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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 />Cigare�te/Tobacco Products License Application <br />f�� � � { � <br />�5'.75:�C�� �+�� i,_ � .� 5j - � I , <br />_� �. � �'l � — <br />BlYR�75�5"k t.i�b5 .' J` � � �-� �1 � i � � F <br />�� ; -���� t�� � `�=� <br />���� �� , -�— - 4 � — <br />Email Address <br />PeYSOn to Cantact in Regard to Business License <br />' � � <br />�7�r_= .—��1��—���"_ <br />f <br />�� ���{� �� 4� Lti ��C <br />Addr��� _ <br />t�- �`�� '�r .r. <br />�'fii��SC �'�� _- �. ��' '� �� <br />—.-� <br />�.4� �-� k � � � �, . � .� - � <br />._.� __ _ _ <br />� <br />� � � r � � � � � ������,;1+� j If �' `'•r �-� � � � � <br />�����- <br />� �t .. � <br />f r' .._ <br />I hereby �� ���� � for the following ficense(s) for the term of one year, beginning July I, ��' ��_� , and ending June <br />�����'� , in the City of Roseville, County of Rar��sey, State of Minnesota. <br />License Required <br />Cigarette/Tobacco Products <br />FPe <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 Minnesota Statue #t76.182, <br />� <br />�' . <br />Signature � �__;��� _ { <br />, f."" . r� <br />'- ��-- I . �"�-' -. � <br />Date <br />If completed license should be mailed somewhere otEter than the business address, please advise. <br />l�� t�.�.� �� ��� �-�� � �_ �_ ��; n i���� FI�L�C �C� ��i"�i Y� �"+E�. <br />3�� Rice Street <br />Little����d�, �N �511� <br />l <br />