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CCP 01-30-2006
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CCP 01-30-2006
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<br />. <br /> <br />. <br /> <br />. <br /> <br />8{05 <br />Page 1 of 2 <br /> <br />Minnesota Lawful Gambling <br /> <br />LG215 Lease for Lawful Gambling Activity <br /> <br />Organization name License number Daytime phone <br /> <br />>t MM:-f f?<>Mj-1./I.4-~&~1HoO"'~ cHuRdl ."'~_n~t 4.rr.:)"'-"f I <br />Nameo!leas doremlses Street address Crty Slale Zip Daytime phone I <br />I \1' I <br />p~-r c (; old kil7"o ---1J7I- C~II~I(<I_k~__J:LdjL___-,,--~,-,-----,-r'--il~~ <br />IName olle~al owner of premises BUSiness/street addr~~ Crty . State Zip Daytime phone I <br /> <br />LG-~ 1~L3~~.l1.I<" C"~J1'---~-"'--JtdiL -"YJ ~r{I'-_ --- J <br />Name of lessor (if same as legal Business/street address City State Zip Daytime phone I <br />owner, write In "SAME") <br />SI<Mf'_ <br /> <br />Check all activities that will be conducted: <br />__PUll-tabs __ Pull-tabs with dispensing device _Tipboards <br /> <br />Paddlewhecl <br /> <br />Paddlewheel with table -X-Bingo __Bar blngo <br /> <br />Pull-tab, Tipboard, and Paddlewheel Rent (No lease requ"ed for caffles,) <br /> <br />Booth operation. Sdles of gambling equipment by an employee <br />(or volunteer) 01 a licensed organilation within a separate 'V"'l!osure <br />that is distinct from areas Wflere food ;:lnd beverages iJre sord. <br /> <br />Bar operation soles at gambling equl[)ment within a leased <br />premisl'S by on employee or the lessor frOrTI a common area where <br />toad and beveruge,> are iJlSO sukJ. <br /> <br />------------ -- <br /> <br />-------""1 <br /> <br />-------' <br /> <br />If you answered yes to the qucStlon above, rcnt limits are <br />based on the followtng combinations of operation: <br />Bootll operation <br />Booth operation and pull-tab dispensing device <br />BOOUl operation and bar operation <br />! _ Booth operation, bar operation, and pull-tab dispensing device <br /> <br />If you answered no to the question above, rent limits are <br />based on tlle following combinations of operation. <br />Bar operdtion <br />Bar operation with pull-tab dispensing deVice <br />Puli-tab dispensing device only <br /> <br />The maximum rent allowed may not exceed $1,750 in total <br />per month for all organizations at this premises. <br /> <br />fhe miJXimum rent allowed may not exceed $2,500 in total <br />per month for all organizations dt this prcmlses. <br /> <br />Complete one option: <br />Option A: 0 to 10% of the gross profits per month. <br />Percentage to be paid _ % <br /> <br />Complete one option: <br />Option A: 0 to 20% of the gross profits per month. <br />Percentage to bc paid_ _____ U/a <br /> <br />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 <br />1 $400 per month may be paid. Amount to be paid $___. to $200 per month may be paid. Amount to be paid t.__. <br /> <br />Option C: $0 to $400 per month may be paid on the first $'1,000 <br />uf gross profit. Amount to be paid $_ ~ Plus 0% to <br />10%, of tile gross profits may be paid per month on gross profits <br />over $4,000 f'ercentage to be paid ___ % <br /> <br />Option C: $0 to $200 per rnonnl may be paid on the first $1,000 <br />of gross proflts_ Amount to be paid $__ ___. Plus 0% to <br />20% of the gross profits may be paid per month on gross profits <br />over $1,000 Pel-cent;-)geto be paid ________% <br /> <br />Bingo Rent <br /> <br />Option 0: 0 to 10% of the gross profits per rnonth from all lawful <br />gambling activities held during bingo occasions, excluding bar bingo. <br />Percentagc to be paid _ % <br /> <br />Bar Bingo Rent <br /> <br />_ _ Option F: No rent may be paid for bingo <br />conductl-'d 111 a bar <br /> <br />Option E: A rate based on a cost per square foot not to exceed 110% <br />of a comparable cost per squJTe foot for leased spacc, as approved by <br />the director of the Gambling Control Board. No rent may be paid for bar <br />bingo. Rate to be paid $____ per square foot. <br />The lessor must attach documentation, verified by the organization, to <br />confnm the comparClble rate and all applicable costs to be paid by the <br />j orgcmization to the lessor <br /> <br />- _.- - - - --- - - - - <br /> <br />For any new bingo activity flat previously <br />I included in a Premises Permit Application, I <br />I attach a separate ",Ileet of paper listing the I <br />days and hours that bingo ,"'-1111 be com1ucted <br />L_____ ___________.J <br /> <br />Amended <br />Lease <br />Only <br /> <br />Jf thiS is an amended lease shov...ing changes occurnng dunn<:J the term of Ule current pr-emlse5 permit, both parties <br />that signed the lease rnustlnitial and date all changes. Changes rnust be submitted to the Gambling Control Board <br />at least 10 days prior to the change Nnte In the date that the changes Will be effectlVf' j ----- --.l_______ <br /> <br />Lessor <br /> <br />Date <br /> <br />Organl1ation <br /> <br />D,Jte <br /> <br />, <br />--.- <br /> <br />~---_._-_._._--_._-_..._-_._---_..__..- <br />
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