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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 /> 4. 0 Aar� 1.Tvx viez,o-� c-.. <br /> J, � <br /> Business Name <br /> Business Address <br /> IV <br /> Business Phone j — r 3-- 1-1 SIC,6 <br /> Person to Contact in Regard to Business License: <br /> Name ` Lki <br /> Address 5 0 c 1.x.1 �.�1. c .�: t cc-cc . � ��: �, _. 1 o :--- It C <br /> Phone Date of Birth <br /> Drivers License Number <br /> Social Security Number <br /> U.S. Citizen? Yes No Naturalized? Yes No <br /> If yes, date and place: <br /> t <br /> I hereby apply for the following license(s) for the term of one year, beginning January 1, , e n d i n g <br /> December 3 1, , Qrj(:w(?-)C4 of Roseville, County of Ramsey, State of Minnesota. <br /> License RequiredFee <br /> On-Sale 3.2 Malt Liquor Beverage $100.04 <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 prescribe,including Minnesota Statue#1 75.182. <br /> Signature <br /> gna re . <br /> Date f i - 'o f r <br /> If completed license should be mailed somewhere other than the business address, please advise. <br /> For office use only <br />