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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 />Amusement Device License Application <br />� <br />f'r J1 � � <br />��LI41'IL'.y'L � al'IL � /�� �+? � t+:� f ���%.J. _ . _. .. <br />� � <br />Business Address �� ��� �x _ ,�• <br />Business Phone �� f — � � �� _. �� �� <br />Emai] Address <br />{'rr.r��a; .r� � r���f.rc•f ir� Qt'i'��i; �ra i�1f.52t1�51 � �?•� M �: <br />r1r811:c �'���� , ��� . r -- "- <br />� ~ <br />Address . _ ���'�'�'�' _ . . . _ ._ <br />Phone - � <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, �„� ��-� �i,.�. <br />ending June 30, {'�'[�r_.� , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Requirec� F�c uantit Ta4r�1 <br />Amusement Device ,�I {.�}�� _ � <br />•, �r:�nr�lrr i ' '-� <br />The undersigned applicant �nakes this application pursuant to all the laws of the State of Minnesota and <br />regulation as the Council of the City of Roseville t'nay from time to time prescribe, including Minnesota Statue <br />3i?�.�s�. <br />�� � � . <br />Signature ' <br />Date � '- � ' ,��_ ,_ <br />A fire Inspection is required before issuance of a license. Please call 651-792-7341 to set u� an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />