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��� � <br />��� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Amusement Device License Application <br />.�: . ; .. . . <br />'} ' +a t� ' `'' �`'�' 7'..' <br />�3i�si���� ��� �r7c ' '�' � �- }�' � , �� x tir�r ,� � <br />Business Address r� �� �, �. ,I i t �} � f'; �.1 _12`� � d r . <br />• f �� ' f { 5 }�� { _ !�' � l. �•.•�. <br />����slr�`�S�!58n; �������'• � J�'_._.�---,�_._.. .�_.r.'._._. �.'..?�. <br />J_. _ _ . l <br />�n-�ail Address <br />Per•son fo Cor�tact i,r� TZegar•d to Business License: <br />7k 7'77� k :: ti� i�..�ti i f� �., � � � j �? �{ i�.r � .r.�� ___ �� ���'' � ��� �� �`�'��•f <br />, � /�1 <br />Address <br />Phone <br />.�.. r i �a � ��.� �. , <br />,.. . .. � _ /� .f <br />� � <br />t'}'~�. �.! � �++ i' 3 <br />� � r•.� i <br />� ��_. .� <br />I hereby apply for the following license(s) for the €en�� of one year, begi�l��ing July I, , and <br />ending June 30, , in tl�e Ciry of Rosevil[e, Counry of Ratns�y, State of Minnesota. <br />License Required Eee uantit Ta;3] <br />�-�. --- � :.— <br />A�nuse€��ent Device $15.00 -�� ��; � <br />(�er maehine} � <br />The undersig��ed appiicant a�aalce� tl�is application pursuant to all the laws of the State of Mii�nesota and <br />regulatiaz� as tlie Council of the Ciry of Roseville �ay from tiille to tii3�e prescribe, ii�cludi��� M€�uzesota Statue <br /># 176.182. �.t .� <br />_ � <br />� ignatur� l � • {� � � � �!%f <br />�_ <br />r � �� I��� .. r J <br />�fI.0 �J-� ?-- • <br />+ � _ '. <br />A fire Insaection is reauired before issuance of a license. Please call 651-792-7341 to set �ira an <br />inspection. <br />If completed license should be mail�d somewhere otlier tha�1 the: business address, please advise <br />