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�� � <br />��� - � _� .� �J,., � � <br />Ci ty o f Roseville <br />Finance Depar�tment, License Division <br />2660 Civic Center� Dr�ive, Ros�ville, MN 55113 <br />(651) 792-7034 <br />Amusement Device License Application <br />���� �,��� �_ ��s � �� L� .. � � ��� . .�� _ -- � � � <br />.,�� � �� �.� � _ � .�� <br />�S.i��� ,,,�� _��o� � ��'����.�� �.r_'��� — <br />F�a�ine.r.s Rhian� � � �_��'�' <br />. � <br />�mail Address <br />�►-�_� �-� ���.. � . �_.�.�`�� ��� � � � <br />Person to Contact in Regard to Business License: <br />Name �. E.' 04 � � � � � ��� <br />}4� dress <br />Phone <br />I hereby apply for the following lice�ase(s) far the term of one year, begimling July I, �„_,� and <br />ending June 30, , in the City of Rosevil�e, County of Ramsey, State of Minnesota. <br />License Required Fee uantit T^*�� <br />Amusement Device $15.00 �_. � O„ �_� <br />(per macl�ine} <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and <br />regulation as the Council of the City of Roseville may from tirt��ta�i�rr�e prescribe, including �Ytinnesota Statue <br />rri ��h. � .�. � .. <br />. �' �• , <br />4� �;• f�;f�P�� .� <br />� i�r�7s�ire T� ���"��`'' �. . '_ — k. <br />Date ,� � � � 4 ''� <br />A fire Inspection is required before issuance of a license. Please call 651-792-7341to set up an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />