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��r�� �'� <br />���� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Cigare��e/Tobacco Products License Application <br />Business Name �3 _ �� � k �� "� � �� � • <br />� � <br />F�us incss Ac d�r�� I �' � � ,{'t � ,� � } —.� .�+ � , ,� <br />� <br />Business Phone � �___ . � � � � O <br />Einail Address <br />Person to Contact in Regard to I3usifz��ss License: <br />�� ii�L <br />Address <br />Phone <br />�i � S <br />�! � Y�. i �: <br />�... � <br />I hereby ap ly for the following license(s} for the term of one year, beginning July 1, ��'�� , and ending <br />June 30, ��JC? , in the City of Roseville, County of Rainsey, State of Minnesota. <br />License Required <br />Cigare�te/Tobacco Products <br />Fee <br />$100.00 <br />The undersigned applicant malces this application pursuant to all the laws of th6tate of Minnesota and regulation <br />as the Councii oftEte City ofRoseville ��iay fi•om ti�ne totiui� �t �� � il��, '�7t1�.�,1i,� �i�n;:cs�:�<i 5�:i1t.4� �� 1'��.14�.. <br />Signature �� �� ��� ___ <br />Date r � � ��,. � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />