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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, IAN 55113 <br />(651) 792 -7034 <br />Cigarette/Tobacco Products License Application <br />��- <br />Business Narne <br />Business Address L ,r7 Aorof.. -t"'f:te ke'V <br />Business Phone <br />Email Address <br />Pei -sore to Contact in Regard to Business License: <br />Name <br />Address <br />Phone <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, 10* Ir-,P , and ending June <br />-to J,. to # , in the C its of Roseville, County of Ramsey, State of Minnesota. <br />License Requireer.1 Fee <br />Cigarette /Tobacco Products S100.00 <br />The Undersigned applicant males this application pursuant to all the laws of the State of Minn ota d regulation as <br />the Council of the City of Roseville may from time to time prescribe, in ding Minnesota atu 176.182. <br />Signature <br />Date <br />If completed license should be mailed somewhere other than the business address, please advise. <br />