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Ci�y of Roseville <br />Fanance Department, Li�ense Division <br />2660 Civi� Center Drive, Raseville, MN SSl ] 3 <br />(651} 792-7036 <br />Ve�erinary Hospital Application <br />Business Nanle <br />� v �Business Address <br />Business Phone � � � � <br />Email Address <br />Person to Co�atact i�a l�egarcl to Busi��ess 1 icense: <br />Name � � �� <br />Address <br />� <br />1'hoE�e <br />� � � <br />1 hereby a��ply for the following license(s} for tl�e terni of one year, beginning July ]., , and endin� <br />Ju��e 30, , in the City of Roseville, County of Ramsey; State af Min��esota. <br />License Reaui.red 1�"ee <br />Veterinary Hospital $80.00 <br />The uE�dersigned a}�plicant n�akes this application pursuant to all tl�e la�vs of the State af Minnesota and regulation <br />as the Couucil of the Ci[y of Roseville may fro�n Ei�z�e ta ti���e presci�ibe, incdiidin� Mi�nesata Statue #176.1 S2. <br />5ignahire _�� <br />Date � r— �r .�- L�'j � <br />If compicted iicense should [�e n�aiied somewi�ere other tl�an tlie I�usiness addF-ess, �lease advise. <br />