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<br />Minnesota Lawful Gambling <br />LG215 Lease for Lawful Gambling Activi <br />Organlzation naine Ucense number <br />. C:4..R c/'~4e Sa /~ C (/..1 - 03800 <br />Name of leased premises Street address State <br /> <br />"';.t_ ;>/... "",~-N'. c,>/'/l 7(~r.8' eenk",./h A:.t <br />Name of legal owner of premises I Business/street address <br /> <br />7.: .5... 'C> ! 7"rtf Lt"~... ;'f /{l' <br />Name of I if same as legal Business/street address <br />owner, Write in 'SAME") <br />.5ei~~ <br /> <br />~heyk all activities that will be conducted: . <br />>>Ull-tabs _Pull-tabs with dispensing device ~lipboards ,(.pacldlewheel .l.Pacldlewheel With table _Blngo,k:.Bar bingo <br /> <br />{' "":~?',, <br /> <br />8/05 <br />Page 1 of2 <br /> <br />Daytime phone <br /> <br />('''.; d~ 1.-,. <br />CIty <br /> <br />.//~ <br /> <br />MN <br /> <br /> <br />,/I, <br /> <br />, State <br />I <br />/i?~. <br />State <br /> <br />City <br /> <br />Pull~tab, Tipboard, and Paddlewheel Rent (No lease required for raffles.) <br /> <br />Booth opera.tlon _ sales of gambling equipment by an employee Bar operation - sales of gambling equIpment within a leased <br />(or volunteer) of a licensed organization within a separate enclosure premises by an employee of the lessor from a common area where <br />that Is distinct frOm areas where food and beverages are sold. food and beverages. are also sold. <br /> <br />r-------D~~~~a~tI;OR~~~o~anID~~~~gambIlng-------i <br />. from . booth operation at this location? .x... Yes _ No <br />L___________________~----------------~ <br /> <br />If you answered yes to the question above, rent limits are If you a~ed no to the q~C)n above, rent limits are <br />based on the following combinations of operation: based on the following combInations of operation: <br />_ Booth operation - Bar operation <br />_ Booth operation and pull-tab dispensing device - Bar operation with pull-tab dispensing device <br />_ Booth operation and bar operation - Pull-tab dispensing device only <br />_ Booth operation, bar operation, and pull-tab dispensing device <br /> <br />The maximum rent allowed may not exceed $1,750 In total <br />per month for all organlzatlons~t this premises. . <br /> <br />Complete one option: <br />option A: 0 to 10% of the gross profItS per month. <br />Percentage to be paid / " % <br /> <br />The maximum rent allowed may not E:Xceed $2,500 In total <br />per monU! for all organizations at this premIseS. <br /> <br />Complete one option: <br />Option A: 0 to 20% of the gross profItS per month. <br />percentage to be paid % <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 />$400 per month may be pard. Amount to be.paid $ to $200 per month may be paid. Amount to be paid $ <br /> <br />Option c: $0 to $400 per month may be paid on the first $4,000 <br />of gross profit Amount to be paid $ . Plus 0% to <br />10% ofthe'gross profits may be paid per month on gross profits <br />over $4,000. Percentage to be paid % <br /> <br />Bingo Rent <br /> <br />Option 0: 0 to 10% of the gross profits per month from all lawful <br />gambling actlvltles held during bingo occasions, exdudlng bar bingo. <br />percentageto be paid % <br /> <br />Option E: A rate based on a cost per square foot not to exceed 110% <br />of a comparable cost per square foot for leased space, 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 />confirm the cOmparable rate and all applicable costs to be paid by the <br />organization to the lessor. . <br /> <br />Option c: $0 to $200 per month may be paid on the first $1,000 <br />of gross profits. Amount to be paid $ . Plus 0% to <br />20% of the gross proftts may be paid per month on gross profits <br />over $1,000. Percentage to be paid % <br /> <br />Bar Bingo Rent <br /> <br />K.. Option F: No rent may be paid for bingo <br />conducted In a bar. <br /> <br />r - - - - - ro-.- - - - - - i <br />I For any new bIngo activity not previously <br />Included In a Premises PennItAppllcatlon, I <br />I attach a separate sheet of paper listing the I <br />days and hours that bingo will be conducted. . <br />L______------~ <br /> <br />Amended <br />Lease <br />Only <br /> <br />If this Is an amended lease showing changes ocaJrrlng during the term of the aJrrent premises permit, both parties <br />that signed the lease rilust initial and date all changes. Changes must be submitted to the Gambling COntrol Board <br />I at I~st lQ..11a~r1or to the change. Write In the date ~w11i be effective ---1---1_. <br />. r <br />Lessor' _ _Date. j6rganlzatlOIl-_' :-,.- ..r' <br /> <br />, <br />