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j�+..�.,, � .° _ � �� <br />Ci�y af Rasev�l�e <br />Finance Depar�ment, License T�i�is��an <br />26G0 C'rvic Center D�r�ve, RasevilIe, MN 55113 <br />(G51j 792-7034 <br />Massa�e Therapy Es�ab���hment License App��cat�on <br />Business Na�ne <br />Business Address <br />Business �'hone <br />En�ail Address <br />--�?�.,.� ��..�z ��-�.__�� � -� �5 � a <br />�xac� `���=.�� �I�a�� � �.�-e,,. C�'�-�-c t� . �3 � � � <br />��~1 ._ ��' _ �',` �� <br />�� <br />� <br />Persnn to Contact in Regard to Busrness Lice�se: <br />}-lt���'�Zegal Name ���.u�.��. ��--�3 ! 1-Se_ <br />�� rr <br />Address � <br />Phone <br />. ' - - .-. : , . , � Date of Birth - <br />Drivers �.,icense Nurnber � � ? <br />I I�ereby apply iar the fa�lowing lice��se(s) fo�• ti�e terin of p��e year, heginning July 1,�, and ending <br />J�ne 31, , in the City of Roseville, County of Rarr�sey�nd State oi Min���sota. <br />License Reqe�ired <br />Massage Th�rapy Es�ablislzmenf <br />]�ee <br />$300.00 <br />$150.OQ Backgrou��d Ct�eck <br />(i�ew license oniY} <br />Tlie u�lders'rg�ied applica��i n�akes this applioa�ion purs�ant to all the laws of tlie State a�'Minnesota and regulai;�oz� <br />as tl�e Council of the City of Roseville may frain tiine to �ime prescribe, including Minnesota Statue # 176.182In <br />addition the a lica�at acicrtnwled es that ihe ar� ras ansible for reviewin �I�e back rouz�d and work histo of <br />theiar em lo ees ii�cludi�l tEiase fil�at 1�ave received �nassa e thera ist ticeuse fro�n tlie Ci . <br />..... --.----7. . <br /><"�_----�,.. �,�..�=. <br />Signatur� _ <br />Date <br />�-/ .�r /�"7 <br />�f coKa►pleted Cicense shaulci iae mai�ed somevvhere ofhe� than t�e business address, piease advise. <br />