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drees <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic tenter Drive, Roseville, ITT 55113 <br />(651) 792 -7034 <br />Cigarette/Tobacco Products License Application <br />Business Flame c C-1 <br />Business Address /Ij <br />Business phone .. 639- 13 6 9 <br />Email Address <br />Pei-son to Contact 1'n Regard to Business L ICOnse: <br />Narne <br />Address <br />Phone <br />I hereby apply for the following lice-nse(s) for the term of one year, beginning July 1, -ADO , and ending Jame <br />3011 00 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required Fee <br />Cigarette/Tobacco Products $100 . o0 <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 pr 'ncluding Minne ota Statue #176.182. <br />Signature <br />Date '4S /1 16 <br />If completed license should be mailed somewhere other than the business address, please advise. <br />