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Ire 1J 2S2 0'0/26/94) Minnesota Lawful Gambling LEASE AGREEMENT Property Owner/Lessor Information Name of Legal Owner of Property Street Address City Zip Daytime Phone /t 4,c, /)'„ riz-� �b( 7 fL .dae.-- "Fe, l <` �� L�.. � �5 / ( Z) f�8f� - 58." Name of Lessor Street Address City Zip Daytime Phone (This may or may not be the same as the Legal Owner of the Property) SS -0/j/ (6(Z) 5ze<5 .X77 Name of Leased Premises Street Address City Goa/ /7//c'�y�o-� Name of Lessee (Name of Organization Leasing the premises) Zip Daytime Phone , // /� /I �,// /Z i/S y — ‘•i'LG FG•t.0 J /t.V S:V GCB License # of Organization Daytime Phone �'- QS ccs (c/2) Yc- 41-727 Gambling Activi and Rent Information Type of gambling activity that will be conducted at this gambling premises (Check all that apply to this gambling premises) Q Bingo ri Raffles 'Paddlewheels y Pull -tabs C Tipboards Rent Information (See Rule 7861.0060, Subp 2D) Indicate the rents paid by your organization to the lessor: Class B and D premises permits pay rent per month: Rent for forms of lawful gambling activity other than bingo may not exceed a maximum of S 1000 per month. Class A and C premises permits pay rent per bingo occasion: Rent for bingo and all other gambling activities conducted during that bingo occasion may not exceed: $200 for up to 6,000 square feet; S300 for up to 12,000 square feet; and S400 for more than 12,000 square feet. Rent to be paid per bingo occasion S Rent to be paid per month S Rent may not be based on a percentage of receipts from lawful gambling, or attendance at 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. Effective Date for Amended Lease Agreements 7 / / / Please list the effective date on which the amendments to the original lease will take place. List dimensions of all areas leased by your organization for gambling activity on this premises: The leased areas are: feet by a feet for a total of 3 square feet. feet by feet for a total of square feet feet by feet for a total of square feet. feet by feet for a total of square feet. Combined total 36 square footage Submit a sketch (drawing) of the gambling premises. This must show the location of your organizations leased areas for the conduct of lawful gambling including areas leased for storage of your gambling product on this gambling premises. Be sure to write the dimensions of the leased areas on the sketch. THE DIMENSIONS ON THE SKETCH MUST BE THE SAME AS ABOVE. Times and Days of Bingo Occasions (for Class A or C premises permits). If you checked bingo activity above, you must fill in the bingo days and times below. Circle a.m. or p.m. after each beginning and ending time. A bingo occasion must continue for at least 1-1/2 hours (90 minutes) but cannot exceed four (4) consecutive hours and at least 15 bingo games must be held at each occasion. An organization (as a whole) rnav not conduct more then seven (7) bingo occasions each week. Begins At: (a.m./p.m.) Ends At: (a.m./p.m.) On Day of Week Begins At: (a.m./p.m.) Ends At: (a.m./p.m.) On Day of Week Begins At: (a.m./p.m.) Ends At: (a.m./p.m.) On Day of Week Begins At: (a.m./p.m.) Ends At: (a.m./p.m.) On Day of Week Begins At: (a.mip.m.) Ends At: (a.m./p.m.) On Day of Week Begins At: (a.m./p.m.) Ends At: (a.m./p.m.) On Day of Week Begins At: (a.m./p.m.) Ends At: (a.m./p.m.) On Day of Week