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��� <br />��r <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 .? ,''���r' 1� I ; �_� _ <br />Business Address � � '-•rJ•� ����c,_; r�;,� ' �;�� •''� <br />�- <br />}',•5 � r. ' /�%5 jJ f�}, 'y/� <br />� i�. kI�IL,L • I'�Ii��IL �.'I� f l� � I � ��J _��. �f,. �� �" { � <br />t <br />Emai� Address <br />Person to Ca7tact in Regard to Business License: <br />+ � <br />Name � ���r :�..i�:�r'�k "��� C" � <br />Address _ - --- * � �-r • — - _ �, � r� _ - ' <br />Phone ' '—` ` <br />I hereby apply for the following Iicense(s} for the term of one year, beginning July 1, _��, and ending June <br />30, �� �_, in the City of Roseville, County of RaEnsey, State of Minnesota. <br />License Required F�.e <br />Cigarette/Tobacca Products $100.00 <br />The undersigned applicant malces 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 time prescribe, including Minnesota Statue #I 76.182_ <br />�'_.. - '"''r� - • -- - <br />� � <br />Signature _ ������;i �:�: L.— ._ <br />Date _�-�_ � � r� � <br />If completed license should be mailed somewhere other ti�an the business address, please advise. <br />