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� <br />��� <br />���� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55ll3 <br />(651)792-7034 <br />Cigaret�e/Tobacco Products License Application <br />_..�.� <br />Business Name j � (.� <br />�4�SFT+►}h5 �4�fC�5 �. �,l � � � �• � <br />� � �. � � <br />L ��sin,: s� T'Jse�e _ �1 �� I :.��.' �.�� � � <br />�trtai� Address �� �Y <br />r! � <br />J ��� A <br />�� ��' `�� —�r�� ��_ .. ���— <br />Person to Contact in Regard to Business License: <br />� r� f r F <br />� 4 �J�ime I�'�'�+ �'} xl�:_ ��'� i-. � � <br />� �4 � � ��. <br />+f 1 4� Address � ���_�_ _ � � <br />Phone � � � " �� � J �� � � . _. <br />����� ��� <br />I hereby apply for the following license(s} for the terit� of one year, beginning July 1, ��G� r , and ending June <br />30, ;{��'� }_, in the City of Roseville, County of Ramsey, State of Minnesota. � <br />License Required <br />Ci�arette/Tobacco Products <br />Ft� <br />$100.00 <br />The undersigned a�spliea��t malces tJais application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may f•�.-r, time to time prescribe, € c[uding Minnesota Statue #176.�$2. <br />f� � � <br />Signature _ �_ .��� �'� f,y�_�?�' �-� <br />�� ��j���- � <br />Date --.��—�. ."� -- — —�.._A <br />If completed license should be mailed somewhere other than the business address, please advise. <br />� �����. � f � �.�� � � �- 1�-��.�fr�� � � <br />