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1� �' ` i � <br />, � ,. <br />C�ty a� Roseville <br />Finance Department, License D�visinn <br />2560 C�vic C'enter Drive, Roseville, M� 55113 <br />{6S�} 792-7D34 <br />�Vlassage 'I'herapy �s�alblish�ent I��cense App�ication <br />Business Name � -� �- .� � �-e r� r .� /-�V � � <br />„ <br />Busin�ss �ddress � l � i �� � � �- � ,I `� <br />Bi1S111�S5 ��701]B ���! � O ( C� L1 J r_5 <br />E�nail Address , <br />PeYSan to Cantact in Regard to Business License: <br />Legal Narr�e _ __. <br />Address . <br />Phone � `' ' <br />Drivers License N�mber <br />r; <br />' Date af Birth <br />i� <br />L'l t G„_r. ti...`. %�[� c\ /'• <br />�. �T.. <br />I hereby apply for ilae followii�g liaense(s) fpr the term of one year, beginni��g Juiy 1, , and e�di��g <br />Jun� 31, , in the City of Rosevill�, County of Ramsey�nd Sta�e af Minnesota. <br />�,icense I��q�ired <br />Massage Tl�erapy Establishrnent <br />Fee <br />��oo.ao <br />$150.Q0 Background Check <br />(ne�v license on1Y) <br />The iti�dersigned applicaiii �nakes tl�is applicatioi� purs�xant to aII t(ie Iaws o�i:he State ofMinnesota and regulation <br />as tlie Co�ncil ofthe City ofRose�vilEe may �rpzn tir�e fo time prescribe, including Minnesota Siatue #175.182Tn <br />add'z�ian �l�e a Iicant ac�nawled es thai the are res az�sible far revi�win ti�e baek rat�nd a��d work l�istn of <br />Date �,: �ry � ^ �, � c".,.� � � �= <br />If coan�leted Ii�ense s�ould ibe ma�led soz�newhere ot�er than the busi�aes� ad€ir�ss, pleas� ac�v�s�. <br />