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2012_0109_amended packet
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2012_0109_amended packet
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2/15/2012 9:18:51 AM
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I I <br /> City of Rosevffle <br /> Finance Department, License Division <br /> 9 9 <br /> 2660 Civic Center Drl've, RosevMe, MN 55113 <br /> (651) 792-7036 <br /> C 0 0 <br /> igarette/Tobacco Products License Application <br /> Business Dame z1'4Ae^T,40'j <br /> Business Adams &ew V .. , <br /> L <br /> Business Phone _ �. .._f ,- r • -1 11._. .— <br /> Ems Address PO <br /> Person to Contact in Regard to Business License. <br /> INS <IF t V(1jr L• <br /> Address t _ IF Ar <br /> Phone <br /> I hereby apply fir the following license(s)for the term of me year,b MENEM g July 1 '� and=Wing June <br /> 301P m the City of Rose,County of Ramsey,,,,Stag of Nfinn.esota. <br /> License l gu red Fee <br /> cigarette/TobawA)l r .ucts $200.00 <br /> The undersigned applicant makes this application pursuant to all the laws of the She of Minnesota and regulation as <br /> the Council of the City of Roscvdle may fium d=to fime prescribe.,inel ding Minnesota Statue-#17f.182. <br /> siguature <br /> „ZAIIII11110 <br /> Date 241 �7Xj <br /> { <br /> If completed license should be mailed somewhere other than the business address,please advise, <br />
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