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r% <br />A <br />WAIA <br />=rTkorm"ZO <br />Finance Department, F n <br />01 <br />660 riv <br />., Civic Center D " e, Roseville, MN 55113 <br />(651) 490-2212 <br />Cigarette/Tobacco Products License Applicafio.T-i <br />Business Name Wal.preens #1804 <br />Business Address 1739 W Lexington Avenue <br />aIIIIIIIIIIIIWIWW1YlYlY ;YNWIVIVIVIVI. - -,... <br />Roseville, MN 55113 <br />Business Phone 651 - 488 -196 <br />Berson to Contact in Regard to Business License: <br />Name e Be 1 inch Dancy Tax Manager <br />Address <br />Phone 847-914-5312 <br />I hereby apply for the following license(s) for the terra of one year, beginning July 1, � ran 2 , and ending <br />June 30, 9 004 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License leg uired F =e <br />Cigarettefrobaeeo Products $100.00 <br />The undersigned applicant mares 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, including Minnesota Statue # 176-182. <br />Signature � � / �.. <br />Date <br />Flo -V & <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For office use only <br />.:ya � : ati:M�, -`r• .y...r rx -r ���,....p ktr S.'a'1��9 �C - `K <br />