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����� �L � <br />�r� _� � , _ J � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center D��w�,.Rose�i��e� MN 55113 <br />(651) 792-7034 <br />1��[��ag� �'����-���� �#���I ���h rr���t� �� ���s� �'� � � � i � �i �� <br />�, , <br />J� usincs� lJam,c. C ��,�1� � � �1 � � vti;� -v�[�� � `��= � <br />�'1 ll•)I1=t �o ;�i: �'t��� <br />Business Phone <br />�n�ail Address <br />�� �'LJ "� � �'�L t�`�� <br />�� •� _ � � �- � -� � � <br />. . � <br />1'ersora to Contact in Regard to Business License: <br />� <br />T.�>.�-3] ;v�m� --- <br />,'�t!ajress _ � <br />Phone _u -� Date of Birth � s <br />�� � <br />�77z-ivers License Number _ _. <br />I hereby apply for the following license(s) for the tei-�n of one year, beginning July �, �°� , and ending <br />June 31, �� L� , in the City of Roseville, Cnu��iy of Ramsey, and State of Minnesota. <br />License Required <br />Massage Therapy �sta6lishzx�e-�t <br />Trr <br />.��oo.oa <br />� 150.00 Background Check <br />(�-�ew license only) <br />The undersigned applicant makes this applicatiou pursuant to all the laws of the State of Minnesota and regulation <br />as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue �176. I. $2. T� � <br />addition, the a�plicant acknowledges that they are responsible for reviewing the background and work histor�f <br />their eYn�lovees, includin� those that have received a massa e� therapist license from the City. <br />� <br />Signature ^ � `�~ ' <br />f],7rc _ :-�'��'��-- <br />If ca�a�pieter� license should be r��ailed son�e�vt�ex-e other than the business address, please advise. <br />� � <br />