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���� �� <br />'��.�� .1 . � <br />City of Roseville <br />Finance Department, License Division <br />�660 Civic Center Drive, Roseville, MN SS� 13 <br />(651) 792-7034 <br />Cigarette/Tobacco Products License Application <br />f,,�:y�� <br />1.}v:= IIlL�3 �: fr v _ � iy ] {� � � � �� 4 �� �.._` � . . ._ -. - - <br />� �� � � �� � � � t [ � <br />�•ri.ddr.c���� -�� ������3 j ���.�. ��� �- ' � �" <br />. r � . � �. <br />ht��;�t�s, �}�.o��= � �=�i�! .. �-:..� � _-,�k � �.. -- - <br />Email Address <br />PeYSOn to Contact in RegaYd to Business License.� <br />Name �� � ' 1 r � -{ ' `� <br />f, <br />f r ��: ,. <br />Address � � � � � � i �r •� <br />Phone <br />L � �� �� W .. .� � <br />�. <br />� ��' <br /><_ � <br />� _w� <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, '�`' �, and ending June <br />30, -�+_�.'r �� , in the City of Roseville, County of R�msey, State of Minnesota. <br />License Required <br />Cigarette!'Y`obacco Products <br />F�e <br />$100.00 <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 Minnesota Statue #176.1$2. <br />u <br />Signature r �.r 1� �.�~� �'� � <br />Tr�L� _ ��`�-1.i� — �- 5 � <br />. <br />If completed license should be mailed somewhere otlier than the business address, please advise. <br />� <br />