12-19-2007 Council Agenda - Laserfiche WebLink

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Minnesota Lawful Gambling LG21 5 Lease for Lawful Gambling Activit 6/07 Pare 1 of 2 Check applicable Item: 1. Lease for new application. Submit with new premises permit application. amended of - lease within 10 days after new lessor assumes ownership. name Booth/bar change Other V2. Renewed lease. Submit with premises permit renewal. 3. New owner. Effective date / / Submit new or 4. Amended lease ° Check the change(s) in the lease: Rent Premises • Date that changes will be effective / / _Activity 1I the change. 7/) logs- 3/3 1 110 ° Both parties must initial and date all changes. • Submit changes at least 10 days before the effective date Organization name License number Daytime phone LirrL� CA-NIA 0A CA- NAD,A+JDA-H OtI2I5-003 Io51- 7�6'1o3y Name of leased premises Street address City State Zip : Daytime phone SAXON LA1J25 &) t rrtrckw4D4 )4D) timRrcANAOA um 5Sll-i (osr -�-8f 6co1 Name of legal owner of premises: Business /street address City State Zip i Daytime phone Amc 6owtING sti I Name of lessor (if same as legal i Business /street address City : State Zip Daytime phone owner, write in "SAME ") sA-mc Check ( '1) all activities that will be conducted' V Puli -tabs Pull-tabs with dispensing device ✓fipboards _Paddlewheel Paddlewheel with table Bar bingo _Bingo Pull -tab, Tipboard, and Paddlewheel Rent (No lease. required for raffles.) Booth operation - sales of gambling equipment by an employee Bar (or volunteer) of a licensed organization within a separate enclosure premises that is distinct from areas where food and beverages are sold. food r Does your organisation OR any other organisation operation - sales of gambling equipment within a leased by an employee of the lessor from a common area where and beverages are also sold. conduct gambling - V - Yes - . No �... from•abooth operationat''thisiocation? If you answered yes to the question above, rent limits are based on t • • •wing combinations of operation: - Booth operati• • If you based - Bar - Bar - Pull The per COMPLETE Option Percentage Option to $200 Option profi Plus, gros J answered no to the question above, rent limits are on the following combinations bf operation: operation operation with pull -tab dispensing device -tab dispensing device only maximum rent allowed may not exceed $2,500 in total month for all organizations at this premises. ONE OPTION: Al 0 to 20% of the gross profits per month. to be paid % - Boot operation and pull -tab dispensing device - Booth operation and bar operation - Booth operation, bar operation, and pull -tab dispensing device The maximum rent allowed may not exceed $1,750 in total per month for all organizatiioops at this pre uses. COMPLETE ONE OPTION: �(r /dg� 3/��/�� Option A: 0 to 10% of the gross profits per month. Percentage to be paid 0/0 • Option B: When gross profits are $4,000 or less per month, $0 to $400 per month may be paid. Amount to be paid $ . B: When gross profits are $1,000 or less per month, $0 per month may be paid. Amount to be paid $ C: $0 to $200 per month on the first $1,000 of gross s. Amount to be paid $ (Option C;)$0 to $400 permoth on the first $4,000 of gross profit. Amount to be paid $ 400.0 0 . Plus, 0% to 10% of the gross profits may be paid per month on gross profits over $4,000. Percentage to be paid 0 % 0% to 20% of the gross profits may be paid per month on profits over $1,000. Percentage to be paid % Bingo Rent. Bar Bingo Rent Option D: 0 to 10% of the gross profits per month from all lawful gambling activities held during bingo occasions, excluding bar bingo. Percentage to be paid °/0 be to _Option F: No rent may be paid for bingo conducted in a bar. Option E: A rate based on a cost per square foot, not to exceed 110% of a comparable cost per square foot for leased space, as approved by the director of the Gambling Control Board. No rent may paid for bar bingo. Rate to be paid $ per square foot. New Bingo Activity For any new bingo activity not previously included in a Premises PermitApplication, attach a separate sheet of paper listing the days and hours that bingo will beconducted. The lessor must attach documentation, verified by the organization, confirm the comparable rate and all applicable costs to be paid by the organization to the lessor. by