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����-�� F� <br />� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />C�garettelTobacco Products License Application <br />. + r� . , •r i , � ti <br />r:uKl=�ti�w :!�F;�1� i'� r�'•1'� i� i �ti�; �- r t V,}�.� ,' ��,1'_ <br />� � . <br />Business Address .:�. rar �. � �� � rr'ti �I i f�,�. '�T�' �' ��, � ���:,1�' LL� �� � f'�# �.� � I w <br />• �� � _ { „r_' <br />li:isi�i::ss f':7{�17C '+rl . Y; � <br />�znail Address <br />Person to Contact ��t Regard to Business License: <br />Name j fi r���'i�l'����„t . <br />°� — <br />Address _ <br />Phone <br />� • '� �':-�' � <br />I hereby apply far the following iicense(s) far the term of one year, beginning July 1, � r_ ;�'w � , and ending June <br />30, , r'.; ti:'.1 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Cigarette/Tobacco Products <br />F�e <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 of Roseville may from time to time prescribe, including Min��sota Statue � 176.1$2� <br />� I <br />Signature ��'�`���--''~ <br />Date f � �;.�_'k <br />If completed license should be mailed somewhere other tl�an tt�e business address, please advise. <br />