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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 />Cigarette/Tobacco Products License Application <br />.................... <br />Business Name C <br />Business Address �'" � Ibl) y1v -- ` <br />Business Phone � '� qVqV <br />Email Address <br />-'P , <br />Person 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 ,duly <br />30, ?� (7 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />4e-2 I <br />License Rem Fee <br />Cigarette /Tobacco Products S100.00 <br />1, 00 and ending June <br />The undersigned applicant makes this application pursuant to all the ws of the to of 'innesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe including n so- atue # 176.182. <br />Signature <br />f <br />Datek <br />If completed license should he mailed somewhere other than the busin -ess address, please advise. <br />