Laserfiche WebLink
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 /> Business Name a �iL A- W f�/ k� C <br /> Business Address 2-21 � � (�v��y�'�� Rj2� <br /> Business Phone �,(�-S�) (2 3� '— 6 7 2 7 <br /> Person to Contact in Regard to Business License: <br /> Name �a�+�Qr» � C_.. I' c-c <br /> 1 <br /> Address 3.5- R ll,���� L„Gtr-C. S Mik/�1 <br /> Phone � ��' � � �-�_3 •— �j� � Date o f Birth <br /> Drivers License Number <br /> r <br /> Social Security Number <br /> U.S. Citizen? X Yes No Naturalizedl. _Z Yes No <br /> If yes, date and place: Sapj Z 1 �jj <br /> I hereby apply for the following license(s) for the term of one year, beginning January 1, 200 <br /> � and ending <br /> December 3 1, '=- 0v 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 from time to time prescribe, includi g Minnesota Statue # 176.182. <br /> Signature <br /> Date �(�2� /'V <br /> z-- <br /> If completed license should be mailed somewhere other than the business address, please advise. <br /> For office use only: <br />