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City of Roseville <br /> Finance Department, License Division <br /> 2660 Civic Center Drive, Roseville, MN 55113 <br /> (651) 490-2212 <br /> On-Sale 3.2 Malt Liquor License Application <br /> BusinessName � ����� <br /> Business Address <br /> Business Phone <br /> Person to Contact in Regard to Business License: <br /> Name •--�� ��1� _� <br /> Address -3�7_o� <br /> oc//V, 4�.el <br /> 0 <br /> Z100? <br /> Phone _ Date of Birth_J t <br /> Drivers License Number <br /> Social Security Number <br /> If yes, date and place: <br /> G�Y! <br /> I hereby apply for the following license(s) for the term of one year, beginning January 1,t2ZZag and ending <br /> December 3 1, , in the City of Roseville, County of Ramsey, State of Minnesota. <br /> License Required Fee <br /> On-Sale 3.2 Malt Liquor Beverage $100.00 <br /> The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation <br /> as the Council of the City of Roseville may tom time to time prescribe, including Minnesota Statue #176.182. <br /> Signature �,or-,�.,� <br /> Date i��c,�}qr/nZ <br /> If completed license should be mailed somewhere other than the business address, please advise. <br /> For office use-only: <br /> I' <br />