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I INZ <br />PO BOX 99 <br />M <br />OL'i V JLX <br />iff i']Capdi -S, M f q 55440 Wbno <br />952 906 6596 <br />�x 952 906 6599 City of Roseville <br />-p a rtmen t, License Division <br />.......ter Drive, o eville, AIN 55113 <br />(651) 490 -2212 <br />Cigarette/Tobacco Products License Application <br />Business Name <br />$usindss Address <br />Business Phone <br />623 ' 3- 4�1�I0 <br />Person to Contact in Regard to Business License: <br />Name <br />Address � pe) <br />I <br />Phone r9l AZ <br />Op <br />1 hereby for the following Iieense(s) for the term of one year, beginning July 1, and ending <br />� pp g <br />Jute 3 03 a in the City of Roseville, lle, County of Ramsey, Site of Minnesota. <br />License Ren rived Fe <br />igarette)Tobaeeo Products 100.00 <br />The undersigned applicant makes this appIieation 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 Min eta Statue # 176.182. <br />Signature At IL <br />Date l <br />If completed license should be mailed somewhere other than the business address, please advise. <br />.fice use only. <br />• b . <br />JL <br />r7 >,. fr 3 7.� h► �. <br />€�.T'y��, r',��f:'�1W �• `emu }�_, fi <br />4F mor., <br />