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V LG202 Minnesota Lawful Gambling
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<br /> LEASE AGREEMENT FOR
<br /> PULL-TAB, PADDLEWHEEL, TIPBOARA AND/OR RAFFLE
<br /> AC77WTY AT A PERMITTED PREMISES
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<br /> Name of Legal Owner of Property Street Address City Zip Daytime Phone
<br /> QA &,L51;&40n 44 ej Y len hO'� SSyi� ((,/zj 743 5 885
<br /> Name of Lessor Street Address City Zip Daytime Phone
<br /> (This may or may not be the same as the Legal Owner of the Property)
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<br /> Name of Leased Premises Street Address City Zip Daytime Phone
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<br /> Name of Lessee(Name of Organization Leasing the premises) GCB License#of Organization Daytime Phone
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<br /> Type of gambling activity(check all that apply)that will be conducted stumbling premises.
<br /> • Q Raffles 0 Paddlewheels Pull-tabs 0 Tipboards
<br /> Total rent cannot exceed S1,000 per month for all non-bingo lease agreements with your organization for this gambling premises.
<br /> An organization may not pay rent to itself or to any of Its affiliates for space used for the conduct of lawful gambling.
<br /> Rent to be paid per month S $QD f cxj
<br /> List dimensions of all areas leased by your organization for the conduct of gambling activity checked above,including storage.
<br /> The leased areas are: t
<br /> feet by 3 feet for a total of square feet.
<br /> feet by feet for a total of square fat.
<br /> feet by feet for a total of square fat.
<br /> feet by feet for a total of square feet.
<br /> Storage feet by feet for a total of square feet.
<br /> Storage feet by feet for a total of square feet
<br /> Combined total square footage
<br /> Submit a sketch(drawing)of the gambling premises. This must show the location of your organization's leased area(s)for the conduct
<br /> of lawful gambling,including area leased for storage of your gambling product on this gambling premises. Be sure to write the dimensions
<br /> Of the leased areas on the sketch. THE DIMENSIONS ON THE SKETCH MUST BE THE SAME AS THOSE LISTED ABOVE.
<br /> MN Statute 349.18 Subd I states that the term of the lease may not begin before the effective date of the premises permit and must expire
<br /> on the same day that the premises permit expires. ONLY write an effective date in this area of the lease if this is a renegotiated lease
<br /> agreement occuring during the term of your current premises permit
<br /> Effective Date foir Amended Lesse`Agreements u r„
<br /> `. „V
<br /> xis .
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