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��� � � <br />�. <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Massage Therapy Establishment License Application <br />Business Name ���� �� ��en�-�-s3 � � � � �s � <br />� �� r' r� <br />Business Address r c�r,—`� ��• � • �� r � —��i�'t ���4', �;�.- � . �'�'� �,' �'�= �5 �S`� � � <br />Business Phone �''� t – � � � � �r���� <br />�nnaii Address —. . <br />Person to Contact in Regard to Business License: <br />i' <br />L�geJ Narnc ����`–{ e� ��^ ��_: �� F�.. <br />��h�i�s� ._. �� ��_ l'�-'� k�� � �� _ _ _ <br />]'h�nc. <br />Drivers License Number <br />_ � � �xr,ti� � � �rGh <br />.---� <br />�' � �' +'�� � �'�� i �i_3 <br />� <br />I hereby apply for the following Iiaense(s) for the term of one year, beginning July �, , and ending <br />June 31, , in the City of Roseville, County of Ramsey, and State of Minnesota. <br />License Reauired <br />Massage Therapy Establishment $300.00 <br />$150.00 Background Check <br />(new license or_�y} <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation <br />�� d7c �cx�rn�.i I t� r ahe �:i i� af l�a��r illfi may rr�ri i i� r�c l�� 1 r-u>. � �� csc-�1 �i:,1H'��U��f7�T �•Ti 17�C5{YLZ �t��l �e ��"6 1:�'. T�ti <br />�ldiliors. �n� �v������ �������,�r�a�*� t�,3t,��,r u� ����an�����.t ��.���a�.��y ��c I�;x ���i�r�d �nd ��s��k his�c�].� <br />�ir �Gna��� tr�cl��d�a�. th!+�b,uti h��e �cciv� � mass�c _. 'sl Ji�cn��1�.1hG �;ll� <br />--�- <br />�igr�atu _ , <br />� <br />E?a« --- - --- -._.- <br />_ {,. {� -� <br />If completed license should be mailed somewhere other than the business address, please advise. <br />