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f/% <br />i w <br />EMW 0 W1 89 <br />City of Roseville <br />Finance Department, Division <br />2660 Civic Center <br />(651) 490-2212 <br />Business Name Ground Round <br />Business Address 2100 forth Snelling Avenue <br />Roseville <br />Business Phone ( 651) 636-7778 <br />Person to Contact in Regard to Business License: <br />Name Theisen Vending Company Wenl*se Matri ous ) <br />Address 3800 Ni col 1 et Avenue south, Iii nneapol i s MN 55409 <br />Phone (612) 827 -5588 <br />I hereby ap for the following licenses) for the term of one year, beginning July 1, 200 � and ending <br />June 30, 1 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Rea uirerl =e Ouantitv Total <br />Amusement Device $15.00 Four (4) 60,00 <br />(per machine) <br />The undersigned applicant makes 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 #176.192. <br />Signature <br />Date May 2. 2003 <br />If completed license should he mailed somewhere other than the business address, please advise. <br />For q <br />ffi C <br />e use only= <br />'r. •:; •°a: ,•, •. : •`Cry: s s& }nor. l..r .1s L.a'� ±F� s <br />.• a' . � - .�•, #.. • iti. °�� ��1•'•Y'' j# -fin }# y f n�F•'µ' • Y <br />R•ecelpt .� A`� TTr'�. .r. ••.• '•s. L'�! � a }s +' ° } <br />it nvrrA.�7 . j'Y''V S..p s••.k:.q•:5 <br />