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�� ��1 ����� <br />���� � ��a se f �r �av,r��� �a rri ��in� ���vi�} <br />�a �H��,�� �n: � �- <br />1 Le�,s� fornew applicauon. Submit wikh new premises permit application <br />�. � {�x�- 5ukxni# w,� �erru�s t�e�r+�e r�.�p�u�r. <br />S�Ofi <br />���� <br />-- 9��-. q�rr�er. SubmEC ��.ri �-,rr,r,� 45g•�i �� 4r]�s t�lt�r �r. ti Ir_isc� na§lmta��+w+�'�� Date eSective— �.._� F- <br />4. Ame d /ease <br />"' . �h�thechancaefslinthelease: _ Rent _Premisesname _[�:.txd-�fi3r �,.Actfvicychange �Clther <br />( Datethatchangeswillb�e�feGCive __ _r„ J <br />*� partiesmust initial and date all ¢�n„yr�._ <br />Or�an�a name � � Licensenum6e ; � Daytimephone <br />. �..��{� ���_�'� �� � � �F�� � —���� — — � _S �t����' � Cf �� ■ <br />��GS�# �� 'f"L� �� �,.rt acld, � i Cb� � i �a1P_ . � ip � a,iyG��' ��xxl� <br />�� �� ..__. � ��� . �`r'�� . . �� ; � .� t i����i - � �',� <br />� �c�qrJ �+�n pmrNsr�s � a1.st�e�s��rre^- avor�ss : +��n� � .��� I .�m ! �ytr�� F� <br />—"�r#��� = �� �# �� � _ � � , �• _� #�-� I r�.� ��_ � .� � � �`� <br />HS�mr. rr! N�w ani fif s[+f�lr- a5 i�*}<71 " j�+,i�i�r.��f��ak rwi���� �•"�y i�,1�Ler ��i� �£3�yhFtk �i�� <br />pyr�ner. ,�m�;f�.!�F."� � � <br />Cl�k all a�tiveti$s ehat vsri-El b� toc�defct�d : <br />��l,f�i�bs �31!-tl7bs++'�t� d+�� [�'�e� ---�'�I''°pr`� �P�rl��wl,-kF . �Name�.vr�el tiv;tr, 9a�1,� . �u,-� _ tf�7 � <br />Pull-tab, Tipboard, and Paddiewheel Rent (r� i�� �u�� �nr ��.y <br />B�dl, eparati� n- sak� Q ��u ��yi1r� equi�i try al'1 employee Ber opsra!'ran • 5r1� •�f S�aa►�bfrtw� etluiQ�r►t �wlti � TEt�Sed <br />(o� vul�r�Lc-; •�1 n c�er�d brgar�urti�n withirt �-F � enctosare �remi'ses hl' m rn�pVOl'ee �af �ht: 1r_c�r. �ror+r R�orlx�►pn �„f,�e <br />� s di'�iy"C frf9R] 3�ta� w4C+� Pe�cc! ��,e�vr:rn�* �m S�fe#. I[x,0 d� be�e�ages d�ri aM0 �Cnd. <br />r J� �^ ^� Does your organiza�tion OR any other organi��tj�n condut�t gaerrk►ling ����� T � <br />fr�m a kwoth aperaiion at this io�t+ott' �T'�s �€o <br />L��—`�—..��`���.�._.��..����---- -- ..........- J <br />ITyou answered�/@Stofhequ�tion above, rent lim'ts are <br />based on the following ccxnbirsations of aperatinn: <br />- �oai� oneration � <br />- Flppti� o�eration and E�b di�t�ng t�rio� <br />Booth aperation an� k�r ?j�r.�u <br />- BOOth E)�es�#osli bar c�peration, and pull-tab dispensios� device <br />T5� rria�arr�tm�i r�r�k a�rr�? m�rM rx�k��t red �i,7� ih bd1�+F <br />G ma� t• � arga�tratsastis��r'�4$ prerr�se� <br />Complete oneoption: <br />Option A: f2 to 10% of the gross profits per month. <br />Percentageto be paid ���_% <br />Option B; When gross profits are $4,000 or less per maro�tt, $0 to <br />�k4H1 per month may be paic#. Amour�t to be paid $ <br />Option C: $0 to $400 per month may be paid on the first $4F�0 <br />ofgroapm�"�. Amounttoaepaid $ . PIusO%to <br />1tl°/¢ pf ttte gross �r� may pe paid per month on gross p r o f i <br />over ��,4� - Percerttage tp`t�e�k3fd _ _, � .- — <br />I f you art�r�d �(? to �-ques-�icx� abcNe, rent limits are <br />based on thefolfowir� combinations of operatian: <br />- Bar operation <br />u o�e��'�+1C�i�-����9Gerrfo� <br />�I �.� disperr�irx� device F�' <br />T�r�max�lnurnrenttljlar,^�+d +yrFot+ :s��antotal <br />pPrtr�cml� For all n�arureEianszt k�ispt'e[nis�e5. <br />Complete o n e optian: <br />Option A: E! to 20% of the gross profits per month. <br />, Percentage to be paid `�a <br />O tion B: When gross p►'oF��� �1,p� � less per ��hr ��� <br />to�200 per month may be paid. Arnount �a be paid $_ _., _ <br />E3�►tian C: $0 t� $200 p�' month may be paid on k� first $���10 <br />of g roa profits. Amountto be paid $. . . Plus Q%tn <br />2Q°/a of ihe gross profits mayr ae p� pe� mnnth ¢r �ro� prt� <br />over �1,Oa€7. Percentageto be paid °!a <br />Bingo Rent <br />Option D: Oto 10% of tl�e gross prof�is per month from a I I lawfu� <br />gam#�ir�gact�v��reshe€� �a�a��� exdudingbarbingo. <br />Perceniageto be paid � _`� <br />Option E: A rate based on a c�sk per square foot not to exceed 110% <br />o�a comparable cast per square foot for leased s{�e, as approved by <br />thedirectoroftheG�rnbli Ga�tralBoard. Norentmaybe��lforbar <br />bingo. Rateto be paid $ �'� � square foot. <br />Tt� lessor must attach documentatian, verified by the organization, i� <br />,� Bar Bingo Rent <br />__�p�r. F: No rent may bepaid for binga <br />avrtdu�i ir:�fa�. <br />New S�ngo Activity <br />rbr �,yr ��w �.��� e��,r�tyno� ��yr <br />kxhx�i in ath�crn�st�r�t�pr��urg, <br />�Il3�. a�XYr�ker sI�L C+f p�3 I�Xrlt� LI'ie <br />d�v,rs anc� �our� tha[:�n9n,�" � �n� �Fu. <br />� <br />� <br />� <br />� <br />� <br />� <br />� <br />�� <br />� <br />