Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the legal description of the well location. Attach a detailed site map that includes the well location, property lines, structures, roads, and landmarks.
3. Fill in the well address, well head finish, depth, and other relevant well location details. Confirm if the well is obstructed, multi-cased, has an annular space, or penetrates a confining layer.
4. Specify the use or type of well(s). Indicate the well condition, and if applicable, submit any required plans for issues like below grade wells.
5. Provide details about the well construction profile, including casing type and grouting plans. Include measurements and materials for casing and grouting.
6. Enter the well owner’s information, including address, contact person, and phone number. If the property owner is different, provide their details as well.
7. Complete the well contractor information, and ensure that the contact details are accurate.
8. A licensed contractor must print their name, sign, and date the application, including their company license number.
9. Review all information to ensure accuracy. Make note of the sealing notification fee and payment instructions, ensuring payment is submitted only by mail or fax.
10. Finalize by selecting how you would like to receive your permit (pickup, mail, fax, or email) and then save, download, print, or share the completed form as needed.

Complete your MN Well Sealing Permit Application online today to ensure compliance and proper well sealing.