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. � �� <br />�. <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, N.�N 55113 <br />(651)792-7034 <br />��i�arette/Tobacco Products License Application <br />Business Name � � � C� � � �a � � �"'i � ��? ��Y � � � � <br />Business Address �.�,� � j),� ['. �1u 1'�� `�_ '�� � �._. '� Q ;?� L L � � C� hJ � '.-r�,S � � % <br />Business Phone ��.� .��� �_� . __ . <br />�mail Address <br />Person to Contact in Regard t4 Business License: <br />����:, ��.� �,�� �� _}� � _. .� �.� � �r � � <br />Address <br />Phone <br />.. �r;�.- - ,r--..,. v , .��_._....,,�,,,_: �� <br />�� ' • <br />- - � � <br />—� <br />1 hereby apply far the following [i�: nac�:3 far the term of one year, beginning July 1, , and ending June <br />30, , in the �iiy of Roseville, County of Aaar�sey, State of Minnesota. <br />License Required <br />Cigarette/Tobacco Products <br />Fe.e <br />$100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Mi�aeso�a and regulation as <br />the Council of the City of Roseville may f��t time to time prescribe, including Minnesota Statue �#176.I82. <br />Signature _ � � f.�,�.� <br />�• - • �•�' <br />Date _ ��'�' ��� <br />If completed license should he mailed somewhere other than the business address, please advise. <br />