Laserfiche WebLink
Minnesota Lawful Gambling <br />����4 Lease for Off-Site Gamblinq Activ <br />5104 <br />Na�neoflegalownerofproperly Streetaddress Ciiy State Zip Daytfinephonenumber <br />— I . ]{. Fr �k I_ L!.�4I:} [�i � �'�� l�.t �� i7 ��=��—�fj��:� I,i'.����r� �— � r� ��} _"�}� ' '" ' y�?� � <br />w�ameoflessor Street address City State Zip Daytime phone number <br />[If same as iegaiowner,wnte in "SAME") <br />..." F <br />; f �! 1�4 <br />waameofleasedpremises Streetaddress,orroaddesignaiians Cily �I� Daytimephonenumber <br />,�. I �},-) �•,l . ,�,;.r; �: _+�f :C-�1�� .���_� ���_�l+,�i �r �� 'r.�—_ i� ���*', i�� � �} � � r <br />Vameoflessee(nameoforganizationleasingthepremises) Qrganizationlicensenumber G�.iin���7:,�enumber <br />..� , �. � � <br />�Qj� ��' h�.�. 'r�.?�'• i����. _' i�"�.}� �l ' 1 ' a EJi� � l% �jL?�r�F�' t�.,� r-� <br />�ambling Activity and LQ�$� Obligations , <br />Beginning date of off-site activity �L� r`��', Q.(o ., Endin date of off-site activi ��� <br />� 9 tY ��' . ..... <br />� Checkthetype of gambling activityihatv,ril�be conducted forthis off-site activity. <br />�p€ali-tabs _bingo �tipboards x paddlew�esls (Noleaseisrequiredforraffles) <br />;�. Rentto be paid for the leased area $���• p� if none, write "0." <br />�1. All obligations and agreements between the organization and the lessor are listedbelow or attached to t3�is lease. <br />Any attachments to this lease must be dated and signed by both the lessor and iessee. <br />This iease is the total and only agreementbetween the lessor and the organization conducting lawful <br />�ambling a�tivities. There is no otheragreementand no otherconsideration requiredbetweenthe parties <br />�s }�E�I; it4fir.�. iri :, riy and ather,matters related to this lease. <br />i f � '.•�� �{ { � yy � � � J j� y} <br />4•:�—/ ? , ' I .:' / ;- — � • 1+4."y.' � k+f' �� . �� � f �y.�t�' ��"-' �L� ' � J�^. <br />.�r�j � , - �rr • ` •�wl� � S-- of�r}7 �;�`e�•, .�Rit;�l (lessee) Date <br />�•• �� f� �1y � f� �� ' 'I :��F��'`I�_+—SY�L�iI� ' � �i�r�'��_�-i� 4ir� <br />Print neme of lessor Print name and title of person signing on behalf of � �' <br />organization <br />This publication'f� ill �� made avaiiabie �I alternativeformat The information requested on thisform++vill become public <br />(i,�_ large print, Braille) upon request. [�uesiions os�this information when received by the Board, and wil� be used tc� <br />formshouldbedirectedtoyourlicensingspecialistatthe determineyourcompliancewithMinnesotastatutesandrules <br />Gambling Control Board at 651-639-4000. Ifyou use a governinglawful gambling activities. <br />TTY, you can call the Board by using t#�e llriinnesota Re1ay <br />Service and ask to place a call to 651-639-4000. <br />