Minnesota well sealing form 2026

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The document is a notification form from the Minneapolis Health Department's Environmental Programs Division regarding the sealing of environmental wells. It outlines the necessary information required for well location, construction details, and conditions, as well as the responsibilities of well contractors. The form emphasizes compliance with Minnesota statutes and local ordinances, including payment instructions and potential penalties for non-compliance.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Legal Description of Well Location' section. Attach a site map that includes well locations, property lines, structures, roads, and landmarks.
In the 'Well Address' field, provide the specific address of the well. Ensure you include details about the well head finish and its depth.
Indicate the type of well by selecting from options such as Environmental, Industrial, Irrigation, or Residential. If applicable, answer questions regarding obstruction and casing conditions.
Complete the 'Well Owner' and 'Property Owner' sections with accurate contact information. If different from the well owner, ensure to fill in all required fields for the property owner.
Finally, review your entries for accuracy before signing as a licensed contractor. Ensure all necessary attachments are included before submission.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (192 Votes)
2014	4.3 Satisfied (184 Votes)

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How much does it cost to seal a well?

When the deed is recorded with the county recorder or registrar of titles, the buyer must provide the Well Disclosure Certificate along with a $54 fee. Contact the MDH for proper procedures for the disclosure of well(s) at the time of the sale of condominiums or state-leased land.

How much does it cost to seal a well in MN?

Well disclosure is the process by which the seller of property provides information to the buyer and the state about the location and status of all wells on the property. This process is required by state law, a portion of the Ground Water Protection Act (Minnesota Statutes, section 103I.

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