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LG202 (11/14/90) Minnesota Lcwfal Gambling Lease Agreement (6/L. ) 7%1'7 Name of Legal Owner of Gambling Premise Address City2ip Code Phone Name and Aoor ss of eased 11ramises Acdress sty/Zip ooe - . ,.v 4f.vr ///99 , -S—el IV —I Name of Organization Leasing the Premises (lessee) License Number, if known ,e�.4RZ- 5%. o f=czirib2zng Aciznztx� The lawful gambling activity which the organization will conduct is (check all that apply): = bingo = raffles = paddlewheels C,'4 pull -tabs �cn tipboards Rent Information (see Rules 7860.0090, Subp 3) Class A and C premise 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 far up to 12,000 square feet; and $400 for more than 12,000 square feet. I Rent to be oaid oer bingo occasion $ 1 Class IS and D premise permits: Rent for gambling activities not including bingo may not exceed $24 per square foot per month, with a maximum of $600 per month. Rent to be cad eer month SS 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. Attach a sketch which identifies the location of the leased premises when a portion of a building is the leased premises. That sketch must include the dimensions of the leased premises. The lease will go into effect at 12:01 a.m. on J'A.V 1 19 9/ . and will end at 12:00 a.m. on - c�7/ 19, for a period of one year. The bingo occasions will be held: from (hours) (a.m./p.m.) to (a.m./p.m.) an (days of week) from (hours) (a.m./p.m.) to (am./p.m.) on (days of week) from (hours) (a.m./p.m.) to (a.m./p.m.) on (days of week) from (hours) (a.m./p.m.) to (am./p.m.) on (days of week) from (hours) (a.m./p.m.) to (a.m./p.m.) on (days of week) from (hours) (a.m./p.m.) to (a.mdp.m.) on (days of week) from (hours) (a.m./p.m.) to (a.m./p.m.) on (days of week)