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
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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):
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PROPERTY
OWNER
Name: / " Les; e F rE U.( - P -Fs j L.,, L Jce.4403�
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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�
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Email: �1 "` � p ��/�' � ~� •(��
Page 1 of 2
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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