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City of Roseville <br />Finance Department, License Divisian <br />2660 Civic Center Drive, Roseville, MN S5113 <br />(651}792-7�36 <br />Theater License App��cation <br />Business 1'ame <br />Busincss Address <br />Business Phone <br />E:mail Address <br />C ' <br />i� . _ <br />�...SU !'�-x�5�n��� CENrF���--�US�uf��E.. Mtir �i�rF 3 ...._ <br />�i �1- �0� - `i'�1?{ <br />�L�a .m_r�..�ca�.s sr� c�. .. <br />Person to Caalucl rs� Rega�°d to Business Lice��se: <br />Name <br />Address <br />Plzone <br />I heret�y a}�ply for the foFlowing iicense(s) for tl�e term of or�e year, lieginning July l, '(j�° �—, a»d ending .Iune <br />30, �pJ(} �_, iiz the Ciry of Rosevillc, Cou�iry of Ramsey, State of Minnesota. <br />Licens_e 17equir•ed <br />Tl�eatea� <br />Pee <br />S 70.00 <br />(per screen) <br />uantitv <br />........ r�— <br />Total <br />�'..� .� <br />The undersigned applicant makes tF�is application pursuant to al] thc ]a���s of the StaYe of Minnesota ai�d regulation as <br />tl�e Councif of tt�e City of Roscvi�Ie ���ay from time to tirne prescribe, including Mrnnesota Statue #] 76, ] 82. <br />5ignature ° <br />Date U�- aG-� � Q � . <br />A f�ire insx�ecfion is reqt�ircd befae'e issuauce of a license Please cail 651-792-7341 to set up an inspection. <br />[f compieted ]ice�isc sho�ild Ue �iiailed somc���liere other tlia�i the busii�ess address, please advise. <br />