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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 />Game Room License Application <br />Business Name � 1� � �' � � <br />Business Address � � �� �'"� �¢ �� � � <br />Business Phone ��.7 � ���-�~ � � � � <br />_ i � <br />�mail Address <br />-- � <br />Person to Contact in Re�ard to .8usine,ss License.• <br />� <br />�J:I��C i. ��� �j�.114� ._.. <br />Addre�a ��o�,���8 w � �� j�a �44 �� <br />�'fit717C .��~�� ��_��� <br />I hereby apply for the following lice�tse(s) for the term of one year, beginning July 1, ��.� a� , and <br />ending June 30, '� �4 %, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required �g <br />Game Room $175.00 <br />The undersigned applicant makes this applicationpursuantto 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 />��`'6 I �2. <br />�-� � <br />Signature � 4 � <br />1 }:_it j �� � � <br />A fire inspection is required before issuance on a license. Please call 651-792-7341 to set up an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise <br />