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<br />ease or u - a , a ew ee, Tip oard, and/or affle Activity - LG221 <br />Name of Legal Owner of Premises Street Address City Zip Daytime Phone . <br />Flahertys Arden Bowl Inc. 1273 W Cty Rd E Arden HtllS 5~ 112 <br />Name of Lessor Street Address City Zip Daytime Phone <br />(If same as legal owner. wrile in "SAME") <br />FlaheSllvs Arden Bowl 1273 W Cty Road E Arden Hills (651 )633-1777 <br />Name of Leased Premises Street Address City Zip Daytime Phone <br />Flahertvs Arden Bowl 1273 1l Co Road E Araen Hills 551p 651) 633-1777 <br />Name of Lessee (name of organization leasing the premises) GCB license no. of organization Daytime Phone <br />Ladv Slinner Chanter ABWA A-03162 651 )481-0672 <br /> <br />. <br /> <br />Minnesota Lawful Gambling <br />L f P II T b P ddl <br /> <br />h <br /> <br />. <br /> <br />Rent Information <br /> <br />. Total rent cannot exceed $1,000 per month for all <br />non-bingo activity for this premises. <br /> <br />. For bingo activity. use lease form LG222. <br /> <br />. For pull-tab dispensing machines, use lease form <br />LG223. <br /> <br />6"f.~1~lf B - '/2 <br /> <br />b <br /> <br />R <br /> <br />. An organization may not pay rent to itself or to <br />any of its affiliates for space used for the conduct <br />of iawful gambling. <br /> <br />Rent to be paid per month $ 1000.00 <br />(If no rent is to be paid, indicate-Q-) <br /> <br />feet by feet for a total of square feet. <br />feet by feet for a total of square feet. <br />feet by feet for a total of square feet. <br />feet by feet for a total of square feet. <br />feet by feet for a total of square feet. <br /> Combined total square feet. <br /> <br />. <br /> <br />Sketch and Dimensions of Leased Area <br /> <br />Sketch: For all areas being leased for the conduct <br />of gambling and storage of gambling product at this <br />premises, attach a sketch (drawing) showing: (1) the <br />ieased area(s), and (2) the dimensions. <br /> <br />Dimensions <br />The leased areas are: <br /> <br />Storage <br />Storage <br /> <br /> <br />Lawful Gambling Activity <br />Type of gambling activity that will be conducted at this gambling premises. Check all that apply. <br /> <br />----lL Paddlewheels <br /> <br />Term of Lease <br /> <br />The term of this lease agreement will be concurrent with <br />the premises permit issued by the Gambling Control <br />Board, unless terminated sooner by mutual consent of <br />the lessor and lessee. <br /> <br />-x--P u II-Tabs <br /> <br />-X.......Raffles <br /> <br />--X...- Tipboards <br /> <br />Amended Lease Only <br /> <br />If this is an amended lease showing changes occur- <br />ring during the term of the current premises permit, <br />write in the date that the changes will be effective <br />_/_/_. Both parties that signed the lease <br />must initial and date all changes. <br /> <br />. <br /> <br />Questions on this form should be directed to the Licensing <br />Section of the Gambling Control Board (Board) at 651-639- <br />4000. This publication will be made available in alternative <br />format (Le. large print, Braille) upon request. Hearing impaired <br />individuals using a TTY may call the Minnesota Relay Service <br />at 1-800-627 -3529 and ask to place a call to 651-639-4000. <br /> <br />The information requested on this form will become public <br />information when received by the Board, and will be used to <br />determine your compliance with Minnesota statutes and rules <br />governing. lawful gambling activities. <br /> <br />Page 1 of 2 <br />1/99 <br />