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���� � � <br />��- � . - --- � � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55ll3 <br />(651)792-7034 <br />Amusement Device License Application <br />,; _.i .� ; <br />Business Name -�� f '�� � �t�. � t'}r � � �` �� �� t� ,�� �� <br />ti. <br />�_ . <br />` r�• i <br />Business Address � -� I } L�•� •�� �}. � .�. � �-', X���. � jy <br />Business Phone �� ��'! ' "�C LJ� � �� I �.�� <br />Emai1 Address <br />PeYSOn to Contact in RegaYd to Business License: <br />{ �- ,- � � { '', <br />G r� f �• -' - � <br />�a�,_' �r� �.,i4, ; F. _.�'�- L '� � �•'4���-�.'_ ��� _ <br />— - _� • --•— • • - <br />_ ' ' _ . ' ....- - <br />{ ' -. � <br />. . —.. . . . p� . <br />� _� � , ���� <br />rlddr��,._ � � —. � �'' � •.r..� <br />..- -�-----.. . .,.._ <br />-���� � ; �:�� .r -� c� ��. �; — - - <br />��h��,�. _ , _ _.. ; . � r �- -- <br />I hereby apply for the following ticense(s) for the term of one year, beginning July 1, , and <br />ending June 30, __,_� in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required Eee n»a�titv To�rG <br />Amusement Device $15.00 _ _,� , � '�� � `l � <br />(per macl�ine} <br />The undersigned applicant malces this application pursuant to all the laws of the State of Minnesota and <br />regulation as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue <br />b 1'G. i 5�_ �'� _� <br />� f <br />Signature • <br />- ._ � - <br />Date '��-'-•�- -'" � .. <br />A fire �n�pecti�n is required before issuance of a license. Please call 651-792-7341 to set up an <br />inspectiou. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />