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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 />Cigare�te/Tobacco Products License Application <br />�._ f.—. - <br />� , '� r . r •, r� <br />Busiri�SS Name y �'ti • --� �} ti `• •. �''_� p,_;.,��_ `� �l' � ��i'-� � � I . . .� <br />� }, + <br />�i�J�_1JLSo- �.r�r�rLwS �f —� �Ij I� � �� � �_ � �-•� � � f �c � �, j � � 1' �.+_ j_ I� �� ,_;.f � � � �'� <br />— +-�� � <br />�r�� � -��,�� -- ;I;�I <br />E�:��;:;c�s nl:t��c - - - -- � - . ._.... _ .. .. _ _. . <br />. � r; . <br />Emai[ Address — <br />Person ta Contact in Regard to Business License: <br />_.{ _ � <br />Name •i � �' �• p •�j i.' � � <br />� �. <br />Address �-�- , �i � � � � -� � r. , � {. � ; � .. � .� � __ � ' � i , r 1 <br />. �., � ,.� i �:,.'� , � �� - �_. �{. � I_�-- . -�k� , ? . � ., . . , - r ��:� l� <br />, �. � � � _.j��j�' �-. <br />Phone Lr'. .� a - +•, k, .1. � <br />L hereby appty far the following Iiceizse�s) for the term of one year, beginning July 1, �.�t. �, r�.�� -` �, and ending 3une <br />30, .. ,:� k r�„ �, in the City of Roseville, County of Ramsey, State of Mimlesota. <br />T,1(`P11CP RPf71111'Pf� Fee <br />i� <br />�igarette/"f'obaccn Products $100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Mimlesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue #l7b.I82. <br />��� <br />Signature ,,, , __ <br />Ll. {,._ I;�'_ _4"r � i_'+£_- '"' �;�.,�� � �'Y.r,�' F-' -r�•�- <br />I '� <br />�I � L <br />Date _�� �. . �:� r-� _.- � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />w;� � _ . <br />? �� .�. 4- �l •.�. [�� ��� ��`�� �� <br />�.�.�_� � �1�����-� l�� f�� <br />�� � '�1_.�. i !Y�f � I � � �� �.�� � ' I � �t�� <br />