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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 />Cigaret�e/'I'obacco Products License Application <br />Ei'.IS'.ii��s ��i-i: . _ r �� } I_ •ti _} �_ -i•:__ �:{ �-�-.�L I - � �F;ti 7 i �*- <br />. _ .. ._.. . .-- . � ... <br />�CIS[I76SS .���I�Sd � �� �j - � 4� �� � ���J r,J ? �" � <br />r <br />I�i�viC�S� PI7oItiC• ..----•• �--k='� ! — I � -���. .r �i+�_�.�. <br />E€na�� Address <br />�r--�� � <br />Person to ConCact in Regard to Business License: <br />Narr� �� �� � I �� ��i� "��� � <br />Addrexx .._ ��-� �_- � 4.��� i ����I� �•€}*}�_ � � �L� ���.�11 �i.�. <br />FI7�i7t <br />lr_ a �� R — �� � i — r'= � � ��� <br />� hereby apply for the following fice�ase(s) for the term of one year, beginning July 1, �-��_� , and ending June <br />30, ��� -C�:�� , in the City of Roseville, County of Axmsey, State of Minnesota. <br />License Req�ired <br />Crgarette/Tobacco Products <br />F e.e <br />$100.00 <br />The undersigned applicant malses this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to �i��e �:rc�:'i�a� i: ��I,�J: i� �.f i7�7�1•'� �i,� �: �� I?�.' �i. <br />L } �, -r--. _ . <br />� , '�� � <br />Signature _._ _.._i� � �� <br />M <br />Date •�� � � {� � � �'�'��- <br />If completed license should be mailed somewhere other than the business address, please advise. <br />