Agenda - Council - 03/22/2005 - Laserfiche WebLink

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Minnesota Lawful Gambling ' ~ L0215 Lease for Lawful G mbling Activity Name of legal owner o¢ premises Business/street address : i2ity Name of ~esscr Business/street address C~ (1[ same as ~egaJ owner, write in "SAME") 7. I/04 Page 1 of 2 S~',e Zip Dayt/me phone - .2 ~:e Z!p Daytime phone Name of leased premises Street address ¢~/ Zip Name of lessee/-(organization leasing the premise-~i _Organization license number Daytime phone Rent Information (;or activit'/ involving pull-tabs, tipboards, paddlewheels, and pull-tab dispensing devices. No lease required for raffles.) Booth operation - sales of gambling equipment by an em~Jcyee (or :Bar operation - sales of gambling equipment .Mthin a leased volunteer) efa licensed organization within a separate endcsure that is premiss by an employee of r.h.e lessor frcm a commcn area where dis~n¢ from areas where rcod and beverages are sold, fccd and bevera~.~ are also sold. from a b~oth ePerati°n atthis l~C~tion~ Yes ~x. No If you answered yes to the question above, rent I?~its are Il'you answered no to ~e question above, rent limits are based on the following combinations of operation:, ba~¢-~ on the following combinations of operation: Booth operarJon ' - Barcperation Booth operation and pull-tab dispensing device - Bar operation with pull-tab dispensing device Booth operation and bar operation Pull-tab dispensing device only Booth operation, bar operation, and pull-tab disgensfr, g de,ice The maximum rent allowed may not exceed the limits ' The maximum rent allowed may not exceed the limits established under Hinnesota Statute 349.18¢$ubd. t(b)(r4), e~ablished under Minnesota Statute 349.18, Subd. 1(b)(4). The limit as of Nay t, 2004 is $1,750 in total per month The limit as of May 1, 2004 is $2,500 in total per month for all organizations at this premises. ; for ail organizations at this premises. :omplete one option: Option A: 0 to 10% of the gross profits per month. Percentage to be paid __% Option B: When gross profits are $4,000 or less per month, $0 to 5400 per month may be paid. Amount to be paid $ Option C: $0 to $400 per month may be paid on the ,Srst $4¢000 of gross profit. Amount to be paid $ . PJus 0% to 10% of the gross profits may be paid per month on gross profits over $4,000. Percentage to be paid % ~:heck all activities that will be conductecJ:~ Pull-tabs ~Pull-tabs with dispensing device TiP~°ards ! Paddlewheel Paddlewheel with table Rent InfOrmatiOn: Bingo Bingo and/or Bar Bingo Occa,ion$ , Noon Hour Bingo Occasions Rent for bingo and all other gambling activities conducted during a bingo occasion may not exceed: : · $200 per occasion for up to 6,000 square feet · $300 per occasion for up to t2,000 square feet · $400 per occasion for more than 12,000 square feet · $25 per cccasion for bar bingo conducted at any time in a bar (regardless of square footage). Your organization Daytime phone -?~. ~--7f'.,?.. 2' ,~-,-/tl' Complete one option: Option A: 0 to 20% of~e gross profits per month. PercentaGe to be paid ~ (D Op, tion B: When gross profits are $1,000 or less per month., $0 to $200 per month may be paid. Amount to be paid $ O~tion C: $0 to $200 per monbh may be paid on the first of§ross profits. Amount to be paid S . Plus 0% to 20% of the gross profits may be paid per month on gross profits over St,000. Percentage to be paid % Rent may not exceed $25 per day for noon hour bingo conducted beb~/een Zt a.m. and 2 p.m. at a premises with a license for the sale of int0xicat~ng beverages on the premises. Rent to be paid per bingo occasion $ must conduct another form of lawful gambling, and the r For any new bingo activity not previously premises must serve intoxicating liquor or 3.2 percent ! [ included in a Premises PermitApplication, malt beverages. : I attach a separate sheet of paper listing the Rent to be paid per bingo occasion $. days and hours that bingo will be conducted.j If ~is is an amended lease showing dha~'~Jes occurring during the term of the current premises permit, both paddes Amended that signed the lease must initial and date all chaiqges, cha~nges must be submitted to the Gambling Conb'ol Board Lease at least &O days prior to the change. Write in the date that the changes will be effective /.__/ ... Only Lessor Date'~ Organization Date