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LG202 (10428192) Minnesota Lawful Gambling Lease Agreement Premises Irtformation Name and Address of Lessor Address City/Zip Code Phone 6K ��( Name o_L-gal Owner of Gamblind Premises Address CityfZip Code Phone f-;tt-r— /1,-, r7L Jr-- ( ) Name and Address o Leased Premises Address City/Zip Code '0�44f" Name of Organization Leasing t e Premises(lessee) License Number,if known GambitngActivity The lawful gambling activity which the organization will conduct is(check all that apply): � O bingo O raffles O paddlewheels /pull-tabs O tipboards Rent Information (See Rules 7861.0060,Subp 213) 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 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 square feet > .. ;: Attach a sketch which shows the location and dimensions of the leased areas. E echve Dates The lease will go into effect at 12:01 am.on 11.12 r 71 t 19 ,and will end at 12:00 a.m,on I 19 cl 4 .for a period,of at least.one .year.: :. .. ....:.. ... 71mes..aTid Days Of Bingo Activity.:(If none;indicate IV/A):= The bingo occasions will be held (a maximum of 7 bingo occasions per organization): from(hours) (a.mJp.m.) to (amJp.m.)on(days of week) from(hours) (a.mJp.m.) to (amJp.m.)on(days of week) from(hours) (a.mJp.m.) to (amJp.m.)on(days of week) from(hours) (a.mJp.m.) to (amJp.m.)on(days of week) from(hours) (a.m./p.m.) to (a.mJp.m.)on(days of week) from(hours) (a.mJp.m.) to (amJp.m.)on(days of week) from(hours) (a.mJp.m.) to (a.mJp.m.)on(days of week)