detached single family/farm & ranch form · steamboat springs region info applies only to...

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© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 1 Detached Single Family/Farm & Ranch Form Status Information Status*: Active Incoming Type*: Detached Single Family Farm and Ranch Agent Listing Agent Information Listing Agent ID*: Co-Listing Agent ID: Showing Info Showing Phone: Showing Email: Showing Notes: Max 1000 Characters Coop Compensation Buyers Agency Transaction Broker Compensation ($ or %)*: Compensation ($ or %)*: Listing Contract Type*: Exclusive Right Exclusive Agency Other Other Listing Contract Type: Variable Commission*: Yes No Submitted Prospect*: Yes No General Address County*: Tax ID* (formerly PIN): Street #*: Street Dir: Street Name*: Street Type: City*: Zip Code*: State*: Unit #: Building #: Property Info Legal Description*: Zoning*: Incorporated: Yes No Locale*: Complex Name: Status & Listing Information Expiration Date*: Investor Blackout Ends: No Showings Until: Price Type*: Auction Base Price List Price Price*: Auction Price: Lowest Bid N/A Reserve Price Seller Type*: Bank/GSE Builder Corporation/Trust Estate Gov’t Individual Relo Company Status Conditions*: Court Equitable Interest None Known Short Sale * = Required field

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© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 1

Detached Single Family/Farm & Ranch FormStatus InformationStatus*: Active Incoming Type*: Detached Single Family Farm and Ranch

Agent

Listing Agent Information

Listing Agent ID*: Co-Listing Agent ID:

Showing Info

Showing Phone: Showing Email:

Showing Notes:

Max 1000 Characters

Coop Compensation

Buyers Agency Transaction Broker Compensation ($ or %)*: Compensation ($ or %)*:

Listing Contract Type*: Exclusive Right Exclusive Agency Other Other Listing Contract Type:

Variable Commission*: Yes No Submitted Prospect*: Yes No

General

Address

County*: Tax ID* (formerly PIN):

Street #*: Street Dir: Street Name*: Street Type:

City*: Zip Code*: State*: Unit #: Building #:

Property Info

Legal Description*: Zoning*: Incorporated: Yes No

Locale*: Complex Name:

Status & Listing Information

Expiration Date*: Investor Blackout Ends: No Showings Until:

Price Type*: Auction Base Price List Price Price*:

Auction Price: Lowest Bid N/A Reserve Price

Seller Type*: Bank/GSE Builder Corporation/Trust Estate Gov’t Individual Relo Company

Status Conditions*: Court Equitable Interest None Known Short Sale

* = Required field

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 2

Loan & Tax Information

Taxes*: Tax Year*: Senior Tax Exemption: □Financial Terms*: (6)

□ Cash□ Conventional□ Exchange

□ FHA□ Jumbo□ Lease Purchase

□ Other□ Owner Will Carry□ Private Financing

□ Qualified Assumption□ USDA□ VA

Property Information: (4) □ 1031 Exchange

□ Accessible/HandicapFeatures

□ Agent Owner

□ Buyers Warranty□ Fix-Up□ HUD Owned□ Income History Available

□ Income Potential□ Quick Move-In□ Quick Possession□ Rent-to-Own

□ Reservations/Pre-Sale□ Subdividable□ Tenant Occupied

Rentals Allowed:

□ Long Term □ None □ Short Term

Other Financial Terms:

Partial Ownership

Partial Ownership Type: Fractional Not Applicable Shared Interest Time Share Vacation Club

Partial Ownership Amount: 1/2 1/4 1/7 1/8 1/10 1/12 1/52

Ownership: Club Membership Fee Simple Right to Use

Weeks Available: Week Remarks:

Region Info

Steamboat Springs Region InfoApplies only to listings entered by Steamboat Springs Board of REALTORS® members.

Buyer Tour Region*: Steamboat Springs Development*:

Building

Building Information - Detached Single Family

Style*: 2 Story 3+ Story Bi-Level Multi-Level Raised Ranch Ranch/1 Story Tri-Level

Architecture: A-Frame Bungalow Cabin Chalet Contemporary Cottage Denver Square

Double Wide Mid-Century Modern Mountain Contemporary Other Patio

Rustic Contemporary Single Wide Spanish/SW Traditional Triple Wide Tudor

Urban Contemporary Victorian

Year Built*:

Building Information

Builder Name:

Construction & Exterior

Construction*: □ Block

□ Brick□ Concrete□ Earth Berm

□ Frame□ Insulated Concrete□ Log□ Manufactured

□ Metal Frame□ Mobile□ Modular□ Other

□ Straw Bale□ Structural Steel

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 3

Exterior Materials*: □ Adobe

□ Asbestos□ Brick□ Cedar Siding

□ Cement Board□ Log□ Metal Siding□ Other

□ Rock□ Stone□ Stucco□ Vinyl Siding

□ Wood Siding

Roofing Materials*: □ Architectural Shingles

□ Built-Up(Tar & Gravel)□ Cement Shake□ Composition Shingles

□ Concrete Tile□ Fiberglass□ Metal□ Other

□ Rolled Roofing□ Simulated Shake□ Slate□ Solar Shingles

□ Spanish Tile□ Stone-Coated Steel□ Unknown□ Wood

Green Features & Certifications

Year Certified Year Installed

HERS Rating : HERS Score: Solar PV: Kilowatts:

Energy Star Qualified Home: Solar Thermal:

Home Energy Score: Solar Thermal Type:

LEED for Homes: Energy Features Addendum Uploaded: □LEED Level: Certified Silver Gold Platinum

NAHB/ICC-700: NAHB/ICC-700 Level: Bronze Silver Gold Emerald

Other Certifications:

New Home

Building Information

Model Name/Elevation Name: Time of completion from groundbreaking:

Construction Details: New Home Under Construction

Community Details

Community Name: Community Website:

MLS # of New Home Community Listing:

MLS # of Associated Land Listings: Lot #:

Available Options:

Max 1000 Characters

Current Promotions:

Max 1000 Characters

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 4

Interior

Square Feet & Basement

Measurement Source: Appraiser Builder County Records Floor Plans Listor

SqFt Upper: Date Measured: Basement Size*: Full None Partial

SqFt Main: Sqft Other Finished : Basement Type: Cellar Garden Level

SqFt Lower: Other Finished Description: Standard Walk-out

Sqft Above*: Basement Finished: Yes No

Sqft Basement: Basement % Finished:

SqFt Total*: Basement Ceiling Height:

SqFt Finished*: Subfloor/Foundation Type:

HVAC

Fuel Type*:

□ Coal□ Electric□ Gas□ Heat Pump/Thermal□ Hot Water□ Oil□ Pellet□ Propane□ Solar□ Wood

Heating Type*:

□ Baseboard□ Floor Furnace□ Forced Air□ Gravity□ Hot Water□ Radiant□ Solar Active□ Solar Passive□ Space Heater□ Steam□ Stove□ Wall Heater

Cooling*: (3)

□ Air Conditioning-Central□ Air Conditioning-Room□ Attic Fan□ Ceiling Fan□ Evap. Cooler (Swamp)□ None□ Other

Other HVAC: (3)

□ Central Hot Water□ Electric Water Heater□ Electronic Air Filter□ Gas Water Heater□ Humidifier□ Other□ Propane Water Heater□ Solar Water Heater

HVAC Detail:

Fireplace Features

# of Fireplaces:

Fireplace Locations: □ Basement

□ Bedroom□ Dining Room

□ Family Room□ Great Room□ Kitchen

□ Living Room□ Master Bedroom□ Other

□ Outdoor□ Rec/Bonus Room

Fireplace Types: □ Coal □ Electric □ Firepit

□ Free-standing□ Gas/Gas Logs□ Insert

□ KIVA□ Pellet□ Recirculator

□ Wood

□ Block Wall□ Concrete Wall□ Crawl Space

□ Slab □ Structural

□ Carriage House□ Guest House□ Mother-In-Law□ Other (refer to remarks)

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 5

Features

Interior Features: □ Breakfast Nook

□ Built-Ins□ Cable Available□ Double Pane Windows□ Eating Space / Kitchen□ Elevator□ Exercise Room□ Exterior Basement

Entrance □ Five Piece Bath

□ Foyer/Entry□ Fully Furnished□ Game Room

□ Handicap Accessible□ Heated Basement□ Home Theater□ Hot Tub/Spa□ Interior Basement Entrance□ Internet Access (Wired)□ Jack & Jill Bath□ Jet Action Tub□ Kitchen Island□ Master Bath□ Master Suite□ No Stairs□ Open Floor Plan

□ Pantry□ Pet Free□ Pool, Indoor□ Radon Mitigation System□ Remodeled□ Sauna□ Security Entrance□ Security System□ Skylights□ Smoke Free□ Speakers, Built-in□ Steam Room□ Storm Windows

□ Sump Pump□ T&G Ceilings□ Triple Pane Windows□ Updated□ Utility Sink□ Vaulted Ceiling□ Walk-in Closets□ Wet Bar□ Window Coverings□ Work Shop (Interior)

Appliances: □ Central Vacuum

□ Compactor□ Convection Oven□ Cook Top□ Dishwasher□ Disposal

□ Double Oven□ Downdraft□ Dryer□ Freezer□ Microwave Oven□ Range Hood

□ Refrigerator (Kitchen)□ Refrigerator (Other)□ Self-Cleaning Oven□ Smoke Alarm□ Stove/Range/Oven□ Sump Pump

□ Warming Oven/Drawer□ Washer□ Water Purifier□ Water Softener□ Wine Cooler

Flooring: (4) □ Carpet □ Concrete

□ Laminate □ Parquet

□ Stone □ Tile Floor

□ Vinyl/Linoleum□ Wood Floors

Smart/Connected Home Features: □ Air Quality Monitor

□ Alarm/Security System□ Audio/Video Controls□ Carbon Monoxide Detector□ Ceiling Fans□ Dishwasher□ Door Locks

□ Dryer□ Freezer□ Garage Door□ HVAC/Fans/Vents□ Lighting□ Microwave□ Pool Alarm

□ Radon Detector□ Refrigerator□ Security Cameras□ Smoke Detector□ Sprinklers□ Stove/Oven□ Thermostat

□ Video Doorbell□ Washer□ Water Leak/Flood Alarm□ Window Coverings

Countertop Type: □ Block □ Butcher □ Concrete □ Corian

□ Granite □ Laminate □ Limestone □ Marble

□ Other□ Quartz□ Solid Surface□ Stainless

□ Steel □ Stone □ Synthetic □ Tile

Laundry: □ Closet

□ Coin-operated □ None

□ Shared Laundry in Building □ W/D Hookups in Unit

□ Washer/Dryer Included

Rooms Note: Bedroom and bathroom level required per REcolorado Rules & Regulations

Detailed Room Information

1 Room Type: Level*: Room Dimensions: x

Description:

2 Room Type: Level*: Room Dimensions: x

Description:

3 Room Type: Level*: Room Dimensions: x

Description:

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 6

4 Room Type: Level*: Room Dimensions: x

Description:

5 Room Type: Level*: Room Dimensions: x

Description:

6 Room Type: Level*: Room Dimensions: x

Description:

Summary Bed and Bath Information

Total Bedrooms*: Full Baths*: 3/4 Baths*: 1/2 Baths*: 1/4 Baths*: Rough In Bath: □Site

Property Size

Lot Size SqFt*: Lot Size Acres*: Front Faces: E N NE NW S SE SW W

Site, Property Features, and Utilities

Site Description: □ Adjacent to Greenbelt

□ Adjacent to Open Space□ Adjacent to Park□ Borders National Forest□ Borders Public Land□ Corner Lot

□ Cul-de-Sac□ Ditch□ Gated Community□ Golf Community□ Historical District□ Irrigated

□ Near Public Transit□ Near Ski Area□ On Golf Course□ Protected Watershed□ Recreation□ Secluded

□ Ski In /Ski Out□ Suitable for Grazing□ Waterfront

Views: □ City View

□ Golf Course View □ Mountain View

□ River/Lake View □ Ski Area □ Valley

Exterior Features: (12) □ Balcony

□ Covered Deck□ Covered Patio□ Deck□ Dog Run□ Elevator Access□ Exterior Basement

Entrance □ Fence

□ Fenced Pasture□ Front Porch□ Garden Area□ Gas Grill□ Gas Valve□ Greenhouse□ Grill□ Gutters□ Heated Gutters

□ Hot Tub/Spa□ Lighting□ Maintenance Free Exterior□ Patio□ Playground Area□ Pond/Lake□ Pool, Private□ Professional Landscaping□ Satellite Dish

□ Solar□ Sprinkler System□ Tennis Court, Private□ Utility Shed□ Water Feature□ Wraparound Porch□ Yard

Site Topography: □ Creek/Stream

□ Flat□ Flood Plain□ Foothills

□ Gently Sloping□ Lake□ Meadow□ Mountainous

□ Pond□ River□ Rock Outcropping□ Rolling

□ Sloping □ Spring □ Steep

Site Type: □ Agricultural

□ Caretaker / Multiple HomesAllowed

□ Live/Work (Mixed Use)□ Mining Claim□ Mobile Homes Allowed

□ Modulars Allowed□ Mountain Property□ Ranch

□ Vineyard

Reports Available:

□ Architectural Plans□ Building Plans□ Drainage Study□ Easements□ Engineering□ Environmental Audit

□ Feasibility□ Lead Based Paint□ Leases□ Legal Description□ License Included□ Location Map

□ Mineral□ P and L Available□ Perc Test□ Plat□ Profit/Loss Statement□ Rental Average

□ Soil Report□ Survey□ Topography Map□ Utility Average

(7)

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 7

Vegetation:

□ Alfalfa Hay□ Aspen□ Brush□ Cleared□ Crop(s)□ Grass Hay

□ Grassed□ Heavily Wooded□ Mixed□ Natural□ Oak□ Other

□ Partially Wooded□ Pine□ Pinon Pines□ Sagebrush□ Small Grains□ Sparse

□ Thinned□ Wetlands□ Wooded□ Xeriscaping

Site Access

Primary Road: □ Alley

□ Dirt Road □ Easement

□ Gravel Road □ Lease

□ Paved Road

Accessed By:

Easement Land Locked Private

Public Road Seasonal Shared Drive

Year round

Access Maintained By:

City County

Forest Service Private

State Tenant

Type & Distance to Public Transit

Light Rail: Bus: Other:

Public Transit Distance Type: Blocks Feet Miles Minutes Steps

Well & Other Water

Water Source: □ Agriculture/Ditch Water

□ Cistern □ Community

□ Public □ Spring

□ Water Rights Available □ Well

Well Type: (3)□ Commercial□ Community

□ Irrigation □ Not Drilled

□ Not Operational□ Operational

□ Private□ Sub-Area Augmentation

Permitted Well Uses: (3) □ Commercial□ Domestic

□ Household Inside Only □ Household w/Irrigation

□ Household w/Livestock□ Other

Water Tap Paid: Yes No Water Tap Fee: Issued Permit #’s: Well Depth:

Water/Mineral Rights: □ Mineral Rights

□ Oil & Gas Rights □ Seller Retains Mineral

Rights □ Seller Retains Water

Rights □ Water Rights

Utilities

Sewer:

Community Holding Public Septic

Electricity:

Available No Yes To Lot Line

Electricity Service:

110v 220v 440v Other Phase 3 Single Phase

Gas:

Available No Yes

Gas Type:

Natural Propane

Other Available Utilities: □ Cable TV

□ Internet Access (Wired) □ Off Grid □ Telephone

□ Telephone Near

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 8

Parking

Parking & Vehicle Storage Features

Parking Features: (7) □ 220 Volts

□ Driveway-Asphalt□ Driveway-Brick□ Driveway-Circular□ Driveway-Concrete□ Driveway-Dirt

□ Driveway-Gravel□ Driveway-Heated□ Dry Walled□ Exterior Access Door□ Finished□ Floor Coating

□ Heated□ Indoor RV Storage□ Insulated□ Lift□ Natural Light□ Oversized Deep

□ Oversized Door□ Oversized Wide□ Pit□ Tandem

Available Amps:

1 Parking Type*: Carport (Attached) Carport (Detached) Community Parking Garage Covered Parking

Garage (Attached) Garage (Detached) None Off-street Parking Lot

Recreational Vehicle Reserved

# of Spaces*: Length: Width: Features:

2 Parking Type*: Carport (Attached) Carport (Detached) Community Parking Garage Covered Parking

Garage (Attached) Garage (Detached) None Off-street Parking Lot

Recreational Vehicle Reserved

# of Spaces*: Length: Width: Features:

3 Parking Type*: Carport (Attached) Carport (Detached) Community Parking Garage Covered Parking

Garage (Attached) Garage (Detached) None Off-street Parking Lot

Recreational Vehicle Reserved

# of Spaces*: Length: Width: Features:

Community

School Information

School District*: Elementary*: Jr High/Middle*: Sr High*:

School of Choice / Open Enrollment: Yes No

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 9

HOA/Management Company Information

Are there HOAs or Management Companies?*: Yes No Multiple HOAs or Management Companies? Yes No

Master HOA/Management Company:

Master HOA:

Master HOA Phone #:

Master Website:

Master HOA Type:

Professionally Managed

Self Managed

Voluntary

Master HOA Fee:

Master Fee Quoted:

Annual

Monthly

Quarterly

Semi-Annually

Included in Property Tax

None

2nd HOA/Management Company:

2nd HOA:

2nd HOA Phone #:

2nd Website:

2nd HOA Type:

Professionally Managed

Self Managed

Voluntary

2nd HOA Fee:

2nd Fee Quoted:

Annual

Monthly

Quarterly

Semi-Annually

Included in Property Tax

None

3rd HOA/Management Company:

3rd HOA:

3rd HOA Phone #:

3rd Website:

3rd HOA Type:

Professionally Managed

Self Managed

Voluntary

3rd HOA Fee:

3rd Fee Quoted:

Annual

Monthly

Quarterly

Semi-Annually

Included in Property Tax

None

Additional HOA Information

HOA Includes: □ Cable TV

□ Capital Reserves□ Clubhouse□ Common Area Grounds

Maintenance □ Community Pool

□ Concierge□ Covered Parking□ Electricity

□ Exterior Maintenance w/Roof

□ Exterior Maintenance w/out Roof

□ Fitness Facility□ Gas□ Heat□ Indoor Hot Tub□ Insurance

□ Internet□ Irrigation Water□ On-Site Check In□ Outdoor Hot Tub□ Recycling□ Road Maintenance□ Sauna□ Sewer□ Shuttle Available

□ Snow Removal□ Storage□ Tennis Courts□ Trails□ Trash Removal□ Valet□ Water

Restrictions & Covenants: (5) □ Age Restricted Covenants

□ Appreciation Restrictions□ Cats OK□ Deed Restrictions

□ Dogs OK□ First Right□ Income Restriction□ No Animals

□ No Covenants□ Other□ Ownership Retention□ Pet Restrictions

□ Pets Only Allowed forOwner

□ Special Assessment

Other Restrictions: HOA Transfer Amount ($ or %):

Private Transfer Amount ($ or %): Status Letter Amount ($ or %):

Special Assessment Description:

Max 1000 Characters

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 10

Internet DisplayBased on your listing agreement, select if this listing and the listing’s address will be displayed on the Internet. Internet display includes REcolorado.com and IDX websites.

Internet display of listing*: Yes No Internet display of address: Yes No

Listing Syndication Settings

Indicate the syndication channel(s) for your listing: Note: Contact your Managing Broker to confirm available syndication channel(s)

You can make this listing available on REcolorado.com and IDX websites before it displays on syndication channels. Please select the date you would like your listing made available to selected syndication channel(s).

Listing Syndication Date:

RemarksPublic Remarks:

Max 1000 Characters

Broker Remarks:

Max 1000 Characters

Directions:

Exclusions*:

Title Company: Earnest Check To*:

Possession : Minimum Earnest Amount ($):

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 11

Under ContractStatus Conditions*: Court Equitable Interest None Known Short Sale

Contingent Approval Conditions*: Kick Out - Contingent on home sale None Known

Offer accepted awaiting REO approval Offer accepted contingent on court approval

Offer waiting on RELO company approval

Short Sale - Have signed offer(s) waiting on lender approval

Short Sale - Have unsigned offer(s) waiting on lender approval

Under Contract Date*:

Accepting Backup Offers: Yes No

SoldSold Price*: Buyer Broker Paid By: Buyer Listor/Seller Owner

Sold Date*: Property Manager None Other

Sold Terms*: □ Cash

□ Conventional□ Exchange

□ FHA□ Lease Purchase□ Other

□ Owner Will Carry□ Qualified Assumption□ USDA

□ VA□ Wrap Around

Selling Agent ID*: Co-Selling Agent ID:

Sales ConcessionsConcessions*:

□ Buyer Closing Costs/SellerPoints Paid

□ Cash□ Personal Property

□ Seller Dn Pmt Assistance□ None

□ Other

Total Concession Amount*:

Broker Closing Comments:

Max 250 Characters

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 12

Horse Facilities

Detailed Horse Information

Horse Property? Yes No Livestock - Other Animals Allowed? Yes No

Horse Property Features: (6) □ Fenced

□ Loafing Shed□ Outdoor Arena

□ Paddocks□ Pasture□ Tack Room

□ Water - Stream/Spring□ Water Not Provided□ Well Allows For

Outdoor Arena SqFt: Paddocks SqFt:

Horse Facility Details

1 Horse Facility Type: Indoor Arena Stable SqFt:

Primary Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

# of Stalls:

Stall Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

Facility Features: □ Electrical □ Heated □ Heated Water □ Loft □ Water

Facility Description:

2 Horse Facility Type: Indoor Arena Stable SqFt:

Primary Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

# of Stalls:

Stall Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

Facility Features: □ Electrical □ Heated □ Heated Water □ Loft □ Water

Facility Description:

3 Horse Facility Type: Indoor Arena Stable SqFt:

Primary Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

# of Stalls:

Stall Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

Facility Features: □ Electrical □ Heated □ Heated Water □ Loft □ Water

Facility Description:

© REcolorado | 6455 S. Yosemite St., Suite 500 | Greenwood Village, CO 80111 | P 303.850.9576 • F 303.850.9637 rev 2/18 Page 13

Farm and RanchAcres Cultivated: Acres Leased: Acres Irrigated:

Acres Crop: Acres Pasture:

Fence: Fully Fenced Partially Fenced Not Fenced

Survey: Boundaries Marked Improvement Location Cert Boundaries Surveyed Pin Survey Corners Marked

Irrigation Type

□ Ditch□ Flood□ Gated Pipe□ Sprinker-Traveling□ Sprinkler-Pivot□ Sprinkler-Side Roll

Possible Use

□ Crops□ Fishing□ Hunting□ Irrigation□ Leased□ Livestock□ Open Range

Features

□ Assessments□ Chutes□ Commercial Improvements□ Corrals□ Environmental Audit Avail.□ Rail Possible□ Rail Spur□ Round Pen(s)□ Silo□ Special Use Permit□ Undermined

Additional Structures

Additional Structures Information

Additional Structures Available? Yes No # of Additional Structures:

Outbuilding Details

Outbuilding Type: Barn/Storage Other Workshop SqFt:

Primary Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

# of Stalls: # of Doors: Door Dimensions:

Stall Flooring: Composite Concrete Dirt Gravel Matting Paving Rubber Sand

Shavings Stone Wood

Outbuilding Features: □ Electrical □ Heated □ Heated Water □ Loft □ Water

Outbuilding Description:

Additional Living Structures

Structure Type: Bunkhouse Cabin Caretaker Living Quarters Structure SqFt:

Features: □ Bathrooms

□ Bedrooms □ Dry Walled

□ Finished □ Heated □ Insulated

Flooring: □ Composite □ Concrete □ Dirt

□ Gravel □ Matting □ Paving

□ Rubber □ Sand □ Shavings

□ Stone □ Wood

Structure Description: