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k iCTl� <br />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 />Business Name <br />Business Address ZLoeos-' <br />Business Phone // /�p <br />Email Address <br />Pets opt to Contact in Regard to Business License: <br />Marne <br />Address <br />Phone <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, } and ending June <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 males this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of 1 oseviIle may from time to tune prescribe, including Minnesota Statue # 176.18 2. <br />r <br />Signature: � <br />Date <br />dw <br />If completed license should be mailed somewhere other than the business address, please advise. <br />T_ o� <br />