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� <br />��*� , <br />�, _R�_� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55ll3 <br />(651)792-7034 <br />Massage Therapy Establishment License Application <br />Business Name ��it. x "� � ��4: �� � - I ��Y��S � � �-�— <br />Business Address � �� � � �'F'�'�� 4 �.'` �' �`� ���' � � � f' ����„� <br />] Gi��i �u�5� Rhl���+' �� f — � �� �r �� �� <br />�raarl Address <br />Person to Contact in Regard to Business License: <br />c• <br />�_�� �+�. � � �"'��.� _���.�.r��,�� <br />r 4�'� ��-��� <br />��aa��� . <br />Phone — Date of Birth � , � <br />Drivers LicenseNurnL_. <br />�.�t � <br />I hereby apply for the following Ticens�(s) for the term of one year, be�m�g*, �?�r.:, and ending June <br />31, ��...aO�i , in the City of Roseville, County of Raznsey, State of Minnesota. <br />License Required <br />�'�� <br />F�c T� I,� r�,•� t� =�� � <br />Massage Therapy Establishment $300.00 <br />$150.00 BackgroundCheck <br />(new license only) <br />The undersigned applicant makes 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 M i e s o t a Statue # 17G. Z 82. <br />s��n�G <br />������f���-c.� �-�-�.����,.�.-_- <br />��,� �� -��'= ��i� <br />If completed license should be mailed somewhere other than the b�sin�ss address, please advise. <br />