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��� <br />��►__ � . --� _ � � <br />City of Roseville <br />Finance Department, License Division <br />?660 Civic Center Drive, Roseville, MN 551�� <br />(651)792-7034 <br />Amusement Device License Application <br />Business Name _� �'� � �� ��� <br />� � , <br />Business Address <br />Business Phone � �r - � � � � � r �� <br />�- - —�. ! <br />�mai{ Address — <br />� <br />Person to Contact in Regard to Business 'cense: <br />Name �+k ��i�� <br />���� r��� �� �� ��, � ��� � � � .� �– — -- � -� <br />Phone ��-� ��� �� <br />I hereby apply for the following licanse(s) for the term of one year, beginning July 1, ��?� J�_, and <br />ending June 30, .��_ �� in the City of Rosevi[ie, CaunGy of l:�a�nsey, �tatc of Minnesota. <br />License Required Fc� uanYit Tnlal <br />Amusement Device $15.00 ��' � �� �� .� <br />ipa machine) <br />'T'he undersigned applicant z�akes this application pursuant to all the laws of £h� State of Minnesota artd <br />re�ulation as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue <br />n I xf�. a �'+� ���� � <br />Signature � <br />Date _�' �'{ � � � <br />A fire Inspection is required before issuance of a license. Please ca11651-792-7341 to set uu an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />