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WAS 4 <br />City of'Roseville <br />Finance Department,, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />{651)792 -7036 <br />C a 6, 1 a <br />igarette/Tobacco, Products License Application <br />Email Address I jl. <br />Person to CoNact hi Rlegal-d' fol Bushiess License.- <br />Name <br />Ad-dress, <br />- - ---- . . .......... .......... <br />Phone <br />I her ap, ly for the following license(s) for the tenn of one year, beginning July 1, 0 and ending <br />June 30, D I, t--, in the City of'Roseville, County of Ramsey,, State of Miinnesolta. <br />License, Required Fee <br />Ciga,rette/Tlobacico Produicts $2OO.Ot <br />The widersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation <br />& 0 <br />as the Council of the City of Rosievillie may frorn, time to ti,m�e prescribe', l'including Minnesota 'Statue # 176. 182. <br />Signature yo, 40-0H lift ......... 0 ...... ....... .................. - <br />Date <br />If completed flicense should be malled somewhere other than the us me ss address, please advise. <br />m <br />