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05�2���ee� ��:�� ��1��2�e�e <br />c�rv �as�vz��E <br />���J � <br />��� �� �������� <br />F9na�c� I��epaz�en�, Lice�.s� Dnvzs�o� <br />�b60 Cx�'i� Cent�r D�rS�e, ��rs�r�iii�, I�II"+TT �SXx� <br />C�S�) ��z�-�o3� <br />�ig�r�tt�l��bacco �'r��d���s I1ic�ns� .�►.������i�n <br />B�si��s�lame �'��� � �� � � ���� <br />Bnsin�ss �,aciress <br />�v��ri������ � i -� � g � � �� �� <br />�mail AdE�ss <br />PAGE 01/�� <br />�-��� _�G� <br />l''� �. ��'E / � <br />t�erso� t� �ra�t�ct in Re�arc� to Busines,s �ic��.se; Walgreen Co. <br />Tax Dept. MS #1435 <br />.lulie Sochawsk3 104 W€iRtot F2oad <br />Nam� License Special��at Deerfiefd, IL60(}15 <br />Addr�as <br />�'hone <br />��.��by ap�t fcsr thc ��`t+ttoursng iiae�se{s} �or the t�t'm o�` os�e ye�, begi�^�in� 7u1� 1, ��, and �,z�ciit�� 3un� <br />3�, 20 �_�, i.n tl�e Caty of Roscv't.11e, Cnunty ��' �arnsey, 5ta'tc of Minnesota. <br />�acer��� Reguired <br />CRgareitefi'obaaca Procfucts <br />Fee <br />$l0�.0(3 <br />'T'he uu�ez���ned appiicanc ztxalccs rl�tis appax�a�.on pursuant tu at1 thc laws o�'th.e State �fMinnesata and reguJ�ti.ar� a� <br />ti�� �o�zncil o.f �he City o#`Ro�uiitc may fram� k�ma ta tsme preseri�o, 'sz�.clud��g M.innesata StPis�c' #176.1820 <br />--�,,� MA�i`GAF�ITA KE��1.,Cr,,` <br />Si�nature r Y �.��-- �"��SISiANT.,�GRE Ii��; � <br />T�ate �" ��� <br />If campteted Efcens� s�auld be z�ailed sarnewvhere e�her �ha�a ik�� krasir��ss address, �iease �dvise. <br />