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Q. <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, AIN 55113 <br />(651) 490-2212 <br />Ciogarette/Tobacco Products License Application <br />Business Name H AM I ME, a 0 0 R-S 2:0C a - <br />Business Address IS Z5_ ++A N1 L.:i r%j 6 - -AV E , N * <br />Ras�Ui LL-E M N -, Y���l3 <br />Business Phone bE50 I - . (0 SGI I,- I � G q . WHO <br />Person to Contact in Regard to Business License: <br />Name V., 4CtAWC, <br />Address 7 7 &Q CAR.KWA-iftN L11- -.55�a(cn <br />Phone 01 5Z - C) 34 — 9 11 :Kr - <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, 1_00, _ - -,and ending <br />June 30, IL 0 0 , in the City of Roseville, County of Rarnsey, State of Minnesota. <br />License Reauired Fee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation <br />q1 <br />as the Council of the City of Roseville may from time to time rescribe, including Minnesota Statue 9176.182. <br />Signature <br />Date <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For qffice on,4pw-i <br />