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Attachment A <br />% I <br />� <br />Cify of Roseville <br />Finance De�artment, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7036 <br />Amusement Device Lieense Application <br />Business Name JQ� �% �d 5� " D� v l'� �� i7%C[y <br />I r /� <br />Business Address � � � � � r (/ r � c,.,,, x /Z, � <br />Business Phone �d S'� i/' r di �./�% /1% ��"S!/ � Ga�1-- <br />�mail Address <br />Person to Contact in Regard to Business License: <br />� <br />A <br />Narr�e <br />Address - �- �-�' � ' - � � "" ' <br />��—. <br />Pf�one , �, i � — <br />[ hereby apply for the fol[owing ]icense(s) for the term of one year, beginning July ], , and <br />ending lune 3fl, , in the City of Rosevi3le, County of Ramsey, State of Minnesota. <br />License Required Fee uantit Tofal <br />Amusement �evice $ ] 5.06 __.__�_ (� • � <br />(per machine) <br />The undersigned applicant makes this application pursuant to al] the laws af the S[ate of Minnespta and <br />regulation as the Council af C�e City of Rosevilie rnay from time to ti e prescribe, including Minnesota Statue <br />##176.182. <br />i <br />Signature <br />C�ate �j -- � ��- d �'% <br />A fre i.nspection i.s required 6efore iss�ance of a license. Please call 651-792-7341 ta set up an <br />inspection. <br />If compleied ]icense s3�oufd be rnailed somewhere other than the business adcjress, please advise. <br />