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LG202 (1028/92) Minnesota Lawful Gambling Lease Agreement Premises Irtformation Name and Address of Lessor / Address f Ciryy2ip Code Phone c fi-.f ��J ��'•'r C r'fi /C d J SJIyf G 7' Name of Legal Owner of Gambling Prerhises Address City/Zip Code Phone Name and Address of Leased Premises Address City/Zip Code S4 Name of Organization Leasing the Premises(lessee) License Number, 6 known ,�J /' lJ 'ii"� V !.r rte• \FGr 'Ll. 81%� / Gdmbting Activity :: The lawful gambling activity which the organization will conduct is 2�11-tabs l that apply): O bingo 0 raffles = paddlewheels O tipboards Rent Information (see Rules 7861.0060,Subp 2D) 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 aff iliates for space used for the conduct of lawful gambling. Premises Descnptcort: : 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 Sketch:. : . :. :.::.: Attach a sketch which shows the location and dimensions of the leased areas. E ective Dates The lease will go into effect at 12:01 am.on A r i 1 19 and will end at 12:00 a.m.on 1 19-94 for a eriod of.at least one ear..:..:::: : :.:<::.::.;;;:.;>:,. ., .;:::::.::: >..:::-::.::: : ::.: :....:::;:::.::::. P , Y .: Times.and'DC1yS Of BtTIgD:`Actttinty..pf none,indicate WA)= 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 (a.mJp.m.)on (days of week) from(hours) (a.m./p.m.) to (amJp.m.)on(days of week) from(hours) (a.m./p.m.) to (amJp.m.)on(days of week) from(hours) (a.m./p.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 (a.mJp.m.)on(days of week)