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LG202 Minnesota Lawful Gambling 06/17/96) S <br />LEASE AGREEMENT FOR <br />PULL -TAB, PADDLEWHEEL, TIPBOARD, AND /OR RAFFLE <br />ACTIVITY AT A PERMITTED PREMISES <br />Property Owner/Lessor Information. <br />Name of Legal Owner of Property <br />Street Address <br />5-e-AhMCe ftyerAeX /O Palley4AP <br />Name of Lessor Street Address <br />(This may or may not be the same as the Legal Owner of the Property) <br />5cyvo LAhes <br />Name of Leased Premises <br />City <br />Zip <br />AsJ :fG.5- BA sSo33 <br />City Zip <br />Daytime Phone <br />4/4)937 -7692 <br />Daytime Phone <br />6).1,0)Coato,haffet 4 %anje, sS //7 (61aWjf Csel <br />Street Address City Zip Daytime Phone <br />°eL 24-72. Jet '537'7 ` <br />&a—f� a- (/P /,7t) y/1,` -‘So/ <br />Name of Lessee (Name of Organization Leasing the premises) GCB License H of Organization <br />Daytime Phone <br />(iv /S VAz-G /.z0 <br />Rent Information <br />Type of gambling activity (check all that apply) that will be conducted at this gambling premises. <br />D Raffles 0 Paddlewheels [Pull -tabs C Tipboards <br />Total rent cannot exceed S1,000 per month for all non -bingo lease agreements with your organization for this gambling premises. <br />An organization may not pay rent to itself or to any of its affiliates for space used for the conduct of lawful gambling. <br />Rent to be paid per month $ 6O0 4,77 <br />List dimensions of all areas leased by your organization for the conduct of gambling activity checked above, including storage. <br />The leased areas are: <br />S feet by / p feet for a total of SO square feet. <br />c."5— feet by / 0 feet for a total of \J O square feet. <br />10 feet by feet for a total of square feet. <br />feet by feet for a total of square feet. <br />Storage / O feet by / 0 feet for a total of / © 0 square feet. <br />Storage feet by feet for a total of square feet. <br />Combined total X00 square footage <br />Submit a sketch (drawing) of the gambling premises. This must show the location of your organization's leased area(s) for the conduct <br />of lawful gambling, including areas leased for storage of your gambling product on this gambling premises. Be sure to write the dimensions <br />of the leased areas on the Sketch. THE DIMENSIONS ON TIME SKETCH MUST BE 'HIE SAME AS THOSE LISTED ABOVE. <br />MN Statute 349.18 Subd t states that the tenn of the lease may not begin before the effective date of the premises permit and must expire <br />on the same day that the premises permit expires. ONLY write an effective date in this area of the lease if this is a renegotiated lease <br />agreement occuring during the term of your current premises permit. <br />Effective Date for Amended Lease Agreements <br />q/ (/q6 TO 331/91 <br />Page 72 <br />