Minnesota Department of Health Well Disclosure Certificate Summary

This is a Well Disclosure Certificate form issued by the Minnesota Department of Health's Well Management Section. The document serves as a property disclosure form required for real estate transactions involving properties with wells in Minnesota. A $45 filing fee payable to the county recorder is mandatory for deed filing.

The certificate captures critical well information including property location details (Houston County, Sections 26 & 27, Township 104N, Range 4W), buyer mailing address for the property buyer (National Decorated Products, Inc., a Wisconsin corporation, located in Sparta, WI 54656), and well-specific data. The form documents two wells on the property: Well #1 marked as "In Use" located in Section 26 with Quarter SW1/4, and Well #2 sealed by licensed well contractor (Gary's Pump & Well Service) on 5/30/2003, located in Section 27 with Quarter SE1/4 (MN Unique Well No. H187278). The seller (National Decorated Products, Inc.) certified the information's accuracy on February 18, 2008. Supporting documentation includes a sketch map (Exhibit B) showing well locations relative to the Root River, driveways, and occupied house, and Exhibit A containing the detailed legal property description across multiple sections and townships. An important compliance note indicates that if any disclosed well is not in use, the property owner must either return the well to use, have it sealed by a licensed contractor, or obtain an annual maintenance permit from MDH for $175.