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�� <br />��� <br />City of R�s��i�l� <br />Finance Department, License Division <br />2660 Civic Center Drive, Rosevilie, MN 55113 <br />(651) 792-7034 <br />�igare��e/'I'�b��c� Pro��ucts License Application <br />BusinessName ��� `�� �q� � r <br />Business Address � ��'� �'� �.•+r� � � #�u� <br />Business Phone �" �j �j�� ��� <br />EmaiI Address -� <br />1'er'son to Contact in Regard to Business License: <br />7ti anre � �rti � . � � � � � � �'� r � � �'� <br />Address <br />� <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, �ia� the City of Roseville, County of it�trisey, State of Minnesota. <br />License Required Fee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant malces this application pursuant to all the laws of the State of Miru�esota and regulation as <br />the Council of the City of Ro�e��Ile may f�om time to time prescribe, including Minnesota Staty�e #176.182. <br />r—� � ���' <br />��Frr_lrrr � � ��� ��'�.�y . <br />�_. <br />Date %�" rs' - �� <br />If completed license should be mailed somewhere other than the business address, please �dvise: <br />