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City Rose v flle <br />F <br />inance Department, License Division, <br />26,60, Civic Center Drive, Roseville, MN 55113 <br />(651) 792,-70316 <br />81 <br />Massage Therapy Establishment License Application <br />IMI-11"It <br />63.3 -rs,s- <br />SUh-ke MCix INC, ckko-v . (oP"� <br />M <br />Dlivers License. Aumbler <br />I hereby app the, following license(s) for the, term of one year, beginning July 1, 2 IrJ and endin <br />June 3 1,1 2- () I a in the City of Roseville, County of R,amsey, nneso <br />d an State, of Mita. <br />V i <br />License U&=T1'K*rAA <br />Massage Therapy Establishment <br />$150.010 Blackgound Check <br />(new license only) <br />IWO <br />Signature <br />WODate <br />OA Q <br />If completed ficense should be mailed somewhere other than the busi I ness address�, please advi I see <br />