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EA184664 - Temporary Use - Outdoor Event - Issued Date 06/16/2023 PERMIT City of Eagan • , , , Permit Type: Temporary Use 3830 Pilot Knob Rd ,,.;; ;, Permit Number: EA184664 Eagan,MN 55122 •--• •• E A A N (651)675-5675 . . 1111111111111 IN 1111111111111111111111111111111 www.cityofeagan.com * E A 1 8 4 6 6 4 * Date Issued: 6/16/2023 Site Address: 4490 Erin Dr Lot: 005 Block: 5 Addition: Honey Tree Ist PID:10-33500-05-005 Iff=M 1111111111 El 11111111111111111111 Use: Synapse: Center for Health&Healing * 1 0 — 3 3 5 0 0 — 0 5 — 0 0 5 Description: Sub Type: Outdoor Event Comments: Work Type: Single Day Event Start 10 am Description: Synapse Center 5K Finish 3pm Active From Date: 7/8/2023 Active To Date: 7/8/2023 Comments: Fee Summary: TU-Outdoor Food Sales $25.00 Total: $25.00 Contractor: Owner: - Applicant - Troy Spurrill 4490 Erin Dr Eagan MN 55122 This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature ssued B : Signaturc Cq I IndI ho For----------------, i Office Use I Permit#: 184664 EAGANFee: $25 . 00 I Date Received: 5-31-2 0 2 3 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I (651)675-5660 1 FAX: (651)675-5694 1 Staff: JH I signpermits(a)cityofeagan.com ----------------- ttppt� OUTDOOR EVENT PERMIT APPLICATION Y�I Attach 1 copy of a Site Plan The site plan shall include locations for parking, tents, stages, booths, sound amplification equipment, fencing, food/alcohol serving areas, signs, banners, portable toilets, trash, and First Aid. Attach written permission of the property owner. Please note: ✓ Events under this permit are not allowed in the public right-of-way. If your event is going to take place on City property or within public streets or trails, please contact the City Clerk at (651) 675-5000. ✓ The location of your event should be 10 or-more feet away from all property lines. ✓ This event must be a minimum of 100 feet from residential zoned properties. ✓ Recycling is required. Recyclables must be collected, including paper and cardboard, cartons, glass bottles and jars, metal cans, and plastics labeled #1, #2, and #5 (Dakota County Ordinance 110, 16.05). • Recycling containers must be clearly labeled and located within 10 feet of each trash receptacle. • Event employees, volunteers, and custodial contractors must adhere to Dakota County requirements. A) EVENT INFORMATION Name: � 14 1 o I ' a Applicant Address: y& 61"1-1 b r'r J-- Q;tWC1'1 ' 12 Z Phone: ���� abs/' / �d�o Email: S t Event Address:Address: !� U �/l,'1 ���i/� ��.,� /��SS(Z Z. Business Name: ( Zoning (if applicable) atrti�kt �, ffe"r,n 5 District: Purpose of event: Event Details Dates of event& �� j days of the week: (,� t.l r Times of event: Start: Finish: 12+�— Set up begins at: Take down completed L� (Date/Time) f 1wv'kby: (Date/Time) hZ I M- Maximum number of people in attendance on any day: /( Name of individual responsible for event: r �/ Event //7U r Contact phone Contact Address: `7 7 ., +n G)r�;z ,l /y'�uring the event: �j 2���� Information Phone: �� ' o2-d y`yyll�, Alternative Phone: i Fax: -54V `� Email: _ OUTDOOR EVENT PERMIT Page 1 of 5 B) TENTS, CANOPIES, & STAGES Will there be any tents (more than two sides) or canopies (two or fewer sides) at the ❑ Yes No event? If you answer"no," please proceed to the next section. Does any tent exceed 400 square feet? ❑ Yes No If you answer"yes," please have the tent contractor apply for a Commercial Building Permit. Inspections are required prior to use of a tent that exceeds 400 square feet. Does any canopy exceed 700 square feet? ❑ Yes ❑ No If you answer"yes," please have the canopy contractor apply for a Commercial Building Permit. Inspections are required prior to use of a canopy that exceeds 700 square feet. ��11 Will there be any stages or elevated platforms at the event? ❑ Yes I.J No If you answer"yes," please contact Building Inspections at(651) 675-5675 to see if a Commercial Building Permit is required. C) TEMPORARY SIGNAGE Will there be signs posted at the event? ® Yes ❑ No If you answer"no," please proceed to the next section. Number of signs: _(maximum of 3) Sizes of the sign(s): 1. 0/' Q 2. )J f lTIncd�4& 3. 13 X I7 Message of the sign(s): 1. 2. t� tj( Wr- 3. J Dates of sign placement: 2 The combined square footage o all signs cannot exceed 100 square feet. Signs must be placed securely and in a sound manner to ensure safety of the public & in accordance with reasonable standards employed by sign makers. D) FOOD & ALCOHOL Will food be served at the event? 171 Yes ❑ No If you answer"no," please proceed to the next section. Will alcohol be served at the event? ❑ Yes No If you answer"no," please proceed to the next section. If you answer"yes," please contact the City Clerk's office at(651)675-5000 for Liquor License requirements. OUTDOOR EVENT PERMIT Page 2 of 5 E) FIREWORKS Will there be a display of Fireworks at the event? ❑ Yes* tit No If you answer"no," please proceed to the next section. Name of Supervising Operator: Certificate Number: Manner&place of storage of fireworks/pyrotechnic special effects prior to display: Type of fireworks/pyrotechnic special effects to be discharged: __ Quantity: _ ❑ Attach proof of$1,000,000 Bond or Certificate of Insurance. ❑ Attach a diagram of the display facilities, drawn to scale. Illustrate the following: ✓ Location of where the fireworks/pyrotechnic special effects are to be discharged ✓ Location of ground pieces ✓ Location of all buildings, highways, streets, communication lines, or other possible overhead obstructions ✓ Location of lines behind which the audience will be restrained ✓ Fallout radius for each pyrotechnic device used during the display Pyrotechnics plan requirements: Certifications that are set, scenery, and rigging materials are inherently flame- retardant or have been treated to achieve flame retardancy. (NFPA 1126: 4-3.2) Application must be completed and returned at least 15 days prior to the date of display. *Contract Firefighters are required for all pyrotechnic displays. Call the Fire Department at (651) 675-5900 for additional information. F) CONTRACT POLICE OFFICER Will there be a request for contract Police Officers? ❑ Yes k:]J No If you answer"no," please proceed to the next section. If you answer"yes," please contact the Eagan Police Department at (651) 675-5700. OUTDOOR EVENT PERMIT Page 3 of 5 G) SOUND AMPLIFICATION Will there be amplified sound at the event? ❑ Yes No If you answer"no," please proceed to the next section. Will there be amplified sound after 10PM? ❑ Yes ,/ No Has this location previously received City Council Approval for Sound ❑ Yes ❑ No Amplification? If liquor will be present and amplified sound is scheduled to occur after 10PM, City Council approval is required. City Council approval may take up to several weeks. Please contact the City Clerk's office at(651)675-5000 for submittal requirements. Name of individual responsible for event*: Contact phone number during the event: Contact Email: *This person must be present at all times during the event and act as the on-site contact for City officials during the event. The applicant and the contact person shall be responsible for compliance with the terms and condition imposed by the permit and Section 10.31. The applicant or contact person shall maintain the permit on the permitted premises at all times during which the permitted electronic sound system or audio equipment is in use. The permit shall be presented to any City official or law enforcement officer upon demand. Description of electronic sound system or audio equipment: Type of sound to be generated (live music, recorded music, announcements,speeches,etc.): Sound will be generated during these hours each day: Name of contractor/individual responsible for sound: Address: Phone: Alternative Phone: — Will there be hired speakers/ performers at the event? ❑ Yes us,.k No If yes, name individuals Description of entertainment to be provided: Name Address City/State/Zip Name Address City/State/Zip Name Address City/State/Zip Sound produced under the permit shall not exceed the maximum allowable sound pressure level as measured by Type 1 or 2 decibel meter, using the A-weighted fast response scale meeting ANSI Specifications, Section 1.4–1971. o '/4 mile radius from the property line, 3-5 feet above ground level–55 decibels o Y2 mile radius from the property line, 3-5 feet above ground level–50 decibels OUTDOOR EVENT PERMIT Page 4 of 5 APPLICANT SIGNATURE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and aproval of plans. X X ell Applica s Prin ed Name Applica s Signafture Date You may subscribe to receive an electronic notification from the city of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.com/subscribe. FOR OFFICE USE STAFF APPROVAL Required NA Department Name Date ❑ ❑ Planning &Zoning Joe Hartmann 6-16-2023 0 ❑ City Clerk Beth VanHoose 6-16-2023 ❑ ❑x Fire Department Darrin Bramwell ] ❑ Police Department Nate Tennessen 5-31-2023 [3 ❑ Public Works Tim Plath 6-15-2023 ] ❑ Parks Paul Watry 6-15-2023 ❑ ❑x Building Inspections Required NA Fees Q ❑ Temporary Outdoor Event Registration NA ❑ ❑ Temporary Sign Permit $25.00 ❑ ❑ Sound Amplification $75.00 Q ❑ Outdoor Food Sales $25.00 $25 . 00 ❑ ❑ Cultural/Entertainment Event $25.00 ❑ ❑ Fireworks Display $105.00 ❑ ❑ Tent and Canopies (separate permit required) See Building Permit Total Fees $25 . 00 Required Inspections: ❑ NA ❑ Final Permit Comments: OUTDOOR EVENT PERMIT Page 5 of 5 Permission from the property owner I Jerzy Szoka, owner of 4490 Erin Drive, Eagan, MN 55122 give permission to Synapse Center of Health and Healing to hold at 5k event on July Sth, 2023. 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