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4566 Cinnamon Ridge Tr - Rental RegistrationPage 1 of 2 3830 Pilot Knob Road | Eagan MN 55122 Phone: (651) 675-5660 | Fax: (651) 675-5674 commdevelopment@cityofeagan.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:  New 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 (person completing form) Name: __________________________________________________________________________________ Address Number/Street: ____________________________________________________________________ City: ___________________________________________ State: _________ Zip: ______________________ Primary Phone: _____________________________ Alternate Phone: _______________________________ Email: ___________________________________________________________________________________ RENTAL PROPERTY INFORMATION Address Number: ______________ Street: ____________________________________ Zip: _____________ Number of Rental Units: _______ Building Name (if applicable): _____________________________________ PROPERTY OWNER Name: __________________________________________________________________________________ Address Number/Street: ____________________________________________________________________ City: ___________________________________________ State: _________ Zip: ______________________ Primary Phone: _____________________________ Alternate Phone: _______________________________ Email: ___________________________________________________________________________________ Yelizaveta petrenko 3300 e 125th st bursnsville mn 55337 9526882238 vitalpetrenko@gmail.com 4566 cinnamom ridge tr 55122 1 Yelizaveta petrenko 3300 e 125th st bursnville mn 55337 9526882238 vitalpetrenko@gmail.com Page 2 of 2 RENTAL MANAGER 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. Name: __________________________________________________________________________________ Address Number/Street: ____________________________________________________________________ City: ___________________________________________ State: _________ Zip: ______________________ Primary Phone: _____________________________ Alternate Phone: _______________________________ Email: ___________________________________________________________________________________ QUESTIONS 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?  Yes  No 2. Does a written lease exist for each and every residential property and unit dwelling thereon?  Yes  No 3. Does a written lease addendum commonly known as “Drug Free/Crime Free Lease Addendum” exist for each and every written lease?  Yes  No You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email updat e on the City’s website at www.cityofeagan.com/subscribe. After completing the Residential Rental Registration form in its entirety, submit it electronically to commdevelopment@cityofeagan.com, fax to (651) 675-5694 or deliver to: Eagan City Hall Attn: Community Development 3830 Pilot Knob Road Eagan, MN 55122 vitaliy petrenko 3300 e 125th st burnsville mn 55337 952 6882238 vitalpetrenko@gmail.com 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 4566 Cinnamon Ridge Tr Eagan, MN 55122 Property Owner: Yelizaveta Petrenko 3300 E 125th St Burnsville, MN 55337 Rental Manager: Vitaliy Petrenko Date: March 16, 2018 Signed: Sarah Brandel, Office Supervisor