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��. j��.�� 1�1 <br />� <br />City of Ros�v,ilke <br />Fireance �D�p�r�ment, ��cens� JDa�as�an <br />266Q CYVic Center Drive, RosevilXe, MN 55�.�3 <br />(G5�) 792-7Q�q� <br />C�€garet�e/rI'obacc�o Praduc�s L�cen�e App�icat�on <br />Business Nazne <br />BuSi��ess Address � � �3 <br />8�����ss �r►o�a� <br />�rnail A�dress <br />�J ��.� ��f C�� �.. � ��,, � 1 � <br />� �"1� � �%� � � <br />, ��1��� � � .° �Cs � � <br />Person to Cnntact in RegaNd to Business License: <br />Name <br />Address <br />�'l�one <br />��� � � <br />� <br />� �� <br />S� �; Il� <br />� <br />T hereb� apply for the �allowiR�g lieense(s) for the t�rm of o��e year, 6eginniug r�zly l, -2 � C' , and endiilg <br />Jun� 30, � cJ D�' , in the City of Rosevill�, County of Ra��sey, State of Minnesota. <br />I�ice�ase ]E�equired <br />Cigarette/Tobacco Products <br />Fe� <br />$ � 0(1,OQ <br />The undersigned applicant makes this application pursuani to all the laws ofti��tate o�'Minnesota and regulation <br />as tixe CounciI of ilhe Ci�y o;F �tosevitle may frorr� ti�ne io tirn� prescrib,,�, iz�clu�ir g Minnesc�ta Statue # I?b.1$2. <br />Sig�xature �� <br />Date -- � --�J '�% <br />If complefed �icense s�xouI[l be mai�d somew�€ere other fhaa� ihe �usiness �dcTress, please advise. <br />