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� � <br />� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651)792-7034 <br />C��arettelTobacco Products License Application <br />Business Name '��j���� � � [ ti ���� � � � <br />Business Address <br />Business Phone <br />��aii Address <br />r <br />,�`f��. s +#�# �� �L����.; ��? <br />�:�.ti � ���� <br />Person to Contact in Regard to Business License: <br />� lL� <br />Name r � �� �� rt�� j:�s�-�I `ri�' ��;� <br />.�5����L� ��� ����,_ .'� � � a_ � <br />Address �i' ��-� �#i',�,C����I.� �� . �� i��':�ti �'�I� . ��1� _ J����-�i <br />Phone � � -' . — 4�3 — `', `� � 1 <br />I hereby apply far the following licenae(s} far the te�'tn of one year, beginning July 1, �` 4� �} b , and ending June <br />30, �Ofli , in the City oi Rose�ille, County of Rarns�y, State of Minnesota. <br />License Required <br />Cigare�e/�'abacco Products <br />F�e <br />$100.00 <br />The undersigned applicant makes this application pursuant 10 all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time ��� �k���n� ��i�� �xn S�staw u���,,Z a�. <br />����_ _r <br />Signature � <br />� i '., j , <br />Date ' �.'f � �: �. <br />Ifcompleted license should be mailed somewhere other than the business address, please advise. <br />