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V <br />4W IV <br />City of RoseI'le <br />0 lip ql <br />Finance liepartment, Licenise Divisillou, <br />,2,6160 Ci'vic Center Drive, Roseville, MN 55113 <br />(651) 792-70314 <br />Cigarette/Tobacco Products, Licellse Application <br />J /I <br />Business Name 0 le <br />P It <br />Buslness Address, �lif�! /�/1.�/�- Dr //,e 11A.71 %� %i'I�J`,�> /[J. <br />���.� 7 '00�'4 1'w <br />Buisiniess Phione� <br />EmailAdidress 4 <br />Person to Ciontaict i'n R'e,gat-ld to, Business License: <br />Name <br />Addriess ff' 4 r r2me L 4t., Lq- 1"l , Sol XM <br />FURIM <br />I I f <br />1, Iherebly apply for the following license(s) for the term of one year, bleginnihig July 1, and endincy June <br />31 0' 61 in the Clity of Roseville, County of Ramsey, State of Minnielsiota. <br />I <br />License Required 'Fee <br />Cigarette/Tobacco Products S'l 10 10. 0 9 <br />T' l n e u der, s ii n <br />,h g eld applicant makes, this application pursuant to all the laws of the 'State lof'Minnesota and regulation as <br />the Counril of the City of Roseville may from time to time pry aril inicl g i, innieso,ta Statue 17'16.182. <br />Signature <br />Date <br />If clompletied licensle shiould I ble mailed somewhere other than the business aid&riess, Ip leasie advise,. <br />