EA187843 - Temporary Event Permit - Issued PERMITV
City of Eagan
Permit Type: Temporary Use
3830 Pilot Knob Rd �� law, �� Permit Number: EA.187843
Eagan,MN 55122 - � aEAG-AN
(651)675-5675 Im
www.cityofeagan.com
* E A I e 7 8 4 3
Date Issued: 11/1/2023
Site Address: 1501 Central Pkwy
Lot: 2 Block: 1 Addition Eagan Central Park
PID:10-22409-01-020
Use: Eagan Rotary Club 1 0 3' 3 4 0 9 - 0 .1 0 Z J �k
Description-`
Sub Type: Outdoor Event Comments:
Work Type: Single Day Event
Description: Live to Give Walk Fundraiser
Active From Date: 5/4/2024
Active To Date: 5/4/2024
Comments:
Fee Summary` TU-Outdoor Food Sales $25.00
TU-Temporary Signage $25.00
Total: $50.00
Contractor: Owner:
- Applicant -
Rotary Club of Eagan City Of Eagan
PO Box 21722 3830 Pilot Knob Rd
Eagan MN 55121 Eagan MN 55122
(651)402-2143
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
1 .For Offlce Use
Parmit
i
i Fee: 50 . 00
E ,AGANI
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p mate Received> 10/2 7/2023
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38,30'PiLOT KNOB ROAD I EAGAN,MN.55122A810 i l
(W., 675-5666 1FX 1) �5694 '8tari': JH
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APPLICATIONOUTDOOR EVENT PERMIT
- attach coy of"a Site Plan --- -
Tlte site plan sholl lnclu0e lacatiorts'or perking, tents, stags, booths;send arnplificat cn equiprn ntt fencingx
food/aloohai arcing ares,"signs, boner ; portableailefs:, trash, a,nrt First Aid.
AftAGh Writt+ n permiss Iion of the pr��e�y wner
Please nate;
E, ents unde"r tl tib permit are not allowed In the public right-4Qf-way, if our`event"is gong to take place on City
propeft or rrVithin`,publiiv streets-or , ploase contact the C ty l rk at( �)070-51 00:
The Iccatiori of your ev nt.should be 1C gar m"ire fedi away from all property line..
This event Must be a minmorn of 100 feet from residential zon6d'properties.
a+c�r lln regir v d. lRecyclables Must be colle ted, iholudi g paper and cardboard, cartons, glass:bottle ani'
jars, metal cans, nd antic labeled#1;#�2, and Makota County Crdir� nce 1 0 .Q )
Re yelir g cc t t irter 'lust be of arly libeled ani located within {7 felt i f each tms.., receptacle;
uerit ernplay es �!c;lunfoor§, and cps todiaf cents ctcar n�ia t..adh re ta�l ek to C(::Whty.r .quirom nts,.
T INFORMATION
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1 otary Club.of Eagan
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Phone*' Eftill,`
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Buainess Name- ing
(if applicable lagan Co. m GenteriC ntral Parks'Trai sl agai ftot ry Bandshetl "
) D strict°
udiv to Give Walk F arl r i rfir Rotary Gelb o Eagan
eren :
tUrd
days bf:the week,
Tit�ries of e eit$ Mari. 1�:� 11`I' Finish; I, QP1
gat u,p beglta att Take down completed
05/04/2024 0:30amif / t l" 1
tDate11'irlse} _..... by;�latelTime} _...
Maximum num borw of people in
afitet�darc� n any dyr
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Contact phone
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Address: 144 Jul let Ave �...__ during the event. 651-402-21:43.
5 � 455 -272_x"511
Phone. A,lteft atiue Phone.
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OUTDOOR EVENT PEAM(T.Dago I of 6
E) FIREWORKS
Will there be a display of Fireworks at the event? Yes* lea
If you answer"no,"please proceed to the next section.
Name of Supervising Operator: Certificate Number:
Manner-&place-of storage of-fireworks I pyrotechnicspecial.effects prior to-display:
Type of fireworks I pyrotechnic special effects to be discharged:
Quantity:
El 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 passible overhead obstructions
Location of lines behind which the audience will be restrained
V/ 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 retardanay. (NEPA 1125:4-3.2)
Application must be completed and returned at least 15 days prior to the date of display,
'Contract Firefighters are required for all pyrotechnic displays. Gall the Fire Department at(651)675-5.900 for
additional information.
) CONTRACT POLICE OFFICER
Will there be a request for contract police Officers? El Yes No
If you answer"no," please proceed to the next section.
If you answer"yes,"please contact the Eagan Police Department at(551)675-5700.
E
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OUTDOOR EVENT PERMIT Page 3 of 5 I
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APPLICANT SIGNATURE
herebyacknawledg that this: ilfpoto and accurate;:that the work will be in conformance with the ordinanoes and
codec of the City of agari;'that I understand this is not s permit, but ohly an application fa(a permit, and work is not to start without
permit;that the work vrili be 101 acprdanc ith`the aaraved pian in the:case of work which requires a review and approval of plans..
x Andrew Lubk'hu
.Applicant's Printed ame Applicant!' rat r• ���_.,
' _0
m
Dat
You may';subscrlbo to recei�+e an�lectrar�ic r�citificaticier frcirn the city af`ptop�eed c�rdInances by st ililn up fpr an email pdate:on�
the City's website at k,."...c t.aj „Srr. a 11'b 'b .:
FOR OFFICIEUSE
STAFF APS OVAL;
R ;qui ed �,A„ pertr . V date; .
Planning Zo,n)ng. Joe Hartmann 11/1/2023 ,
City Clerk
Seth VanHoose 10/27/2023
F.ireteaartment, Darrn Bramwell j 10/31/2023
El
P•al'we.iep ,rtre� t' Nate Tennessen 10/31/2023
x PUW,1. Warks
Ti.m Plath 10/31/2023
Parks _
Andi Galatowitsch 10/27/2023
X ' �uildirig;inspction'aAnders Kittelson 10 31 2023
Rutred
Fe ..
x r : fir. u oar F r t i e ist ti q
x. Tera rWarT,81% Parti� �,OQ $25 . 00
u.nd
25 . 00
and rplifrctian .OQ
UK Outdoor Poo 010$ _$2S 0 0
Cultural/ me tainmen'Evant w>00
FkOw. ;brks Displey.
Tent and Cenpis
(saparate permi(reqfired) e Building;hermit
Tsatal Foe -$..5 0 0 0
Required Inspections; EINA 'O.Filhal
pefnift Comments:
OUTDOOR,EVENT PERMIT PIPP5 of
FACILITY SALES RECEIPT
Receipt# 2164025
Payment Date: 10/27/23
Household: 20078
City of Eagan Parks &Recreation Anderson Race Management
1501 Central Parkway 3727 Denmark Court, W
Eagan, MN 5512.1 Eagan MN 55123
Phone: (651)675-5500 Jennifer@andersonraces.com
cityofeagan.com
Reservation Details: Festival Grounds, Central Park-Special Event
Address: 1501 Central Parkway, Eagan,MN,55121
Reserv.Contact: Jennifer Williams
Phone Number: (612)475-0600
Reserv.Number: 39922
Status: Firm
Anticipated Count: 300
Date(s)And Times New Fees Total Fees New Paid Total Paid Amount Due
Sat 07/06/2024 7:OOA to 1:OOP 500.00 500.00 0.00 0.00 500.00
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Resident-Special Event, Run/Walk 500.00 1.00 0.00 0.0.0 500.00
Facility Comments Thank you for reserving your event with us!
Please feel free to reach out to me directly with any questions.or comments.
Ashley Blix
(651)675-5501
ablix@cityofeagan.com
Event Fee Includes: Use of the following from 7:00 a.m. 1:00 p.m. Central Park Pavilion featuring
a kitchen; electric oven and stovetop, dorm-sized refrigerator, sink and ample counter space,
restrooms, 20 picnic tables, large charcoal grill, water, electrical outlets, Festival Pavilion featuring 10
picnic tables, restrooms and electrical outlets, Eagan Rotary Sand Shell (no use of electronic sound
system), plenty of event parking, trash receptacles& removal, and trail closure signage indicating
that the facility and trails will remain unavailable to the public during the event.
Applicable ROW (Right-Of-Way)Permit Fees are not included.
Special Questions: What Type of Event are you having? Eagan Kick-Start Rotary 5K and Kids Run
Will.you be having an inflatable? NO
Food Truck? NO
Announcement Message for Park Whiteboard: (40 characters): Eagan Kick-Start Rotary 5K and Kids Run
Reservation Permit Holder hereby personally assume all risks in connection with this reservation and hereby agrees to hold the City,its officials,employees,
agents and contractors harmless and waive any right to make claims or bring lawsuits against the City or anyone working on behalf of the City for any injuries or
damages related to the alleged negligence of the City.This waiver does not apply to any injuries or damages that are the result of any willful,wanton,or
intentional misconduct by the City or anyone acting on behalf of the City.
Please review the Facility Sales Receipt to verify the information is correct.Call Eagan Parks&Recreation(651)675-5500 immediately if you notice any
discrepancies.
TRASH:, Garbage/Recycling containers,bags and removal is a service provided to the renter,but one that should not be abused. Please note and observe the
Page#'1 of 2
FACILITY SALES RECEIPT
Receipt# 2164181
Payment bate: 10/27/23
Household: 3475
City of Eagan Parks &Recreation Eagan Rotary
1501 Central Parkway P.O. Box 21543
Eagan, MN 55121 Eagan MN 55121
Phone: (651)675-5500 eaganrotary@eagan.com
cityofeagan.com
Reservation Updated: Festival Grounds, Central Park-Special Event
Address: 1501 Central Parkway,Eagan,MN,55121
Reserv.Contact: Andy Lucking
Phone Number: (651)402-2143
Reserv.Number: 33989
Status: Firm
Anticipated Count: 500
Date(s)And Times New Fees Total Fees New Paid Total Paid Amount Due
Sat 05/04/2024 7:OOA to 1:OOP 0.00 500.00 500.00 500.00 0.00
Fee Details: Fee Description Amount Count Discount Sales Tax TotalFee
Resident-Special Event,Run/Walk 500.00 1.00 0.00 0.00 500.0.0
Facility Comments Thank you for reserving your event with us!
Please feel free to reach out to me directly with any questions or comments.
Ashley Blix
(651)675-5501
ablix@cityofeagan.com
Event Fee Includes: Use of the following from 7:00 a.m. 1:00 p.m. Central Park Pavilion featuring
a kitchen, electric oven and stovetop, dorm-sized refrigerator, sink and ample counter space,
restrooms, 20 picnic tables, large charcoal grill, water, electrical outlets, Festival Pavilion featuring 10
picnic tables, restroomsand electrical outlets, Eagan Rotary Band Shell(no use of electronic sound
system), plenty of event parking, trash receptacles &removal, and trail closure signage indicating
that the facility and trails will remain unavailable to the public during the event.
Applicable ROW(Right-Of-Way) Permit Fees are not included.
Special Questions: What Type of Event are you having? Run/Walk Fundraising Event
Will you be having an inflatable? NO
Food Truck?YES -can't sell at event and must provide own power
Announcement Message for Park Whiteboard: (40 characters): Live to Give Walk Presented by Eagan Rotary
Change Questions: Will you be having an inflatable? NO
Food Truck?YES-can't sell at event and must provide own power
Announcement Message for Park Whiteboard: (40 characters): Live to Give Walk Presented by Eagan Rotary
Processed on 10/27/23 @ 11:31 am by CHagalatowitsch Total New Fees 0.00
Old Balances Included 500.00
Total t5ue 500::00
Total Fees Paid 500.00
Total,paid; 500;:00
Payment of: 500.00 Made By: Check With Reference: 3323
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