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City of Roseville <br />Finance Department, License Division <br />��I G ic IV <br />Center <br />6. (651) 490-2212 <br />Cigarette/Tobacco Products Lic-ense Application <br />Business Name <br />Business Address 2 y �LI rt% % � <br />ds G V I& <br />Business Phone '� 6 3 9 � � y <br />Person to Contact in Regard to Business License: <br />�Q�["1►'Q �O? d � C ` <br />Name <br />Address ��. � ✓� Sri 01-, <br />Phone (� /Z - 3") 3 - ?co Z -- <br />.v !F6*ydy <br />l 1 for a following license(s) for the term of one year, beginning July I, and ending <br />I hereby apply June 30, in the City of l oseville, County of Ramsey, State of Minnesota. <br />License Required . Fee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursuant M <br />all the laws of the ate of Minnesota and regulation <br />� P� <br />as the Council of the City of Roseville may from time to time pre i�cludi.ng )�nnesota Statue # 176.182. <br />.,Wrib5e <br />Signature <br />Date <br />a <br />If completed license should be mailed somewhere other than the business address, please advise. <br />