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��;1� � � <br />�M�_ � • -- 1_ � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Massage Therapy Establishment License Application <br />F�ti�s�acss i� 7in o <br />�457f1�5� ���L'�55 <br />�i45i flr#S �cne_ <br />I • I.i.� I I •�LILI�.;s <br />=r��.~� � <br />..... . . . . <br />—� . � 4 �' � <br />���� � � � 1 4 � � ��k;� �� -� r� � � � <br />._. . , � f � � � �:� <br />-..���- =-�:��.:- . . <br />Person to Contact in �i'r�,r�ia to �?usine,ss �ice�zse: <br />f� <br />�•� 4 r 'y _ �/ . <br />J.L'i�:I � JI"IL' .kv �LJ' .. L�._ I r+ll. .�. 7 ��� �'y��� <br />Address <br />, ��: �,n� ��a � � _ ����_�r��._���_. <br />Drivers License Number <br />`?�[� t}� �,r[fs <br />e <br />I hereby apply for the following license(s) for tlae term of one year, beginning July ], , and ending June <br />3'l, , in the Ciry of Roseville, Counry of Rar€�sey, State of Minnesota. <br />License Required <br />Massage Therapy Establishment 0�.00 <br />'1 .fl0 Background Checic <br />(new license only) <br />The undersi�ned applicant malces this application pursuant to all the laws of the State of Minnesota and ������fi�a� as <br />;11�= Council of the Ci#y of Roseville may :�ri'r� tiine to tiGr.� ]�r�;�� �- �� i: i� T+�{i�ir�o-�.'I,l �l�:L'L' LT �ti �€'• <br />��� <br />M:�11�'.11l� � . <br />� � <br />� � � <br />Date .—.,�� •'��- �: �'�,,� t n , <br />If completed license should be mailed somewhere otl�ar than the business address, please advise. <br />