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k ��fH Vq h I J I _J <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 5511 <br />(651) 792 -7034 <br />Cigarette/Tobacco Products License Application <br />Business Name (� L2 <br />. L y <br />Business Address it /rte '- t <br />Business Phone 14 9— 9 1:1 3 <br />Email Address <br />Pet -son to Contact in Regard to Business License: <br />Name <br />Address <br />Phone _ <br />I hereby apply for the following license(s) for the terra of one year, beginning July 1, , and ending ,tune <br />30) , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required Fee <br />Cigarette /Tobacco products $100-00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue # 176.182, <br />ig nature <br />late -� ,� -5 <br />If eom pleted license should be mailed somewhere other than the business .address, please advise. <br />