Laserfiche WebLink
��� <br />_ �-�� <br />Finance Depax#ment, License Division <br />26G0 Civic Center Darive, Roseville, MN 55I13 <br />{651.} 792-7036 <br />Amusement Devi�ce License Application <br />Business Name �a���ct.) r ' �. L <br />Business Addres s �1(1, _�,►�1�1� U��C'2,� �� j� �`7 O� �C] l'� �/ l�.l� �"'� �%e � <br />gusiness Phone <br />Email Address <br />�3 - �-1y 4 - ,,��� <br />Tax. bepartment[r�nen-irc.com <br />Person to Contact in Regard to Business License: <br />Name _ Je�ifllf@r Hoo11 <br />325 I nterlocken Pkwy B <br />Addzess Broomfield, CO 80021-8043 <br />Tax. Departme�t@nen-ir�c.com <br />Phone _ <br />� <br />cr re�s s <br />I hereby apply for the fallowing license(s) for the terxn of one year, beginning July 1, v� (� 1'J� , and <br />endin� Ju�e 30, �, in the City of Rosevilte, County of Rarnsey, State of Minnesota. <br />License Required �'ee uantitv Total <br />Aannusement Device $15.00 � � (� . (� <br />(permachine) .LY1S���.'�, ���S��t{ <br />The undezsigned applieant ma.kes this application pursuant to all the taws of the State of Minnesota and <br />regzilation as the Council of the City of Roseville may from time to time prescrihe, includiz�g Minnesota <br />Statue #17 . <br />� <br />Signature <br />Date � oi.� � j <br />A fire 7nspect�on is required be�ore issuance of a license. Please call b51-792-7341 to set up an <br />inspection. ��, �� �� _��G� �_ � . <br />-J <br />If completed license shauld be mailed sornewhere other than the business address, please ad�ise. <br />, <br />�'e.�� � National Fntertainment Network <br />�25 Interlocken Parkway — B <br />Broom�Field, CQ 80021 <br />