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<br />Minnesota Lawful Gambling <br />LG215 Lease for Lawful Gamblin <br /> <br />Check applicable item: <br />_1. Lease for new application. Submit with new premises permit application. <br />K2. Renewed lease. Submit with premises permit renewal. <br />_3. New owner. Effective date _1--1_ Submit new or amended lease within 10 days after new lessor assumes ownership. <br />4 Amended lease <br />8' Che8!< trH? ,:~hanqefs rne lease Pent o'ep~;!se'3. ":8J,?- 8:'.,r;t.r,ft:<a' .~2<:t-;J!"f',,:h3'Kll:' -Jthe~ <br />. :)3~e tna t -:f'!;:ii":gf3f:' i\flfl 06 ~~ffe(..,:tt\iF, <br />It 8otr' 08rt1es ;"n"JST ;r(niai ,:v'\(j Jate Cr'8('ge:::: <br />· Submit changes at leasr i 0 days before the effective dare )1 the cnange <br />Organization name I License number Daytime phone <br /> <br />'C~~ ro/.e See..e'A: 6U i /J -03BCO %I-.JOj'-~YZ!3 <br />Name of leased premises Street address City State , Zip . Daytime phone <br /> <br />tl/0 C/ ~ A ZZ'c;. 9-M 7"'?6/" z... ~ve- I Cc'~"""~C- MN jG30J8~/-P-3' -1077 <br />Name of Ie al owner of premises i Business/street address City State 'Zip : Daytime phone <br /> <br />J"cA"i- H~ rl/ i 770'/ 2oJ'r( ue- c'e'e--~~,4 ffviS-5l>>8:t-J7-t'53-,gBlt. <br />Name of lessor (if same as legal Business/street address City : State Zip Daytime phone <br />owner, write in "SAME"),. f# <br />SCCc",1- I'rQ e/'I: i.S 70fS- ze."I1ve- ce~;#c-- <br /> <br />Check ("I) all activities that will be conducted <br /> <br />1::]>ull-tabs _Pull-tabs with dispensing device _TIpboards ~ddlewheel <br /> <br /> <br />6/07 <br />Page 1 of 2 <br /> <br />Pull-tab, Tipboard, and Paddlewheel RentCNoleaserequiredforrQffles;} <br /> <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 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 />r - - - -....,.. ----~ -.-'..-.-.-..- --:---- --.......--:---.........,....----<....,..---- -___ ....,..____., <br />.... .... ...Do~sypur (lr:"an'~;;ltiQn()~~'1YQtb~rpr"anl~atiQ,,(:oQ(\lJ~galt1blll'l9<<. <br />L.. . ............ ......fromaboothoperationatthislocation?<Yes'VNo .. ................. ..............<.... . <br />~~-~~----------- -~--~~--~------~ <br /> <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 /> <br /> <br />The maximum rent allowed may not exceed $1,750 in total <br />per month for all organizations at this premises. <br /> <br />The maximum rent allowed may not exceed $2,500 in total <br />per month for all organizations at this premises. <br /> <br />COMPLETE ONE OPTION: <br />Option A: 0 to 10% ofthe 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 be paid I 0 % <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 paid. Amount to be paid $ to $200 per month may be paid. Amount to be paid $ <br /> <br />Option C: $0 to $400 per month on the first $4,000 of gross <br />profit. Amount to be paid $ <br />Plus, 0% to 10% of the gross profits may be paid per month on <br />gross profits over $4,000. Percentage to be paid % <br /> <br />Bingo Rent <br /> <br />Option D: 0 to 10% of the gross profits per month from all lawful <br />gambling activities held during bingo occasions, excluding bar bingo. <br />Percentage to be paid % <br /> <br />Option C: $0 to $200 per month on the first $1,000 of gross <br />profits. Amount to be paid $ <br />Plus, 0% to 20% of the gross profits may be paid per month on <br />gross profits over$l,OOO. Percentage to be paid % <br /> <br />Bar.Bingo Rent <br /> <br />_ Option F: No rent may be paid for bingo <br />conducted in a bar. <br /> <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 <br />approved by the di rector of the Gambling Control Board. No rent may be <br />paid for bar 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 />New Bingo Activity <br /> <br />For any new bingo activity not previously <br />induded in a Premises Permit Application, <br />attach a separate sheet of paper listing the <br />days and hours that bingo will be conducted. <br /> <br /> <br />JS <br />