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�t;;� �� <br />�� <br />C�ty of Roseville <br />Finance Department, License Division <br />2Gb0 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7U36 <br />�Vlassage 'I'herapy Esiablishment I,icense Applica�ion <br />Business Name <br />Business Ac�dress <br />Business PElone <br />Email Address <br />�.�1�:��� <br />�- - � <br />s <br />..,- <br />Person to Contact i�z Regard to Business License: <br />Legai Na�ne _ <br />Address <br />Phone . <br />Drivers License Numb� <br />� �- <br />I hereby apply for the following license(s) far the term of one year, beginning July l, ��, and ending <br />.Tune 31, , in the City af Roseville, Covnty of Ramsey, and State of Minnesota. <br />��se�e� <br />Massage Therapy Establishment <br />�e.e <br />$�oa.00 <br />�150.00 Backgro�tnd Check <br />(new license only) <br />� <br />The undeesig��ed applicani makes [his application pursuant to al] the laws of the State of Minnesota and reg�Iat�on <br />as the Cou�icil af the City of Roseville �nay from time to time prescribe, including Minnesota Statue #176.182. � <br />addition, the app]icant acknowledges that th.ey are responsible for reviewin� the l�ack�round and wark hist� of <br />their emplo�ees, inclt�d«ng those thar have received a massage therapist license from the Ci�. <br />Signature � <br />Date � <br />If con�pleted license sl.�ould be n�ailed somewhere other than the business address, please advise. <br />� <br />