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LG202 <br />(7/10/91) <br />emises' information <br />Minnesota Lawful Gambling <br />Lease Agreement <br />Name and Address of Lessor Address City/Zip Code Phone <br />Name of Legal Owner of Gambling Premises Address City/Zip Code Phone <br />s rat., Nl eL o».✓ 9 ) 4 8-Y l 171,) <br />me and Address of Leased Premises Address City ip Code <br />Name of Organization Leasing the ePPremises (lessee) <br />ambling Activity <br />License Number, 11 known <br />Ao /et , <br />The lawful gambling activity which the organization will conduct is (check all that apply): <br />I I bingo raffles 1 J paddlewheels 0 pull tabs � 1 1 tipboards <br />Rent Information (See Rules 7860.0090, Subp 3) <br />" Class A and C premises permits: <br />Rent for bingo and all other gambling activities conducted <br />during that bingo occasion may not exceed: <br />$200 for up to 6,000 square feet; <br />$300 for up to 12,000 square feet; and <br />$400 for more than 12,000 square feet. <br />Class B and D premises permits: <br />Rent for gambling activities not including bingo <br />is a maximum of $1000 per month <br />Rent to be paid per month <br />Rent may not be based on a percentage of receipts, profits from lawful gambling, or on the number of <br />participants attending a bingo occasion. <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 />Premises Description <br />The area(s) leased within the premises are feet by feet, for a total of <br />feet by feet, for a total of <br />feet by feet, for a total of <br />Sketch <br />square feet. <br />square feet. <br />square feet. <br />Combined total square feet <br />Attach a sketch which shows the location and dimensions of the leasedareas. <br />Effective <br />The lease will go into effect at 12:01 a.m. on 19 and will end at 12:00 a.m. on <br />19 _J for a period of at least one year. <br />Times and of Bingo o o Days 9 Activity' (If none, fndlcate WA) 1---1 WA <br />The bingo occasions will be held (a maximum of 7 bingo occasions per organization): <br />from (hours) (a.m. /p.m.) to <br />from (hours) (a.m. /p.m.) to <br />from (hours) (a.m. /p.m.) to <br />from (hours) (a.m. /p.m.) to <br />from (hours) (a.m. /p.m.) to <br />from (hours) (a.m. /p.m.)- to <br />from (hours) (a.m. /p.m.) to <br />(a.m. /p.m.) on (days of week) <br />(am. /p.m.) on (days of week) <br />(am. /p.m.) on (days of week) <br />(am. /p.m.) on (days of week) <br />(am. /p.m.) on (days of week) <br />(a.m. /p.m.) on (days of week) <br />(a.m./p.m.) on (days of week) <br />Page 41 <br />