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City of Roseville <br />Finance Deparfinent, License DivYSi�n <br />26G0 Civic Center Drive, RosevilEe, MN 55113 <br />(651} 792-7036 <br />Pool/Billiards License Applica�ion <br />Bus;ness IVame /�Ls ��GLr A-r��s <br />Busicless Addr'css �_3 ��__ G✓� �. f�-{��il/T�GGt/' _/q'{/e , <br />Business Plio�a� � s� �� � " G �Q � <br />En�ail Address �' <br />Persoi2 to Contael in Regard to Busi��ess License: <br />I�'ame , . _ <br />Address � � < < - , _ . .. _. � <br />Phoiie <br />1 herehy apply for the fol�o�ving lice�ise(s} for t�ie ten�� of one year, begi�ining July I, ;Leop , and endin�; Jut�e <br />30, 20(O , i�� the City af Roseville; County of Ramsey, State nf Minnesota. <br />License Repi�ired <br />PoollBilliards <br />Fee <br />$70.00 (iirst rable) <br />�20.00 (each additiona] tabie} <br />uantity <br />� <br />Z'� <br />Total <br />7d e� <br />��� pa , <br />Th.e undersigned a�plica��t nzakes this application pursuant ta all the laws of t11e State of Minnesata and regulatia�� as <br />ttie Council of t�te Cify of Rosevil�e m�y fram iime £o tiane prescribe, includrng Mi�3nesota Statue #]i6.182. <br />Sig�7aturc �( �� <br />Date 6� �D?� <br />A lire ins �ection is re uired before issuance of a l.icense. Please cail 651-792-73A1 to set u an ins ec#ion: <br />]f com�leted �icense should be mailed so�i�ewhere otlier d�a�� the business address, plcasc advise. <br />