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AOVA <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 551I3 <br />(651) 792 -7034 <br />co gareEtel'I'obacco Products License Application <br />Email Address <br />Name <br />f <br />Address <br />Phone <br />1 hereby apply for the following license(s) for the terra of one year, beginning July 1, JP.6 9 a and ending June <br />, - <br />in the City of Roseville, County of Ramsey, State of Minnesota, <br />License Required Fee <br />Cigarette/Tobacco Products $1 00.00 <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 may from time to ti.m.e prescribe, including Knnesota Statue 9176,182. <br />S ionature _ . � �— r <br />Date <br />If completed license should be mailed somewhere other than the business address, please advise. <br />