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r <br />-1. jonv <br />Tinance Department, License Division <br />&660 Civic Center Drive, Roseville, MN 55110 <br />(651) 490-2212 <br />Amusement Device License Application <br />Business Name Ra d i s s o n hotel <br />Business Address 2540 North Cleveland Avenue <br />Roseville MN 55113 <br />Business Phone (651) 636 -4567 <br />Person to Contact in Regard to Business License: <br />Name Theisen Vending Company (Denise Matri eus ) <br />Address 3800 N i collet Avenue South, Minneapolis MN 55409 <br />Phone (612) 827 --5588 <br />I hereby app l for the following license(s) for the term of one year, beginning July 1 a 2003 and ending <br />.tune 30, O in the City of Roseville, County Ramsey, of l , State of Minnesota. <br />License Required Fee -Ouandty Total <br />Amusement Device $15.00 Six 6) 90,00 <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 le may from time to time prescribe, including Minnesota Statue #176.182. <br />Signature ✓�� 4. ✓��- -� <br />Date May 2,, 2003 <br />If completed license should he mailed somewhere other than the business address, please advise. <br />For office use only <br />-A ' <br />f <br />