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� <br />��� r�. <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 />, r , �. `��� - <br />Business Nan�e � C- i�������ti `. • �-��'�� C��'� _ i r�5 C. �'� - f'ti `� <br />�usiness Ac3dress 5 � � �` � �r_ .x. ��?� K� %�� � , 4��,� � �', i � � r'F ti��i .�y. � �1,� - � �� �.� <br />�«s���v�s ���o�;� _.. � <�1� � I — :� �� �'�� <br />E�nail Address <br />Persax to Corztact in Regm•d to Business License <br />Legal Name �� i C.. �l T� �� I'���',� <br />��.�1'���. <br />��5 �1�f4�x I � �r � _k� til �� i i�k �`�� ��_ � `�fNl �'� �,t���= �� • �4/` 1 '�f, f � r�'�v. <br />Fho�iG +�'��� - •.� � �� - � �� � �she e�F T�i riL7 <br />[�,;.:.�..,�..R�-�•._.�.;.w.�, r f � ' � � . � . _ . . <br />I herel�y apply for tlte following ![ceiise(s) far tlie tenn of one year, beginning July 1, ��=�' +} , and ending June <br />31, ��'•� Ce , �i� tlie City of Roseville, County of Rat�lsey, State of Minnesota. <br />License Required Fee <br />Massage Therapy Establishment $300.00 <br />$150.00 Backgroui�d Check <br />(new license only) <br />The ui�dersigi�ed applicant inakes tl�is application pursuant to all the laws of the State of Mi�wesota attd regulation as <br />tlie Council of tlie City of Roseville ; rtr� from :_ir�• to ;i r.i� p� �� rilk�� i r••I �;: ii I i�� �fi- --' �i � R I':'ty.', �{� <br />a� � �� — <br />Si,gnature ' � � „ <br />-�- � . - <br />� ' <br />� - � �'. ! 1 5 <br />"7:i'.r • 1 <br />If completed license should be mailed somewhere other than the 6usiness address, please advise. <br />