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M <br />CITY OF ROSEVILLE, MINNESOTA <br />7 FOR PAWN SHOP/PRECIOUSI METAL DEALER LICENSE <br />W97 & 4 <br />(Jan,uary 1, 2008 through December 31.. 2009 ) <br />Directions,,,_, <br />Please complete with typewriter or by printing 'in ink. If the <br />i1cation is by a natural perison, by such person; if by a <br />appi I <br />corporation, by an officer thereolf; 'if by a partnership, by one of <br />It <br />'if by an unincorporated associat'on, by the manager <br />the partners,; <br />or manalging off i,cer thereof. <br />Name olf ApplIcant (name of indi'vidual, Partnership, <br />corporation, or association) - <br />Pawn America Minnesota, <br />(If individual) LAST FIRST FUEL MIDDLE NAME <br />2. Name under which applicant will be doing business, business <br />aiddress, and telephone number,: <br />Full Name Pawn America Minnesota, L,.L.C./ Pawn America <br />Business Addre,ss 181 River RI*dg,e Circle S., Burnsville, Mn 55337 <br />ctusiness Telephone 952�646-17601 <br />3. Type of Applicant: <br />Indi vi'Lidual Partnership Corporation <br /># 4 <br />Association Limited Liabill ity Company Other <br />4 e e e ... e <br />ic,ns lit sks: <br />Typi of 1' <br />Type of' L,iicense/Pexmit Fee Per Year <br />Pawn Shop $10,000.00 <br />P' iou Metal Dealer $10 f 000. 00 <br />XXXXXPawn Shop and Precious Metal $13,000-00 <br />Dealer <br />9 <br />5,. A. If applicant i's an individual, state full name, residence <br />and business address, and telephone numbers: <br />Name <br />LAST' FI'RST FULL MIDDLE NAME <br />DIiate of Birth <br />3WATOM <br />