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<br />Minnesota Lawful Gambling
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<br />LG215 Lease for Lawful Gamblin
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<br />Check applicable item:
<br />1. Lease for new application. Submit with new premises permit application.
<br />2. Renewed lease. Submit with premises permit renewal.
<br />_3. New owner. Effective date --.-J --.-J _ Submit new or amended lease within 10 days after new lessor assumes ownership.
<br />4 Amended lease
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<br />6/07
<br />Page 1 of 2
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<br />. '.:fieSY the '.~ha!lge(S jr, cne tease Rent
<br />., )ar€' Tfj:.:F-;narl!-d6S '!\J'iH ()s effect\ viE
<br />. 80!!'"; 08rt18& ;'rFJst ini~lal ane) oatE' 2I! r:J1a'-lges
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<br /> . Submit changes at least i 0 days before the effective Oal& of the cnange
<br />Organization name 5~d//1c c~6 I License number Daytime phone
<br /> /JC~J? 6',r od -c::.. 8-03800 :(,71-303 - t'~Z8
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<br />Name of leased premises . Street address City State Zip Daytime phone
<br /> 1/-,~ hrL 70BZ- Ct:/4-lr-"",-/le- If..e Ce'~rp,;#c:- MN 'S-~03B ~1-1'2r - Z-f'~
<br />Name of legal owner of premises' Business/street address City ! State i Zip i Daytime phone
<br />/4/ ~'" 1-4, "1.--- :?5/& U'r ../;.,-",,://c. I?...e Lint!:) ~'c..:> i /?,p l5'.5P/f'" 6;l Y2? -z- ~,,-e;
<br />Name of lessor (if same as legal Business/street address City State Zip Daytime phone
<br />owner, write in "SAME")
<br /> S~~ -c:.-
<br />Check ('.!) all activities that will be conducted ... ... ..... .... / ............. ......
<br /> .. " ......... <,.<;'."
<br />; KPull-tabs _PUll-tabs with dispensing device _lipboards ~~ddlewheel _Paddlewheel with table _Bingo _Bar bingo
<br /> Pull-tab, Tipboard, and PaddleWhee I.Re nt.... (No lease requiredJorraffles.).. .
<br />Booth operation - 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 endosure 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 /> r - ---,.....,,.....,....... ,.....,--- ---- -.-:-;-. .......-- - ,.....,-.,.....,..,.....,.,.....,..............,.....,.......,.....,-.,.....,. -,.....,.......,.....,..-..,
<br /> ................. ...... Does.rQ4rQrgan,zat'?'l'O~ .~.~},.Qtb~r.J)rg~iQO .~O"dllGtgarnbling.......... ... ... .........................
<br /> L............... __ _______ ...!,romaboo~operatiOn..tthlsioca~on7 __ ___!!..e~: . _NO_______=________..J
<br />If you answered yes to the question above, rent limits are If you answered no to the question 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 /> The maximum rent allowed may not exceed $1,750 in total The maximum rent allowed may not exceed $2,500 in total
<br /> per month for all organizations at this premises. per month for all organizations at this premises.
<br />COMPLETE ONE OPTION: COMPLETE ONE OPTlON:
<br />Option A: o to 10% of the gross profits per month. Option A: o to 20% of the gross profits per month.
<br />Percentage to be paid ~ % Percentage to be paid %
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<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 paid. Amount to be paid $ to $200 per month may be paid. Amount to be paid $
<br />Option C: $0 to $400 per month on the first $4,000 of gross Option C: $0 to $200 per month on the first $1,000 of gross
<br />profit. Amount to be paid $ profits. Amount to be paid $
<br />Plus, 0% to 10% of the gross profits may be paid per month on Plus, 0% to 20% of the gross profits may be paid per month on
<br />gross profits over $4,000. Percentage to be paid % gross profits over$1,00O. Percentage to be paid %
<br /> Bingo Rent '.. Bar Bingo Rent ..
<br /> , . .. .' .'.
<br /> Option 0: 0 to 10% of the gross profits per month from all lawful _ Option F: No rent may be paid for bingo
<br /> gambling activities held during bingo occasions, excluding bar bingo. conducted in a bar.
<br /> Percentage to be paid %
<br /> Option E: A rate based on a cost per square foot, not to exceed . '. .
<br /> 110% of a comparable cost per square foot for leased space, as New Bingo Activity . ..
<br /> approved by the director of the Gambling Control Board. No rent may be For any new bingo activity not previously
<br /> paid for bar bingo. Rate to be paid $ per square foot.
<br /> The lessor must attach documentation, verified by the organization, to induded in a Premises Permit Application,
<br /> confirm the comparable rate and all applicable costs to be paid by the attach a separate sheet of paper listing the
<br /> organization to the lessor. days and hours that bingo will be conducted.
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