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1MV l��ur���,pnr��r� <br />s <br />v�� <br />u r �lrr r'"r�r�u <br />/„ rp <br />1 1� a i l dV l <br />11 �.... <br />C #y of ]Roseville <br />Finance Department, License Division <br />2660 Civic Center Dave, Rnseville,1VXN 55113 <br />(651) 792 4032 <br />cigarette/Tobacco Products License Application <br />Business Name <br />$uses Address N t <br />.RO'S lie <br />Business Phone � l(),4} [ -- <br />Person Ia Contact in g4rd to Businems Liceme+ <br />Name <br />Address <br />+J <br />Phone <br />I Eby aPP1y for the followi.g license(s) for <br />303 t of i3ne year, begs a jug 1 <br />M the City of Roseville, County Of � s and ending jund <br />Lim $ctuired <br />Fee <br />Cigarettc/Toba000 Products S FO0. <br />The undersigned applicant mak&q this application <br />�� ��� �f the �i p�t � all �e la�vO of the State of 1i�ii�.ota a.n�1 reL <br />#y of Ros le may from t`ilne to time P=WT b , Yu 176.182.1 tion as <br />g Minnesota Staff # <br />Signature { <br />Date <br />where, other than the lbuginass address i <br />