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Business Nan�e <br />Business Address <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN SSll3 <br />(651) 792-7034 <br />Veterinary Hospital Application <br />�� � ��� � �� �� <br />3�J�1LJ��,}A�!�,;�Jf���,� Ff�SpJ7AL <br />Business Phane �.,,������ ��� � <br />��s���, r�r� ���i rt� <br />E�nai1 Address <br />Person to Contact in Regard to 13tiasiness License: <br />a <br />� - � _�� <br />Nan1e ' ,� '�?-� <br />�� �—sz� __ � . <br />r <br />Address <br />Phone <br />r� _ .-� � ^ -� <br />�� <br />_ <br />I hereby apply for the following license(s) for the terrt� of one year, beginning July 1, , and ending <br />June 30, , in the City of P.osevil�e, County of Ran�sey, State of Minnesota. <br />License Required <br />Veterinary Hospital <br />Fee <br />$80.00 <br />The undersigned applicant makes this application 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 �176.1$2. <br />f <br />� <br />Signahire ��������` - � _ <br />I�L:[I. _ �� � ?_ �_. �_ � � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />