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

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Minnesota Lawful Gambling 5/06 LG215 Lease for Lawful Gamblin" Activity Pagelof2 Checkapplk:ableilem: _ 1. Leasefor new application. Submit with new premises permit application. X2. Renewed lease. Submit with premises permit renewal. _3. New owner. Submit neW or amended lease within 1 0 days alter new lessor assumes ownership. Date effective---1_'_ - 4. Amended lease . Check the change(s) in the lease: _Rent _Premises name _Boothlbar _Activity change _other Date that changes will be effective_'---1_ . Both parties must initial and date all changes. , . Submit ch;~~'es ~;Ieast 10 da;;s -"::rlorto the chan....e. Organization name Ucensenumber Daytime phone R~i'lAjt:L..,.[l:-vJ (lab 0" 0 :5 11-"?5'-o;:n Name of leased premises Street address Coy \S:: Zip Daytime phone !:u n~ r ~'''o-l b'71.0 fU.Ll(.....liDl-6 Or I(u- ~., S'S.?();, -710> '~Iaj -77?P Name oflegal owner of premises BusinessJstreetaddress Coy I State Zip Daytimephone "</11 r~'I' &u I :;:,,'-- /ODJ.1w.rl-trfr,,<,l+O,- \JJro~~."-'--' io'!;:,_ )J??' ItA", .rs- 0. ~ s:7 - " Name of lessor (if same as legal Business/streetaddress Citj state ZIp Daylimephone owner, write In "SAME") :; A "",e ~k all activities that will be conducted: !I-tabs _Pull-tabs with dispensing device _Tipboards _Paddlewheel _paddJewheel with table _Bingo _Bar bingo Pull-tab, Tipboard, and Paddlewheel Rent (No lease required for raffles.) Boothoperation-salesofgamblin9eqUlpmentbyenemployee Bar operation - sales of gambling equipment within a leased (or volunteer) ofa Iic:ensed organization within a separateendosure premises by an employee of.the lessor from a common area where that is distim:t from areas where food and beverages are soJd. food and beverages are also sold. r------------------------------------' Does your organization OR any other Organiz~ conduct gambling from a booth operation at this location? Yes No L______________________ --==---------~ If you answered yes to the questiol'l ?kx:Ne:, rent limits are If you answ.ered 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 dispensing device only - Booth operation, bar operation, and pull-tab dispensing device The maximum rent allowed may not exceed $1,750 in total The niaximum rent allowed may not exceed $2,500 in total per month for aU organizations at this premises. per month for all organizations at this premises. Complete one option: Complete one option: Option A: Oto10%ofthegrossprofitspermonth. Option A: 0 to 20% of the gross profits per month. Percentage to be paid % Percentage to be paid % Option B: When gross profits are $4,000 orless per month, $0 to Option B: When gross profits are $1,000 or less per month, $0 $400 per month may be paid. Amountto be paid $ to $200 per month may be paId. Amount to 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. Amounttobepaid $ . PlusO%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 pCl:id % over $1,000. Percentage to be paid % Bingo Rent Bar Bingo Rent Option D: Oto 10% of the gross profits permonth from all lawful _OptionF: Norentmaybepaidforbingo gambling activities held during bingo occasions, exduding bar bingo, conductedinabar. Percentagetobepaid_% Option E: A rate based on a cost per square foot not to exceed 110% of a comparable cost per square foot for leased space, as approved by New Bingo Activity the director of the Gambling Control Board. No rent maybe paid for bar bingo. Rate to be paid $ persquarefoot. ForanynewbingoactivitynotpreviOusly The lessor mustatta<:h dOOJment<ltion, \lenfied by the organization, to Included in a Premises Permit Application, confinn the comparable rate and all appllcable coststo be paid by the attach a separate sheet of paper listing the organization to the lessor. days and hours that bingo will be conducted. -63-