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�,,�' ' �� <br />� <br />City of Raseville <br />Fina�c� Depa�°tment, L�cense Divis�on <br />2bG0 C�v�c Cea�ie�- D�°ive, i2mseville, 1VIl� 55�13 <br />(65�) 792-7034 <br />Ma��ag� Thera�y� Establishment License App��cation <br />Business Name <br />Business Adar�ss <br />Businass Phone <br />Email Address <br />�.�. � �- ( � � <br />,� � � .�. �:�.�. E <br />�� �:��°�'�j � c.� <br />� <br />,,,�,,.r-�� �"-�-°--� �� �� �. <br />Person to Contact in 12egr�rd to Business Licerase: <br />C <br />Legal Name � � � -�' �� �"�' � <br />Address �� � a 1�' �. �t � � � �� ,/Y[ � jr' �f �a <br />Phone �( �- � � � - �� � � � Date af Birth <br />Drivers Licensa Nurnber � �� <br />�� � <br />�(�C <br />�;�.�..< � - �� <br />,��. <br />� ����f 3 <br />I herel�y ap�ly for the following license{s) for the term of one year, beginning July 1, �`' `' �, and ending June <br />31, ��s frd , in the City of Rosevii]e, County oi Ramsey, State of Mi�nesota. <br />Lieense Re uired Fee <br />Massage Therapy Establishment $300.00 <br />The undersigned applicant makes this applicatian p�rsuan# io ail the 1 <br />the Counci] of the City af Roseville �nay franr� time to time prescribe, <br />S ignaEure <br />Date <br />If cnnnpleted Iicense shonl� b� ►r�ail�� sprnewhere other titan the <br />$150.00 Ba�k ound Check <br />,.--P`°'"�� (new�cense onIY) <br />�ie State of,�znnesota and regulation as <br />it� Mi�ti�sota Sta�e #1'ifi.l$2. <br />� <br />� ��� � <br />address, ptcas� ada�se. <br />