EA190356 - Temporary Use - Outdoor Event - Issued Date 04/19/2024 PERMIT
City of Eagan , , ° Permit Type: Temporary Use
3830 Pilot Knob Rd ' Permit Number: EA190356
EAGAN
Eagan, MN 55122 _,s®
(651)675-5675 ,.�„
www.cityofeagan.com * E R 1 9 0 3 S 6
Date Issued: 4/19/2024
Site Address: 1497 Central Pkwy
Lot: Block: Addition:
PID:
Use: Anderson Race Management
Description:
Sub Type: Outdoor Event Comments:
Work Type: Single Day Event Sam- 12pm
Description: Jordyn Clark Memorial 5K
Active From Date: 9/7/2024
Active To Date: 9/7/2024
Comments:
Fee Summary:
Total:
Contractor: - Applicant - Owner:
Anderson Race Management
4047 Camberwell Dr N
Eagan MN 55123
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 Issued By: Signature
r----------------�
` I For Office Use
Permit#:EAGAN I V ✓
.s A
I Fee: 0 0 I
� I I
Date Received: 2/14/2 0 2 4 j
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)675-5660 1 FAX: (651)675-5694 I JH I
signpermits aacityofeagan.com I Staff:
------------------
OUTDOOR EVENT PERMIT APPLICATION
® 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: Anderson Race Management for Jordyn Clark Memorial 5K & 1 Mile Walk/Run
Applicant Address: 4047 Camberwell Dr N
Phone: 612-475-0600 Email: jennifer@andersonraces.com
Event Address: Central Park Pavilion
Business Name: _ {� Zoning
(if applicable) L �-• l Y�1( District:
Purpose
event:t: Run/Walk
Event Details Dates of event& Sat Sept 7 2024
days of the week: e p
Times of event: Start: 8 am Finish: 11 am
Set up begins at: 7am Take down completed 12 pm
(Date/Time) by: (Date/Time)
Maximum number of people in 400
attendance on any day:
Name individual Jennifer Williams/Anderson Race Management
responss ible for event: g
Event Address: 4047 Camberwell Dr N Contact
un to the event: TBD
Contact
information Phone: 612-475-0600 Alternative Phone:
Fax: Email: jennifer@andersonraces.com
OUTDOOR EVENT PERMIT Page 1 of 5
E) FIREWORKS 77II
Will there be a display of Fireworks at the event? ❑ Yes* 0 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 ��77II
Will there be a request for contract Police Officers? El Yes 0 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 6
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 approval of plans.
X Jennifer Williams X
Applicant's Printed Name Applicant's Signature
1/18/2024
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.citvofeacian.com/subscribe.
FOR OFFICE USE
STAFFAPPROVAL
Required NA Department Name Date
❑ Planning &Zoning Joe Hartmann 4-17-2024
❑ City Clerk Beth VanHoose 4-17-2024
® ❑ Fire Department Darrin Bramwell 2-27-2024
❑ ® Police Department
® ❑ Public Works Tim Plath 2-27-2024
® ❑ Parks Ashley Blix 2-27-2024
❑ ® Building Inspections
Required ' NA Fees
® ❑ Temporary Outdoor Event Registration NA
❑ ❑ Temporary Sign Permit $25.00
❑ ❑ Sound Amplification $75.00
® ❑ 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: See notes on the final page.
OUTDOOR EVENT PERMIT Page 5 of 6