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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 />Massage Therapy Establishment License Application <br />�, � � <br />r�t7si:�css �,:.r•7c __�f �f.�''� _ ��'���� �����1"���'{� � ' <br />�uai���� A�drr�.; � � � �_ �.� �`��� ��_�� r� C�� —� � ��� ��_ rr�.�: r� � �— <br />. �. . ... <br />... ... _. _. _. .. _ ..� <br />���Groess Pt�o�tia ��J_� � +� �� � ��� �` <br />1=: � �,��i !�1'�' ���L• ~ - • � <br />Person to Contact in Regard to Business License: <br />� •� ' <br />Legal Name 4 �f ��:�s�r �� � ,� ,° . . . . . '.: ..�. .. ' � <br />Address _ . _ . - <br />P110ne , i+�� u� wcw <br />Drivers License Number _ _ _ <br />I hereby appl,y for the following iicense{s} for the texzn of one year, beginning July 1, � r'�� �+, and ending rune <br />31, �•'� �,: , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required <br />Massage Therapy Establishment $300.00 <br />$150.00 Background Check <br />(new license only) <br />The undersigned applicant malses 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 #176.182, <br />f� <br />�;�ta.is�c. �� ��'? •'t��:����~ . <br />� ' <br />r <br />L7$1C r• •��Y r r� � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />= �'r'.� � �,.��.�' �}��d��'�� +:s�f2 � ��+��k��5.� �}+,�'�.�,�� �+r_��� ��.� ��-0,y°Cj�?�`�� �� <br />� ��r���z,�'� ',�;��r�.-{f,� ;+f��+��'�{}'��+ �.��'� ; <br />r . <br />��•� �'� � - .�,� �� ? r��'�Li�` � � � � •�+�,� ��,{� � C� �.�5`;�•'�/�l � ��� ; � <br />��.����.��;�� ��d��+}.�'/�k � ����' ,�� ��.��� �`���`� �,����'��5.�,?�r�� �,r��� �. �} rf� <br />f r� r, ��f �� r Y ���, <br />� � � � � <br />+� ���� . ����� k � �� � •�� ? � J � :�� �'� �� }� f �t�,`��} +r�x� •�'. <br />� <br />