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-,---- Minnesota Lawful Gambling LG215 Lease for Lawful Gamblin Organization name ;;)\ mVt\~~ Name of teased premises Street address ~O\ c\ f). License number 8/05 Page 1 of 2 Daytime phone . A- OLi'~q I City i) ~ '7(P Lbmt'11 Business/street address """ Ln n,~. Bla,yyt. City Name of legal owner of premises 0old:s S, ' ' , Name of lessor (if same as legal owner, ~.i~C J C-/ Check all activities that will be conducted: _Pull-tabs _Pull-tabs with dispensing device _llpboards _Paddlewheef _Paddlewheel with table ~Bjngo _Bar bingo Business/street address A0l;,,\-j71ls Stale ~I\ State Zip ;;21 Pull-tab, Tipboard, and Paddlewheel Rent (No lease required for raffles.) Booth operation - sales of gambling equipment by an employee (or volunteer) of a licensed organization within a separate enclosure that is distinct from areas where food and beverages are soh Bar operation - sales of gambling equipment within a leased premises by an emploYe€ of the lessor from a common area where food and beverages are also sold. r---------------_____________________j Does your organization OR any other organization f;onduct gambling from a booth operation at this location? _ Yes _ No L~___________________________________~ If you answered yes to the question aooye, rent limits are If you answered no to the question above, rent limits are based on the following combinations of operation: based on the following combinations of operation: Booth operation Bar operation Booth operation and pull-tab dispensing device Bar operation with pull-tab dispensing device Booth operation and bar operation Pull-tab dispensing device only Booth operation, bar operation, and pulHab dispensing device The maximum rent allowed may not exceed $1,750 in total per month for all organizations at this premises. Complete one option: Option A: 0 to 10% of the gross profits per month. Percentage to be paid ~~ % The maximum rent allowed may not exceed $2/500 in total per month for all organizations at this premises. . Complete one option: Option A: 0 to 20% of the gross profits per month. Percentage to be paid % Option B: When gross profits are $4,000 or less per month, $0 to Option B: When gross profits are $1,000 or less per- month, $0 $400 per month may be paid. Amount to be paid $ to $200 per month may be paid. Amount to be paid $ Option C: $0 to $400 per month may be paid on the first $4,000 of gross profit. Amount to be paid $ . Plus 0% to 10% of the gross profits may be paid per month on gross profits over $4,000. Percentage to be paid % Bingo Rent Option 0: Oto 10% of the gross profits per month from all lawful gambling activities held during bingo occasions, excluding bar bingo. Percentage to be paid _% Option E: A rate based on a cost per square foot not to exceed 110% of a comparable cost per square foot for leased space, as approved by the director of the Gambling Control Board. No rent may be paid for bar bingo. Rate to be paid $ per square foot. The lessor must attach documentation, verified by the organization, to confirm the comparable rate and all applicable costs to be paid by the organization to the lessor. Option C: $0 to $200 per month may be paid on the first $1,000 of gross profits. Amount to be paid $ . Plus 0% to 20% of the gross profits may be paid per month on gross profits over $1,000. Percentage to be paid % Bar Bingo Rent ~ Option F: No rent may be paid for bingo conducted in a bar. r -- --- - ------ -~ r For any new bingo activity not previously I included in a Premises Permit Application, I I attach a separate sheet of paper listing the I days and hours that bingo will beconducted. L--__________.J Amended Lease Only If this is an amended lease showing changes occurring during the term of the current premises permjt, both parties that signed the lease must initial and date all manges. Changes must be submitted to the Gambling Control Board at least 10 days prior to the change. Write in the date that the changes will be effective _J _~_. . lessor Date Organization Date