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City of Rose -vine <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55H3 <br />(651) 792 -7034 <br />Cigarette/Tobacco Products License Application <br />a <br />Business fame s <br />Business Address 9�2so-V (i lik- �Opj .5 S <br />B Las kIess Phone � ' �' 33- 1 <br />Entail Address. <br />Person to Contact in Regard to Business License. <br />Name aYylo -. A6 Obe' VP- <br />Address I t 1 ) <br />Phone t) / 1 <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, , and ending .dune <br />) 5 Qj Of , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required Fee <br />Cioare-tte /Tobacco Products S100.00 <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 inay from time to time prescribe, including Minnesota Statue # 17 .182. <br />Signature <br />Date <br />If completed license should be mailed somewhere other that the business address, please advise. <br />