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0 <br />CITY QF ROSEVILLE, MINNESOTA <br />- '�OR PAWN SHOP/PRECIOUS METAL DEALER LICENSE <br />Par� � - Generai Informa�ion <br />(Jarzuary 1; through ]]eceuiber 3�., - ) <br />Direct �.ons : <br />Please complete with typewriter o�r by prin�ing in ink, Zf the <br />application is by a natural person, by such person; if by a <br />corpora�ion, by an officer ther�af; if by a partnership, by one of <br />th� partners; if by an unincorporated association, by the manager <br />or managing officer �hereof. <br />1. Name af Applicant (name of individual, partnership, <br />corporation, or association): <br />�f��J �'FE�_ �c �.-TT (�'1 R� � <br />(If Individual) LAST FIRST FIILL MIDDLE NAME <br />2. Narne under which applicant will be doing business, business <br />address, and telephone number: , <br />Fu1 1 Name � o�-� �'uZ � x X <br />Business Address � to �Se��Q�� �'���-�.� �-J�5 , �, ,,,��f.� M,.} ; S I� 3 <br />Busaness 'rel.ephone {„5 � - C��3 - � 3 � y <br />3. Type of Applicant: <br />%� Individual <br />Association <br />Partnership <br />4: Type of license applican� seeks: <br />`i�rpe o� Licertse/Permi� <br />Pawn. Shap <br />Precaous Metal Dealer <br />Pawn op an�recious Meta� <br />Dealer <br />Corporat�on <br />Other <br />Fee Per Year <br />$�o,000.ao <br />�ia,00a.00 <br />�13,OOD.00 <br />5. A. If applicant is an individual, s�ate full name, residence <br />and business address, and telephone numbers: <br />Name a FF�� 5��� �v���� <br />LAST FIRST �FULL MTDDLE NAME <br />Da�e of Sirth <br />Residence Add�ess <br />