New Aggregate Source Number Request Form

Please provide the following information to send a New Aggregate Source Number Request to MnDOT Grading and Base Unit.

You will be contacted within three business days with the aggregate source number to use.

Date/Time

Name*

First Name

Last Name

Organization*

Phone*

Email*

How should we contact you? (Select One)*

Information About the Aggregate Source:

County:*

Nearest City:

Section:*

Township*

Range:*

Legal Description (to at least 1/4 section)*

Pit/Quarry Local Name:

Owner:*

Operator

Please Check All That Apply:

Gravel Pit Quarry Concrete Aggregate Source Leased by MnDOT (See note below)

Note 1: For a MnDOT leased aggregate source, send copies of Lease and any survey/prospecting data to: MnDOT Materials Office, Geotechnical Section, Mail Stop 645, attention Terry Beaudry.

Additional Comments: