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IMM <br />NO& 9A a Iowa <br />-A -low <br />City of Roseville <br />Finance Department,,, License Division <br />2660 Civic Center Dn"ve, Roseville, MN 55113 <br />(651) 792-71036 <br />JIM ii <br />- t _s1M <br />L4i*&m+4=se N'u,mber I <br />Date, of Bkffi <br />I bereby apply for the following license(s) for, the term ofone year, bleginmn,g', July 1, and endingi <br />June 311, :2- 0 t 1- -,in the City f Roseville, County of Ramsey., an State <br />o d ofMinnesota. <br />Massage Therapy Establishment <br />rLiagni <br />SIR 300-001 <br />$150.0 ground Check <br />(new license onlA <br />MUM TMO "0 <br />I <br />MIOUM <br />_4I; <br />if completed license should be mailed somewhere offi,er, than the busm"hess address, please advise. <br />ey <br />Ma <br />45JOY37 <br />S+ r% U, ke City, Utah 84145-M <br />