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�� 1 '� <br />��� � <br />City o f Roseville <br />�`inanc�-D�par-t�nent, �,xce�.se�Division. <br />2�i��6_ �idic Center ll.�ive,_ �t.osev�lle,_ N.��T_ 55113 <br />(�5�j_ 792,7034: <br />��i�ar. e��l.'l�o�.bacco_ �'a�o.duct�_ License Application <br />Business Name <br />Business Address <br />Business Phone <br />�rr�ai� Address <br />�� �/ � <br />�.�.���1��I�t� l/ �� �e.S�_� �f__S' �" <br />� � �•� i�.' �Ac� � � � � K✓f ; r � � O,r � �+: �����`�+� •� ���, <br />� � � � ��w .�� s�� � <br />Person to Contact in �?egard to Business License: <br />NaYTIe- ���t��'3 ���C3 �S�f'� <br />Address j i�,� k�v Cc�� �i� 1 r �l•����' ��=e�� � 1d�� �'-.r'k� �5'f �� <br />Phone ��� f� �'{.�� � -���,.� <br />I herebv apply for the following license(s) for #�ze term of one �rear, beginning� 3�t , and andir�g June <br />30, �'�� , in.tl�.e City of Rose�ille, County of Ranzsey, State of Miesota. ������i �� ��� �. <br />��-r - � <br />License Required <br />Cxgare�te/�ohacco Products <br />� <br />$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 o f Roseville may from time to time prescribe, incluclin� Minnesota Statue # l 7G 182: <br />Signature �� �- ��� � _ <br />Date .1 I — + �`� � �� <br />If-completed license should be �:aa��ed somewhere other than the business address, please advise. <br />