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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 7927034 <br />Amusement Brie License Application <br />Business Name <br />Business Address - <br />Business phone <br />Email Address <br />Pei -.Yon to Contact in Red #ai -d to Business License., <br />Narne - - <br />.add: e s s L <br />Phone <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, , and <br />ending June 30, � , in the City of Roseville, County of Ramsey, State of i%rIinnesota. <br />License Required fee uantity Total <br />Amusement Device S15.00 <br />(per ra achiile) <br />The undersigned appheant makes this application pursuant to all the la %.vs of the State of Minnesota and <br />regulation as the Counci l of the City of Roseville may from- time to time prescribe, including Minnesota Statue <br />9!76.!$2. <br />Signature <br />Date <br />A fire fns a -etion is required before issuance of n license. Pie -ase call 651-792-7341 to set up an <br />inspection. <br />I f completed license should be mailed som.e�vhere other than the business address, please advise. <br />