12-11-1991 Council Agenda - Laserfiche WebLink

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LG202 (7/10/91) Premises Information Name and Address of Lessor Address j//o _ y� City/Zip Code Phone Name of Legal Owner of Gambling Premises yAdd Address ( ) ��,Zl .-�7�c �� City2ip Code Phone !/ etZ, SS/ o 9 me and Address of Leased Premises 7 � ' c..€ ..) Cit y2ip Code Minnesota Lawful Gambling Lease Agreement Name of Organization Leasing the Premises (lessee) Gambling Activity '. License Number, if known /40 in iv The lawful gambling activity which the organization will conduct is (check all that apply): bingo raffles 1 I paddlewheels 1 1 pull -tabs Rent Information (See Rules 7860.0090, Subp 3) Class A and C premises permits: Rent for bingo and all other gambling activities conducted during that bingo occasion may not exceed: $200 for up to 6,000 square feet; $300 for up to 12,000 square feet; and $400 for more than 12,000 square feet. I I IRent to be paid perAlisse occasion $ /. Crt 1 1 tipboards Class B and D premises permits: Rent for gambling activities not including bingo a maximum of $1000 per month. 1 Rent to be paid per month $ Rent may not be based on a percentage of receipts, profits from lawful gambling, or on the number of participants attending a bingo occasion. An organization may not pay rent to itself or to any of its affiliates for space used for the conduct of lawful gambling. Premises Description The area(s) leased within the premises are Sketch feet by feet by feet by feet, for a total of feet, for a total of feet, for a total of ICombined total Attach a sketch which shows the location and dimensions of the leased areas. Effective Dates The lease will go into effect at 12:01 a.m. on 19 fora period of at least one year. Times and Days of Bingo Activity (If none, Indicate WA) N/A The bingo occasions will be held (a maximum of 7 bingo occasions per organization): 1 square feet. square feet. square feet. square feet I 9 _ and will end at 12:00 a.m. on from (hours) (a.m. /p.m.) to (am. /p.m.) on from (hours) (a.m. /p.m.) to (am./p.m.) on from (hours) (a.m. /p.m.) to (am. /p.m.) on from (hours) (a.m. /p.m.) to (a.m. /p.m.) on from (hours) (a.m. /p.m.) to (a.m. /p.m.) on from (hours) (a.m. /p.m.) to (a.m. /p.m.) on from (hours) (a.m. /p.m.) to Page ( /p.m.) on (days of week) (days of week) (days of week) (days of week) (days of week) (days of week) (days of week)