3583 Blue Jay Way Unit 203 - 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: ___________________________________________________________________________________
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
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
3583 Blue Jay Way 203
Eagan, MN 55123
Property Owner: Fortune Lane Property LLC 7510 Cahill Rd 212B
Edina, MN 55439
Rental Manager: Renters Warehouse - Todd Wermager
Date: May 14, 2018 Signed:
Sarah Brandel, Office Supervisor