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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 /> Off-Sale 3.2 Malt Liquor License Application <br /> Business Name ' <br /> Business Address 2785 North Hamlin Ave. <br /> Fbseyiue, MN 55113-1755 <br /> Business Phone 651-631-1241 <br /> Person to Contact in Regard to Business License: <br /> Name Sharon Stevens for rrlca LLC <br /> Address P 0 Box 15Ba-Attn License Dept., Springfield, OH 45501 <br /> P <br /> Phone 937-863-n 91 Date of Birth - <br /> Drivers License Number <br /> Social Security Number <br /> U.S. Citizen? x Yes No Naturalized? Yes No <br /> If yes, date and place: <br /> I hereby apply for the following licenses for the term of one ear, be innin y, 1 2003 , and ending <br /> #Aoty pp y g � ) y � g <br /> ry-1 2003 in the City of Roseville, County of Ramsey, State of Minnesota. <br /> License Reauired Fee <br /> Off-Sale 3.2 Malt Liquor Beverage $30.00 <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 from time to time,prescr' e,includi Minnesota Statue #176.182. <br /> 0 <br /> n 9i'me, <br /> Signature <br /> Pbnal L, 'ston, Treasurer for 5peedway bra mer,i c a U C <br /> Date Ia., /Z� &Z. -- <br /> If completed license should be mailed somewhere other than the business address, please advise. <br /> For offiee use only: <br />