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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, osevi -Ile, MN 55113 <br />(651) 792 -7034 <br />Pool/Billiards License Application <br />Business Name � Z31446QA>-5 t <br />Business Address R <br />Business Phone 02 <br />Email Address <br />Pet-son to Contact in Regard to Business License. - <br />_1 <br />Name <br />Address <br />Phone - - — — <br />I hereby apply for the following Iicense(s) for the term of one year, beginning July 1, 2WO , and ending June <br />0 <br />} in the City of Roseville, County of Ramsey, State Gf Minnesota. <br />License Required Fee Quantity Total <br />70 CV <br />Pool/Billiards $70.00 (first table <br />$20.0 each additional table O 400, 0 o <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Counci -1 of the City of Roseville may from time to time prescribe, including Minnesota Statue #176.182. <br />Signature de �� m <br />Date <br />.A fire inseection is required before issuance of a_ license. Please call 631 - 792 -7341 to set_upan inspection. <br />If completed license should be nailed somewhere other than the business address, please advise. <br />