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Attachment A <br />L��� _ <br />�� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />Sale of Consumer Fireworks License Application <br />Business Name Dollar Tree #4588 <br />Business Address 1121 Larpenteur Ave. W <br />ROSEVILLE, MN 55113 <br />Business Phone � �� ) 't �� ' `�'3�� <br />Person to Contact in Regard to Bzrsrness License: <br />Name t�Y✓1G1,+'l�. G �+�' l. <br />- (�t�C.t.�Si <br />U <br />Address 5`�-°O ��� �� � �G'�-� ��Ztf d,.� C.� �LL'- S <br />Phone l � � 1 � ���L- ( - SO <br />�3 <br />I hereby apply for the following license(s) for the term of one year, beginning January 1, 2014 , and ending <br />December 31, 2014 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Sale of Consumer Fireworks in existing retail business <br />Sale of Consumer Fireworks as a sole business <br />Fee <br />$100.00 <br />$350.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue #624.20. <br />Signature �� �t' � <br />( <br />Date `� � 2 i �-1A� �I <br />If completed license should be mailed somewhere other than the business address, please advise. <br />FIRE SAFETY INSPECTION IS REQUIRED PRIOR TO THE SALE <br />OF ANY CONSUMER FIRE WORKS ITEMS. <br />INSPECTION TO BE SCHEDULED WITH THE <br />ROSEVILLE FIRE DEPARTMENT (651 792-7341). <br />LICENSE TO BE PROMINENTLY DISPLAYED IN SALES AREA. <br />�'1�Y� Y�i\ �rCSzrl�, � : <br />�,\�C�r�e�. ���`� <br />�� �t�'� � � <br />C�l�_'��C��- � � � Z��"� <br />