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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792 -7034 <br />G garettel'I'obacco Products License Application <br />Business Name _ Cub �L S <br />Business Address C4 /fr/o A&rW4 5deAq,:?, /0 i le—'-%�_/� ✓511. <br />�` _1 <br />Business Phone <br />Email Address <br />Pei-son to Conlact in Regard to Business LiCO175e: <br />atn e <br />Address <br />Phone <br />I her by apply for the following license(s) for the term of one year, beginning July 1, 8 and ending .dune <br />3 0, , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required Fee <br />Cigarette /Tobacco Products S100,00 1. <br />The undersigned applicant makes this application pursuant to all the laws bf-the -State of Minnesota and regulation as <br />the Council of the City of Roseville may from tirne to time prescribe, including Minnesota Statue # 176-182. <br />Signature <br />- j� r <br />Date jfs <br />If completed license should he ,nailed somewhere other than the business address, please advise. <br />