Agenda - Council - 04/10/2007 - Laserfiche WebLink

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Minnesota Lawful Gambling 5/06 LG215 Lease for Lawful Gamblin!! Activitv Pagelof2 Checkappflcableilem: _ 1. Lease for new application. Submit with new premises permit application. ..K 2. Renewed lease. Submit with premises permit renewal. _ 3. New owner. Submit new or amended lease within 1 0 days after new lessor assumes ownership. Date effective_'-'_ ~ 4. Amended lease . Check the change(s) in the lease: _Rent _Premlsesname _Boothlbar _Activity change _Other Date thai changeswil1 be effective_'_'_ . Both partles must inilial and date all changes. . Submll cha~;'-~s alleast'~D da ~s-':':riorto the chan e. Qrganizationname License number Daytime phone /1.*""P~ L ,"Nt 0",6 tJ/2-Oj tbl~ 7C -,57 Name oflease.apremises Streeladdress Cily I:; lip Daytime phone Spt2C+A,..{.6~f f.UI'- tf~" ID "n\ SS'303 7"3 ~~....e.r~ l", QA, l>\..fe- '7' '-I'$J- - ,- Name of legal owner of premises Businesslstreetaddress Cily Slate lip Daylimephone R.,4~,r./t"1 ~'itr ;f-./oNvI 12~"l?'" "'I" mt,.-t} '7b'? .fpec~fers :r~ ,,# _"",'S- Name oflessor (if same as legal Business'streetaddress CiIy Stale Zip Daytime phone owner, write in "SAME") 5A""-'" ~I~all activities that will be conducted: Pull-tabs _pun-tabs with dispensing device _l1pboards _Paddlewheel ..Jaddlewheel with table _Bingo vSar bingo Pull~tab, Tipboard, and Paddlewheel Rent (No lease required for raffles.) Booth operation - sales of gambling equipment by an employee Baroperation-salesof gambiingeqtJipmentwithlnaleased (orVolunteer}Ofallt:el1Sec!organlzationWlthinaseparateendosure premises by an employee of the lessor from a common area where that 15 distinct from areas where food and beverages are sold. food and bevel1lges are al50 $Old. r---------~--------------------------, Does your organization OR any other Organl% conduct gambling from a booth operation at this location? Yes _ No L___'______________.......,___ ______________...J If you answered yes to the question above, rent limits are If you answered no to the question above, rent limits are based on the following combinations of operation: based on the following combinationsofoperation: - Booth operation - Bar operation - Booth operation and pUll-tab dispensing device - Bar operation with pull-tab dispensing device - Booth operation and bar operation - Pull-tab dispenslng device only - Booth operation, bar operation, and pUll-tab dispensing device The maximum rent allowed may not exceed $1,750 in total The maximum rent allowed may not exceed $2,500 in total per month for all organizations at this premises. per month for a1\ organizations at this premises. Complete one option: complete one option: Option A: 0 to 10% ofth6"oSS profits per month. Option k 0 to 20% of the gross profits per month. Percentagetobepaid f % Percentage to be paid % Option B: When gross profits are $4,000 or less per month, $0 to Option B: When gross profits are $1,000 or less per month, $0 $400 per month may be paid. Amount to be paid $ to $200 per month may be paid. Amountto be paid $ Option C: $0 to $400 per month may be paid on the first $4,000 option C: $0 to $200 per month may be paid on the first $1,000 of gross profit. Amount to be paid $ . Plus 0% to of gross profits. Amountto be paid $ . PlusO%to 10% of the gross profits may be paid per month on gross profits 20% of the gross profits may be paid per month on gross profits over $4,000. Percentage to be paid % over $1,000, Percentagetobepaid % Bingo Rent ;.s:; Bar Bingo Rent option 0: Oto 10% of the gross profits permonth from all lawful option F: No rent may be paid forblngo gambling activities held during bingo occasions, exduding bar bingo. c.cnducted\l'labaT. Percentageto be paid % option E: A rate based on a cost per square foot notto exceed 110% of a comparable cost per square foot for leased space, as approved by New Bingo Activity thedirectorofthe Gambling Control Board. No rent may be paid for bar bingo. Rate to be paid $ per square foot. For any new bingo activity notpreviously The lessor must attach documentation, verified by the organization, to lnduded in a Premises Permit Application, confirm the comparable rate and all applicable coststo be paid by the attach a separate sheet of paper listing the organlzaliontothelessor. days and hours that bingo will be conducted. -57-