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��4;�� -� � <br />����_� ,_ � � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Cigarette/Tobacco Products License Application <br />Business Name _ La,�,�.L ti Q��,Q.��..�. �$� _ <br />Business Address G� � � �• �� �����!�� � <br />Business Phone �#;� � �� � � �� .� <br />�rriail Address <br />F�rson to Contact in, R�gard to Business License: �-� <br />Walgree� , . <br />Name .. . . . . , . '%i DQF��i�.M1� ��SPS _ <br />1U�4'�4i!rr�k Ro�d <br />Address .. ... .. ... ��i:�; �?6it��kl. . . . .......... f�Ap r�kt� ll �t115 <br />' � �{;���s� Specialist <br />Phone rr r, �, ���4 �, !1 �, � `?, <br />ti. , <br />I hereby apply for thefollowing license(s) for the te�az of on��year,.begir�ning July 1, f�� , and ending June ' <br />30, ���_, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License �equirer� Eee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the Stale of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, includingMi�esota Statue #176.1$2. <br />Ma�r� l�eal�� <br />r�... � <br />AsslStar�t S�cr'et�ry Signature � ��� _�, �'"-i . ' ,1����. <br />�a� _ .. .� �� _ <br />Ifcompleted license should be �nailed somewhere other than the business address, please advise. <br />� <br />� <br />