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MINNESOTA LAWFUL GAMBLING <br />LG230 Application to Conduct Off -Site Gambling <br />10/24 Page 1 of 2 <br />No Fee <br />ORGANIZATION INFORMATION <br />Organization Name: Hometown Hero Outdoors <br />Address: 1342 Macey Court <br />Chief Executive Officer (CEO) Name: Chris Tetrault <br />Gambling Manager Name: Mitchell Bollin <br />License Number:94271 <br />City: Stillwater <br />, MN Zip: 55082 <br />Daytime Phone: 651-795-1695 <br />Daytime Phone: 651-353-2242 <br />j GAMBLING ACTIVITY <br />Twelve off -site events are allowed each calendar year not to exceed a total of 36 days. <br />From 10 / 24 / 26 to 10 / 25 / 26 <br />Check the type of games that will be conducted. <br />nRaffle <br />Pull -Tabs []Bingo ]Tipboards []Paddlewheel <br />1 GAMBLING PREMISES <br />Name of location where gambling activity will be conducted: Adrenaline Sports Center <br />Street address and 55 3 °3 <br />City (or township): 8310 147th lane Zip:- 5-3130 County: Anoka <br />• Do not use a post office box. <br />• If no street address, write in road designations (example: 3 miles east of Hwy. 63 on County Road 42). <br />Does your organization own the gambling premises? <br />—1Yes If yes, a lease is not required. <br />�No If no, the lease agreement below must be completed, and signed by the lessor. <br />LEASE AGREEMENT FOR OFF -SITE ACTIVITY (a lease agreement is not required for raffles) 1 <br />Rent to be paid for the leased area: $0 <br />(if none, write "0") <br />All obligations and agreements between the organization and the lessor are listed below or attached. <br />• Any attachments must be dated and signed by both the lessor and lessee. <br />• This lease and any attachments is the total and only agreement between the lessor and the organization conducting lawful <br />gambling activities. <br />• Other terms, if any: <br />Lessor's Signature: <br />Print Lessor's Name: <br />Tu 6 O h �-c� �►,' <br />Date: iz7/a6 <br />CONTINUE TO PAGE 2 <br />