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City of Roseville <br />Finance Department, License Division <br />2660 Vivre Center Drive, Roseville, MN 55113 <br />(651) 792 -7034 <br />Amusement. Device License Application <br />Business Name e7h /V � k 0 S -e V r <br />13usiness Address Q - <br />Business Phone 7-0 S- --e V <br />Email Address <br />Pe � -son to Contucl to Regard to Business License: <br />.In A <br />Name <br />Address <br />Phone <br />1 hereby apply for the following license(s) for the terra of one year, beginning July 1, _ , and <br />ending June 30, } in the City of Roseville, Counter of Ramsey, State of Minnesota. <br />License Required Fee Quantity Total <br />Amusement Device $1 5.00 .. <br />(per n-lachine) <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and <br />regulation as the Council of the City of Roseville may from time to time rescribe, including 11�1innesota Statue <br />41 76 182, Signature <br />Date <br />A !ire Inspection is required before issuance of a license. Please call 651 -- 792 -7341 to set up an <br />inspection. <br />If completed license shou -id be mailed somewhere other than the business address, please advise. <br />