes only. An address change requires the owner’s signature. Additional documentation may be required for name changes.)
Date: ___________________________ Account number(s): _____________________________________________ Name: __________________________________________________________________________________________
_____________________________________________________________________________ Phone: __________________________________________________________________________________________ Email:___________________________________________________________________________________________ _______________________________________________________________________________________ Signature: X
Property Information150-553-008 Report, (Rev. page 8 (For Report Disclaimer see page 1) 06-22)
1/1 5298
New mailing address: _____________________________________________________________________________
100
200
200.00'
200
1
300
2
400 Feet
200.00'
N 89º45'45" E
300
1.17 AC
200.00'
COMMON AREA
Y DR
1326.08'
200.00'
1.17 AC
400
3
4
19
EAST
'
SEE
18
5
COMMON AREA
200.00'
600
200.00'
1.17 AC
EAST
200.00'
1600
.94
139.38'
1.22 AC
20
17
16E
WY
6
N 89º46'43" E
16S
1" = 200'
MAP
200.00'
700
1.17 AC
200.00'
200.00'
EAST
1500
1.25 AC
200.00'
09 395.43'
7
E CR 200.00'
800
1.17 AC
21
N
5.8
37
4' º4 1'1 8"
56
.5
5'
EK 200.00'
900
1.17 AC
200.00'
288.00
'
8
2'
1.17 AC
203.81'
N 17 º34'4
166. 23'
22
85 N
.99
7'
33
N
º5 4'3
42
8"
º0
9'
S
56
10
º4
3'3
7"
W
(CO
11
º49'
13
34"
W
'
S 76º33
RD)
200.00'
12
E R D)
200.00'
1.17 AC
1300
276.
27
1/4 COR
S 88º39'08" E
CEN SEC
S 87º04'47" W
9" W S 80º24'1 108.07'
43'
' 79.06 '49" W
.63
1.26 AC
2500
' 200.00 E 57" N 78º50'
(PRIVAT
D
COMMON AREA
255.00'
PU
435.09'
200.00'
1.17 AC
200.00'
1200
'
LN 178.46
S 69
26 0' 1.8 W 29 4" 0'1 1º0 S6 ' 0 4.9
22
1.77 AC
2400
21
0.0
0
6.3
12
25
42.62' 26.12'
COMMON AREA
200.00'
1.17 AC
1100
200.00'
SE DAVIS LP
9
N 89º32'15" E
200.00'
1000
200.00'
(PRIVATE RD)
E
2300
5'3 1"
314.37'
84.97'
1.87 AC
148.63'
S 82º50'02"
RK PA 104.67'
24 115.03'
S 86º33'07" W
1.99 AC
2200
13.17'
73.17'
AIR
23
SKIES
W
190.00'
7.6 º0
24 50
6"
7'
1.45 AC
2100
16
COMMON AREA
200.00'
200.00'
RUNWAY
1400
W
22
200.00'
1.25 AC
199.03'
1.00 AC
2000
138.01'
22"
16
º06'
2.66 '
N 88º58'42" W
N 70
N
5'5
.7
60'
S.W.1/4 SEC.9 T.16S. R.16E. W.M. CROOK COUNTY
200.00'
1.17 AC
500
200.00'
SE LANDINGS
200.00'
200.00'
1700
1.28 AC
'
BLUE 288.16'
21
7" W6 5.3 S 80º13'4 4' N 20 72.51' 61º3 .08 7'0 ' 3" W 107.05' S 87º02'35" W
16E
97
255.00'
0
200.00'
1.17 AC
W
.36
SE
1.54 AC
"W
16S
8'
255.00'
NORTH
0
41.25 AC
7'
100
6.9
4"
255.00'
3'2
NORTH
1º0
52
5'
1900
14.0
2'11
W 2" 2'0 1º2 20" W S 6 ' S 79º15' ' 6.64 .72 ' 125.40 30 41
MAP
º5
0.2
255.00'
0
09D
16E
16S
MAP
SEE
N 6
N6
COMMON AREA
0'
20 '
W º3 4" 6'4 S 70
.66 0º0
58 S6
SEE
55
26
03" W N 11º09' ' 276.19
18
º5 W
9
0.9
W
13
2"
N
"W
K
3'1 6
EE
03" W N 11º09' ' 280.59
255.00'
60'
255.00' 272.50'
CR
456.60'
51 '05 "
34 .01 '
W
8'5
Y DR
2645.63'
378.74'
0 411.54'
255.00' 272.50'
255.00'
S 89º29'50" W
252.67'
150.00'
1.58 AC
1800
58
º0
8'04 "
S
19'
º2
3'
210.
1.1
N 69
18
S 88º57'49" W
66.76'
NORTH
0 '
54.33
255.00'
1/4 COR
N 68 º0 61.3 6'09 "W 7'
9
255.00'
594.26' N 02º33'26" E
16
204.39'
255.00' 272.50' '25" W S 13º06
30' 277.18'
4' .5 78
237.50'
9' 6.8
255.00' 287.50' 252.43'
16E 16S MAP SEE
0
THIS MAP WAS PREPARED FOR ASSESSMENT PURPOSE ONLY
8
17
16S16E09C
Revised: DBJ 7/17/2006
16S16E09C
Property Information Report, page 9 (For Report Disclaimer see page 1)
2641.92' N 01º52'57" E
W 8" W
W
' W
Community Well Loca on. This Well is monitored by the state and does not fall under private well regula ons.
PUBLIC HEALTH DIVISION Center for Health Protection, Drinking Water Services
2023 ANNUAL SUMMARY REPORT CROSS CONNECTION & BACKFLOW PREVENTION DRY CREEK AIRPARK, 41-06110 WS Name and PWS ID#: ________________________________________________________________________ 03/08/24 3:50 PM Small System, 1-299 connections System Size: ___________________________________________________________ Submitted:___________
ASR Contact Information: (if there are questions about the ASR who should we contact?)
Bob Bronson Name: _________________________________________________________________________________ BobBronson444@gmail.com +1 (541) 447-2777 Email: ____________________________________________ Phone #: _____________________________ Customer Base Who does your water system serve? Count each service connection only once, include connections with and without a backflow assembly.
30 How many residential connections are in your water system? _______ How many high hazard connections in your water system?
0 _______
How many other types of connections not listed above?
0 _______
Enabling Authority An enabling authority is required for all community water systems. The enabling authority
allows for a water system to discontinue service for various reasons. A sample enabling authority is available for small water systems on our website: www.healthoregon.org/crossconnection. If you have not submitted an enabling authority to the State, please complete one and submit it as soon as possible.
Yes Does your water system have an enabling authority? ____________________________ No Was your enabling authority revised within the last year? ________________________ This section is for Large Systems only (300+ connections) Certified Cross Connection Specialist Information: __________________________________________________ Name: Email Address:
_______________________________________________ Cert #:_______________________ ____________________ Phone #: _____________________
Does your water system have a current written backflow prevention program plan? Does the backflow prevention plan include the following:
____
1. A list of premises where health hazard cross connections exist, including, but not limited to, those listed in Table 42 (High Hazard Table). 2. Procedure for continually evaluating the degree of hazard posed by a water users premises. 3. Procedure for notifying the water user if a non-health hazard or health hazard is identified, and for informing the water user of any corrective action required. 4. The type of protection required to prevent backflow into the public water supply, commensurate with the degree of hazard that exists on the water user’s premises. 5. A description of what corrective actions will be taken if a water user fails to comply with the water suppliers cross connection control requirements. 6. Current records of approved backflow prevention assemblies installed, inspections completed, test results, and verification of current backflow assembly tester certification. 7. A public education program about cross connection control. Oregon Cross Connection & Backflow Prevention Annual Summary Report
Page 1 of 2
____ ____ ____ ____ ____ ____ ____
Assembly Data Reduced Pressure Backflow Prevention Assemblies (RP, RPBA, & RPDA)
No Are there any RPs installed in your water system? ____________ How many assemblies are installed in your water system?
__________
How many assemblies were tested?
___________
How many assemblies passed their annual test?
___________
How many assemblies failed their annual test?
___________
Comments:_______________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Double Check Backflow Prevention Assemblies (DC, DCVA, & DCDA)
Yes Are there any DCs installed in your water system? ____________ 30 How many assemblies are installed in your water system? ____________ How many assemblies were tested?
30 ___________
How many assemblies passed their annual test?
30 ___________
How many assemblies failed their annual test?
0___________
Comments:_______________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Pressure Vacuum Breaker Assemblies (PVB, PVBA, & SVBA)
No Are there any PVBs installed in your water system?____________ How many assemblies are installed in your water system? ____________ How many assemblies were tested?
____________
How many assemblies passed their annual test?
____________
How many assemblies failed their annual test?
____________
Comments:_______________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
Oregon Cross Connection & Backflow Prevention Annual Summary Report
Page 2 of 2
CROOK COUNTY
Inspection Summary Report Onsite Inquiry
300 NE 3rd St, Rm #12 Prineville,OR 97754 Phone: 541-447-3211 Fax: 541-416-2139
Permit #: 217-21-001543-INQY bld@crookcountyor.gov
co.crook.or.us
IVR # 217031703831 Address:
1832 SE BLUE SKIES LN PRINEVILLE OR 97754
Parcel:
161609C001800
Inspection in a Floodplain: No Inspection Type: Inspection Date: Inspector: Inspection Result: Comments:
Schedule Inspections online at: www.buildingpermits.oregon.gov or by calling: 1-888-299-2821 Use IVR # 217031703831 Schedule using the Oregon ePermitting Inspection App, search “epermitting” in the app store
Print Date: 1/20/2025
Page 1 of 1
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 1 2
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760 (the "Property")
INSTRUCTIONS TO THE SELLER 3 4 5
Please complete the following form. Do not leave any spaces blank. Please refer to the line number(s) of the question(s) when you provide your explanation(s). If you are not claiming an exclusion or refusing to provide the form under ORS 105.475(4), you should date and sign each page of this disclosure statement and each attachment.
6 7 8
Each seller of residential property described in ORS 105.465 must deliver this form to each buyer who makes a written offer to purchase. Under ORS 105.475(4), refusal to provide this form gives the buyer the right to revoke their offer at any time prior to closing the transaction. Use only the section(s) of the form that apply to the transaction for which the form is used. If you are claiming an exclusion under ORS 105.470, fill out only Section 1.
9 10 11
An exclusion may be claimed only if the seller qualifies for the exclusion under the law. If not excluded, the seller must disclose the condition of the Property or the buyer may revoke their offer to purchase anytime prior to closing the transaction. Questions regarding the legal consequences of the seller's choice should be directed to a qualified attorney.
DO NOT FILL OUT THIS SECTION UNLESS YOU ARE CLAIMING AN EXCLUSION UNDER ORS 105.470 12
Section 1. EXCLUSION FROM ORS 105.462 TO 105.490:
13 14
You may claim an exclusion under ORS 105.470 only if you qualify under the statute. If you are not claiming an exclusion, you must fill out Section 2 of this form completely.
15
Initial only the exclusion you wish to claim.
16 17
This is the first sale of a dwelling never occupied. The dwelling is constructed or installed under building or installation permit(s) # issued by .
18
This sale is by a financial institution that acquired the Property as custodian, agent or trustee, or by foreclosure or deed in lieu of foreclosure.
19
Seller is a court appointed (select only one)
20
This sale or transfer is by a governmental agency.
receiver,
personal representative,
trustee,
conservator, or
guardian.
21
Signature(s) of Seller(s) claiming exclusion:
22
Seller
Date
a.m.
p.m. ←
23
Seller
Print Elise Burnham- Juteau, TTE Date
a.m.
p.m. ←
24
Signature(s) of Buyer(s) to acknowledge Seller's claim:
25
Buyer
Date
a.m.
p.m. ←
26
Buyer
Date
a.m.
p.m. ←
IF YOU DID NOT CLAIM AN EXCLUSION IN SECTION 1, YOU MUST FILL OUT THIS SECTION 27 28
Section 2. SELLER'S PROPERTY DISCLOSURE STATEMENT: (NOT A WARRANTY) (ORS 105.464)
29 30
NOTICE TO THE BUYER: THE FOLLOWING REPRESENTATIONS ARE MADE BY THE SELLER(S) CONCERNING THE CONDITION OF THE PROPERTY LOCATED AT 1832 Blue Skies Lane, Prineville OR 97760 THE "PROPERTY".
Buyer Initials
/
Date
Seller Initials
/
Date
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 1 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Natalie Nolte
Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
www.lwolf.com
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 31 32
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760 (the "Property")
33 34 35 36 37
DISCLOSURES CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME OF DISCLOSURE. BUYER HAS FIVE BUSINESS DAYS FROM THE SELLER'S DELIVERY OF THIS SELLER'S DISCLOSURE STATEMENT TO REVOKE BUYER'S OFFER BY DELIVERING BUYER'S SEPARATE SIGNED WRITTEN STATEMENT OF REVOCATION TO THE SELLER DISAPPROVING THE SELLER'S DISCLOSURE STATEMENT, UNLESS BUYER WAIVES THIS RIGHT AT OR PRIOR TO ENTERING INTO A SALE AGREEMENT.
38 39 40 41
FOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS PROPERTY, BUYER IS ADVISED TO OBTAIN AND PAY FOR THE SERVICES OF A QUALIFIED SPECIALIST TO INSPECT THE PROPERTY ON BUYER'S BEHALF INCLUDING, FOR EXAMPLE, ONE OR MORE OF THE FOLLOWING: ARCHITECTS, ENGINEERS, PLUMBERS, ELECTRICIANS, ROOFERS, ENVIRONMENTAL INSPECTORS, BUILDING INSPECTORS, CERTIFIED HOME INSPECTORS, OR PEST AND DRY ROT INSPECTORS.
42
Seller (select one) ✔ is
is not occupying the Property.
I. SELLER'S REPRESENTATIONS 43 44
The following are representations made by Seller and are not the representations of any financial institution that may have made or may make a loan pertaining to the Property, or that may have or take a security interest in the Property, or any real estate licensee engaged by Seller or Buyer.
45
(Select or fill in an answer to each question below. Select “N/A” if a question is not applicable to the Property.)
46
*If you mark "Yes" on items with *, attach a copy or explain on an attached sheet.
47
1. TITLE
48
A. Do you have legal authority to sell the Property? ..........................................................................................
Yes*
No
Unknown
49 50
B. *Is title to the Property subject to any of the following? .................................................................................. First right of refusal Option Lease or rental agreement Other listing Life estate
Yes*
No
Unknown
51
C. *Is the Property being transferred an unlawfully established unit of land?......................................................
Yes*
No
Unknown
52 53
D. *Are there any encroachments, boundary agreements, boundary disputes or recent boundary changes? ............................................................................................................................
Yes*
No
Unknown
54 55
E. *Are there any rights of way, easements, licenses, access limitations or claims that may affect your interest in the Property? .................................................................................................
Yes*
No
Unknown
56
F. *Are there any agreements for joint maintenance of an easement or right of way? .......................................
Yes*
No
Unknown
57 58
G.*Are there any governmental studies, designations, zoning overlays, surveys or notices that would affect the Property? ..........................................................................................................
Yes*
No
Unknown
59
H. *Are there any pending or existing governmental assessments against the Property? ..................................
Yes*
No
Unknown
60
I. *Are there any zoning violations or nonconforming uses? .............................................................................
Yes*
No
Unknown
61
J. *Is there a boundary survey for the Property? ................................................................................................
Yes*
No
Unknown
62 63
K. *Are there any covenants, conditions, restrictions or private assessments that affect the Property? ..................................................................................................................................................
Yes*
No
Unknown
64 65
L. *Is the Property subject to any special tax assessment or tax treatment that may result in levy of additional taxes if the Property is sold?..................................................................................
Yes*
No
Unknown
/
Date
Buyer Initials
/
Date
Seller Initials
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 2 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
www.lwolf.com
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 66 67 68 69
Property Address or Tax ID #1832 Blue Skies Lane, Prineville OR 97760 (the "Property") 2. WATER A. Household water
70
(1) The source of the water is (select ALL that apply):
71
(2) Water source information:
Public
Community
Private
Other (specify)
72 73
a. *Does the water source require a water permit?................................................................................... If yes, do you have a permit? .............................................................................................................
Yes* Yes
No No
Unknown Unknown
N/A
74 75
b. Is the water source located on the Property? ...................................................................................... *If not, are there any written agreements for a shared water source? ...............................................
Yes* Yes*
No No
Unknown Unknown
N/A N/A
76 77
c. *Is there an easement (recorded or unrecorded) for your access to or maintenance of the water source? .....................................................................................................
Yes*
No
Unknown
78 79 80
d. If the source of water is from a well or spring, have you had any of the following in the past 12 months? ......................................................................................................... Flow test Bacteria test Chemical contents test
Yes
No
Unknown
81
e. *Are there any water source plumbing problems or needed repairs?...................................................
Yes*
No
Unknown
82 83
(3) Are there any water treatment systems for the Property? ......................................................................... Leased Owned
Yes
No
Unknown
84
N/A
B. Irrigation
85
(1) Are there any
other irrigation rights for the Property?..............................................
Yes
No
Unknown
86
(2) *If any exist, has the irrigation water been used during the last five-year period?......................................
Yes*
No
Unknown
N/A
87
(3) *Is there a water rights certificate or other written evidence available? .....................................................
Yes*
No
Unknown
N/A
88
water rights or
C. Outdoor sprinkler system
89
(1) Is there an outdoor sprinkler system for the Property? .............................................................................
Yes
No
Unknown
90
(2) Has a back flow valve been installed? ......................................................................................................
Yes
No
Unknown
N/A
91
(3) Is the outdoor sprinkler system operable? ................................................................................................
Yes
No
Unknown
N/A
92
3. SEWAGE SYSTEM
93
A. Is the Property connected to a public or community sewage system?............................................................
Yes
No
Unknown
94
B. Are there any new public or community sewage systems proposed for the Property? ..................................
Yes
No
Unknown
95
C. Is the Property connected to an on-site septic system?..................................................................................
Yes
No
Unknown
.........................................................................................
Unknown
N/A
96
(1) If yes, when was the system installed?
97
(2) *If yes, was the system installed by permit? ............................................................................................
Yes*
No
Unknown
N/A
98
(3) *Has the system been repaired or altered? ..............................................................................................
Yes*
No
Unknown
N/A
99
(4) *Has the condition of the system been evaluated and a report issued?....................................................
Yes*
No
Unknown
N/A
100 101
(5) Has the septic tank ever been pumped? ................................................................................................... Yes No Unknown If yes, when? ............................................................................................................................................
N/A N/A
Buyer Initials
/
Date
Seller Initials
/
Date
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 3 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
www.lwolf.com
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 102 103
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760 (the "Property")
104
(6) Does the system have a pump?.................................................................................................................
Yes
No
Unknown
N/A
105
(7) Does the system have a treatment unit such as a sand filter or an aerobic unit?......................................
Yes
No
Unknown
N/A
106
(8) *Is a service contract for routine maintenance required for the system?....................................................
Yes*
No
Unknown
N/A
107
(9) Are all components of the system located on the Property? ......................................................................
Yes
No
Unknown
N/A
108
D. *Are there any sewage system problems or needed repairs? ........................................................................
Yes*
No
Unknown
109
E. Does your sewage system require on-site pumping to another level? ...........................................................
Yes
No
Unknown
110
4. DWELLING INSULATION
111
A. Is there insulation in the:
112
(1) Ceiling? .....................................................................................................................................................
Yes
No
Unknown
113
(2) Exterior walls?...........................................................................................................................................
Yes
No
Unknown
114
(3) Floors? ......................................................................................................................................................
Yes
No
Unknown
115
B. Are there any defective insulated doors or windows? ....................................................................................
Yes
No
Unknown
116
5. DWELLING STRUCTURE
117 118
A. *Has the roof leaked?...................................................................................................................................... If yes, has it been repaired?........................................................................................................................
Yes* Yes
No No
Unknown Unknown
N/A
119 120 121 122
B. Are there any additions, conversions or remodeling? ..................................................................................... If yes, was a building permit required?........................................................................................................ If yes, was a building permit obtained?....................................................................................................... If yes, was final inspection obtained?..........................................................................................................
Yes Yes Yes Yes
No No No No
Unknown Unknown Unknown Unknown
N/A N/A N/A
123
C. Are there smoke alarms or detectors?.............................................................................................................
Yes
No
Unknown
124
D. Are there carbon monoxide alarms?................................................................................................................
Yes
No
Unknown
125 126 127 128 129
E. Is there a woodstove or fireplace insert included in the sale?......................................................................... *If yes, what is the make? *If yes, was it installed with a permit?.......................................................................................................... *If yes, is a certification label issued by the United States Environmental Protection Agency (EPA) or the Department of Environmental Quality (DEQ) affixed to it?........................................
Yes
No
Unknown
Yes*
No
Unknown
N/A
Yes*
No
Unknown
N/A
130 131
F. *Has pest and dry rot, structural or "whole house" inspection been done within the last three years? .............................................................................................................................................
Yes*
No
Unknown
132 133 134 135
G.*Are there any moisture problems, areas of water penetration, mildew odors or other moisture conditions (especially in the basement)?................................................................................. *If yes, explain on attached sheet the frequency and extent of problem and any insurance claims, repairs or remediation done.
Yes*
No
Unknown
136
H. Is there a sump pump on the Property?...........................................................................................................
Yes
No
Unknown
137 138 139
I. Are there any materials used in the construction of the structure that are or have been the subject of a recall, class action suit, settlement or litigation? ................................................................... If yes, what are the materials?
Yes
No
Unknown
140
(1) Are there problems with the materials? .....................................................................................................
Yes
No
Unknown
/
Date
Buyer Initials
/
Date
Seller Initials
NA
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 4 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
www.lwolf.com
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 141 142
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760 (the "Property")
143
(2) Are the materials covered by a warranty? .................................................................................................
Yes
No
Unknown
N/A
144
(3) Have the materials been inspected? .........................................................................................................
Yes
No
Unknown
NA
145 146
(4) Have there ever been claims filed for these materials by you or by previous owners?.............................. Yes No Unknown If yes, when? ...........................................................................................................................
N/A N/A
147
(5) Was money received? ..............................................................................................................................
Yes
No
Unknown
N/A
148
(6) Were any of the materials repaired or replaced? ......................................................................................
Yes
No
Unknown
N/A
149
6. DWELLING SYSTEMS AND FIXTURES
150
If the following systems or fixtures are included in the purchase price, are they in good working order on the date this form is signed?
151
A. Electrical system, including wiring, switches, outlets and service...................................................................
Yes
No
Unknown
152
B. Plumbing system, including pipes, faucets, fixtures and toilets.......................................................................
Yes
No
Unknown
153
C. Water heater tank ..........................................................................................................................................
Yes
No
Unknown
154
D. Garbage disposal.............................................................................................................................................
Yes
No
Unknown
N/A
155
E. Built-in range and oven....................................................................................................................................
Yes
No
Unknown
N/A
156
F. Built-in dishwasher...........................................................................................................................................
Yes
No
Unknown
N/A
157
G.Sump pump ....................................................................................................................................................
Yes
No
Unknown
N/A
158
H. Heating and cooling systems
159
(1) Heating systems.........................................................................................................................................
Yes
No
Unknown
N/A
160
(2) Cooling systems .........................................................................................................................................
Yes
No
Unknown
N/A N/A
161
I. Security system
Leased.............................................................................................................
Yes
No
Unknown
162 163 164
J. Are there any materials or products used in the systems and fixtures that are or have been the subject of a recall, class action suit settlement or litigation?............................................................ If yes, what product?
Yes
No
Unknown
165
(1) Are there problems with the product?........................................................................................................
Yes
No
Unknown
N/A
166
(2) Is the product covered by a warranty?.......................................................................................................
Yes
No
Unknown
N/A
167
(3) Has the product been inspected?...............................................................................................................
Yes
No
Unknown
N/A
168 169
(4) Have claims been filed for this product by you or by previous owners?..................................................... If yes, when?
Yes
No
Unknown
N/A
170
(5) Was money received? ...............................................................................................................................
Yes
No
Unknown
N/A
171
(6) Were any of the materials or products repaired or replaced? ...................................................................
Yes
No
Unknown
N/A
Yes
No
Unknown
/
Date
172 173 174 175 176 177
Owned
7. COMMON INTEREST A. Is there a Home Owners' Association or other governing entity?................................................................... Name of Association or Other Governing Entity: Contact Person: Address: Phone Number: Buyer Initials
/
Date
Seller Initials
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 5 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
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RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 178 179
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760
180
B. Regular periodic assessments: $
181
C. *Are there any pending or proposed special assessments? ..........................................................................
Yes*
No
Unknown
182 183 184
D. Are there shared "common areas" or joint maintenance agreements for facilities like walls, fences, pools, tennis courts, walkways or other areas co-owned in undivided interest with others?........................................................................................................................
Yes
No
Unknown
185 186
E. Is the Home Owners' Association or other governing entity a party to pending litigation or subject to an unsatisfied judgment?..............................................................................................
Yes
No
Unknown
N/A
187 188
F. Is the Property in violation of recorded covenants, conditions and restrictions or in violation of other bylaws or governing rules, whether recorded or not? .........................................................
Yes
No
Unknown
N/A
Yes Yes
No No
Unknown Unknown
N/A
189 190 191 192
(the "Property") per ✔ Month
Year
Other ______________________________________
8. SEISMIC A. Was the house constructed before 1974? ...................................................................................................... If yes, has the house been bolted to its foundation? .................................................................................. 9. GENERAL
193 194
A. Are there problems with settling, soil, standing water or drainage on the Property or in the immediate area? ...............................................................................................................................
Yes
No
Unknown
195
B. Does the Property contain fill? ........................................................................................................................
Yes
No
Unknown
196 197
C. Is there any material damage to the Property or any of the structure(s) from fire, wind, floods, beach movements, earthquake, expansive soils or landslides? ...............................................
Yes
No
Unknown
198 199
D. Is the Property in a designated floodplain? .................................................................................................... Note: Flood insurance may be required for homes in a floodplain.
Yes
No
Unknown
200
E. Is the Property in a designated slide or other geologic hazard zone?.............................................................
Yes
No
Unknown
201 202 203
F. *Has any portion of the Property been tested or treated for asbestos, formaldehyde, radon gas, lead-based paint, mold, fuel or chemical storage tanks or contaminated soil or water? ..................................................................................................................................................
Yes*
No
Unknown
204 205
G.Are there any tanks or underground storage tanks (for example, septic, chemical, fuel, etc.) on the Property? .....................................................................................................................................
Yes
No
Unknown
206 207
H. Has the Property ever been used as an illegal drug manufacturing or distribution site?................................. *If yes, was a Certificate of Fitness issued? ...............................................................................................
Yes Yes*
No No
Unknown Unknown
208
I. *Has the Property been classified as wildland-urban interface?......................................................................
Yes*
No
Unknown
Yes*
No
209 210 211 212 213
N/A
10. FULL DISCLOSURE BY SELLER(S) A. *Are there any other material defects affecting this Property or its value that a prospective buyer should know about?........................................................................................................... *If yes, describe the defect on attached sheet and explain the frequency and extent of the problem and any insurance claims, repairs or remediation.
Buyer Initials
/
Date
Seller Initials
/
Date
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 6 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
www.lwolf.com
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT 214 215
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760 (the "Property")
VERIFICATION 216 217 218
The foregoing answers and attached explanations (if any) are complete and correct to the best of my/our knowledge and I/we have received a copy of this disclosure statement. I/we authorize my/our agents to deliver a copy of this disclosure statement to all prospective buyers of the Property or their agents.
219
Total number of pages attached, including all addenda, reports, or any other documents.
0
220
Seller
Date
a.m.
p.m. ←
221
Seller
Print Elise Burnham- Juteau, TTE
Date
a.m.
p.m. ←
(complete even if zero)
II. BUYER'S ACKNOWLEDGMENT 222 223
A. As buyer(s), I/we acknowledge the duty to pay diligent attention to any material defects that are known to me/us or can be known by me/us by utilizing diligent attention and observation.
224 225 226 227 228
B. Each Buyer acknowledges and understands that the disclosures set forth in this statement and in any amendments to this statement are made only by Seller and are not representations of any financial institution that may have made or may make a loan pertaining to the Property, or that may have or take a security interest in the Property, or of any real estate licensee engaged by Seller or Buyer. A financial institution or real estate licensee is not bound by and has no liability with respect to any representation, misrepresentation, omission, error or inaccuracy contained in another party's disclosure statement required by this section or any amendment to the disclosure statement.
229 230
C. Buyer (which term includes all persons signing the "buyer's acknowledgment" portion of this disclosure statement below) hereby acknowledges receipt of a copy of this disclosure statement (including attachments, if any) bearing Seller's signature(s).
231 232 233 234 235
DISCLOSURES, IF ANY, CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME OF DISCLOSURE. IF THE SELLER HAS FILLED OUT SECTION 2 OF THIS FORM, YOU, THE BUYER, HAVE FIVE BUSINESS DAYS FROM THE SELLER'S DELIVERY OF THIS DISCLOSURE STATEMENT TO REVOKE YOUR OFFER BY DELIVERING YOUR SEPARATE SIGNED WRITTEN STATEMENT OF REVOCATION TO THE SELLER DISAPPROVING THE SELLER'S DISCLOSURE UNLESS YOU WAIVE THIS RIGHT AT OR PRIOR TO ENTERING INTO A SALE AGREEMENT.
236
BUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS SELLER'S PROPERTY DISCLOSURE STATEMENT.
237
Buyer
Date
a.m.
p.m. ←
238
Buyer
Date
a.m.
p.m. ←
239
Agent receiving disclosure statement on Buyer's behalf to sign and date:
240
Real Estate Agent
241
Date received by Agent
← Real Estate Firm (identify)
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 020 | Released 01/2025 | Page 7 of 7 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
www.lwolf.com
RESIDENTIAL
SELLER'S PROPERTY DISCLOSURE STATEMENT ADDENDUM 1
Property Address or Tax ID # 1832 Blue Skies Lane, Prineville OR 97760
2
(the "Property")
3
Responses marked "yes" on items with an * require a written explanation. See below.
4
Question #
5
Details:
6 7 8 9
Attachment Identified as:
10
Question #
11
Details:
12 13 14 15
Attachment Identified as:
16
Question #
17
Details:
18 19 20 21
Attachment Identified as:
22
Question #
23
Details:
24 25 26 27
Attachment Identified as:
28
Question #
29
Details:
30 31 32 33
Attachment Identified as:
34
Seller
Date
a.m.
p.m. ←
35
Seller
Print Elise Burnham- Juteau, TTEDate
a.m.
p.m. ←
Buyer Initials
/
Date
LINES WITH THIS SYMBOL ← REQUIRE A SIGNATURE AND DATE OREF 028 | Released 01/2025 | Page 1 of 1 No portion of this form may be reproduced without the express permission of Oregon Real Estate Forms, LLC | Copyright Oregon Real Estate Forms, LLC 2022 This form has been licensed for use solely by the user named below under the terms of the Oregon Real Estate Forms license agreement located at: https://orefonline.com/oref-forms-license-terms-and-conditions. Natalie Nolte
Phone: (541)5089581 Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201
Fax: 5413234488 www.lwolf.com
Listing Template
©2026 Engel & Völkers. All rights reserved. Each brokerage independently owned and operated. Engel & Völkers and its independent License Partners are Equal Opportunity Employers and fully support the principals of the Fair Housing Act. All information provided is deemed reliable but is not guaranteed and should be independently verified