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1891 Deer Hills Tr - Rental Registrationgon 1>eor 407 S13 4/2.Gif RECEIVED City of Eaffall 3830 Pilot Knob Road APR 2 5 HS Eagan MN 55122 Phone: (651) 675-5660 Fax: (651) 675-5694 Email: commdevelopmentc citvofeagan.com RESIDENTIAL RENTAL REGISTRATION Either a property owner or rental manager shall register all residential rental properties with the City of Eagan. In the case of a transfer of ownership, change in rental manager, change in the number of rental units or change in dwelling occupancy from owner occupancy to rental tenant occupancy, the property owner or rental property manager shall complete and submit a registration form for every property affected by the transfer within thirty (30) days of the transfer. Please complete one registration form for each residential rental property address. Check one of the following that applies: iNew Rental Registration ❑ Change of address/phone number ❑ Change of owner ❑ Change of rental manager ❑ Change in number of units ❑ Change from owner to rental occupancy APPLICANT/ REGISTRANT completing form) Name: l E u'S1 - F Fes' kA -10 L( Address Number/Street: 1S, / Dir- 1--/4 Its T l I/ 2..._(person City: ail k State: M t) Zip: G5LJ,2 Primary Phone: (s) 4 84'.21% 7 Itemate Phone()5/):3,8 f,6 A 3 4 Email: n e9 t./s'S i e kkd a {-j yob 1 f . l .n1/1\ ... RENTAL PROPERTY INFORMATION . r ���77 ` 1 r71, --- Address Number: 0 9 I Street: D eeV 1' I IS' ! Eq QM Zip: S5'J c Number of Rental Units: 1 Building Name (if applicable): � PROPERTY OWNER Name: / " Les; e F rE U.( - P -Fs j L.,, L Jce.4403� CCCJJJ R ��'d + Address Number/Street: lge/ [ r O.C€!S 11— City: FarlA State: hit kl Zip: �1C1 Primary Phone: 6.9, 4814 24' 7 9 Alternate Phone:VSI)-7'..1-0.7-1SS� ,,�,e � C c�J $ r Wi i U �� Email: �1 "` � p ��/�' � ~� •(�� Page 1 of 2 T -eor [- q s Tr - SEE REVERSE -! A rental manager is required. A rental manager is any person who has been delegated by the residential rental property owner with the charge, care or control of a residential rental property and is able to respond in-person to issues related to the residential rental property. The rental manager may be the same as the owner and/or applicant. RENTAL MANAGER L QUESTIONS Name: N e .CSS' / f r Pe `, 1 Address Number/Street: $ " l /_0.0e/tr.- 44-Yi./, City: 6-4eire State: 01 Ai Zip: T5 !gal- -Primary Phone:09/5?.._) `"L rzT Altemate Phone(651 ) j - 6 tg� Email: `r, S) - e-PeL-� Any person providing false information on the prescribed registration form shall be guilty of a misdemeanor and subject to a fine. The responses are being collected for informational purposes and a 'yes' answer is not required. 1. Does the residential property owner or rental manager conduct a criminal background check on each and every residential tenant? D Yes D No 2. Does a written lease exist for each and every residential property and unit dwelling thereon? D Yes D No 3. Does a written lease addendum commonly known as 'Drug Free/Crime Free Lease Addendum" exist for each and every written lease? D Yes D No After completing the Residential Rental Registration form in its entirety, submit it electronically to commdevetopmentftityofeagan.com, fax to (651) 675-5694 or deliver to: Eagan City Hall Attn: Community Development 3830 Pilot Knob Road Eagan, MN 55122 Page 2 of 2 i CERTIFICATE OF RENTAL REGISTRATION City of Eagan Department of Community Development This certificate verifies that the below property is registered as a residential rental property within the City of Eagan. Site Address: Number of Units: 1 1891 Deer Hills Tr Eagan, MN 55122 Property Owner: Negussie Fekadu 1891 Deer Hills Tr Eagan, MN 55122 Rental Manager: Negussie F Fekadu Date: April 26, 2016 Signed: <40A4d4g-utu,tfflte-0 Sarah Brandel, Office Supervisor