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0000�-r <br />Business Marne <br />/�rGd <br />ms����®r <br />Finance Department, License Division <br />01660 Civic Center + Roseville, <br />(651) 490w2212 <br />+ i Y i': <br />1 <br />4 <br />,A-qp on <br />Business Address e2,�_ til, 5'N <br />7Ws�v� nI Al 03//3 <br />Business Phone Gv`/ �' .� Cgd <br />Person to Contact in Regard to Business License: <br />Nd..i <br />Name � <br />IV#M <br />,Yg,FX - <br />Address OW Z' 4. <br />Phone 0 <br />Y hereby apply a t for the following license(s) for the term of one year, beginning July 1, , PO3 and ending <br />June 30, in the City of Roseville, County of mosey, State of Minnesota. <br />License Reg uired Fee Ouantity Total <br />Amusement Device $15.00 z <br />(per machine) <br />The undersigned applicant makes this application pursuant to all the laws of the State of Miniimta and regulation <br />as the Council of the City of Roseville may from time to ti scribe, includin Minnesota Statue #176.182. <br />Signature <br />df <br />Date T — 03 <br />If completed license should be mailed somewhere other than the business address, please advise, <br />