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LG202 (7/10/91) Minnesota Lawful Gambling Lease Agreement Premises information Name and Address of Lessor Address City/Zip Code Phone C: S4. 444VDe 33& s, it)« lak=- ,e.,Z ssyiyc6•Z) ;7,W-9,091/ N Legal Owner of Gambling Pre(hises Address City/Zip Code Phone O �0 S7<,Aj Ajij�4 Z3 v r 12-) ?mss- ame ra Address o ease remise Address ity ip e < `F Pie—Ito-)S,' X 7 0 o A-- u. S)? .S/. 4 tj it . .emu SSy� ame of�Organization Leasing S•/¢�1 io N the Premises remises(lessee) License Num o er, d l known -- d ii as xMr4 d Oc�.✓� Gambling Activity The lawful gambling activity which the organization will conduct is(check all that apply): O bingo O raffles = paddlewheels pull-tabs D tipboards Rent Information (See Rules 7860.0090, Subp 3) Class A and C premises permits: Class B and D premises permits: Rent for bingo and all other gambling activities conducted Rent for gambling activities not including bingo during that bingo occasion may not exceed: is a maximum of$1000 per month. $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. Rent to be paid per bingo occasion 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�_ feet by IVA- feet,for a total of -2 7 square feet. feet by feet,for a total of square feet. feet by feet,for a total of square feet. Combined total _square feet Sketch 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_12_ and will end at 12:00 a.m.on r / 19-91,for a period of at least one year. Times and Days of Bingo Activity (If none, Indicate N/A) f--j N/A The bingo occasions will be held (a maximum of 7 bingo occasions per organization): 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.m./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.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)