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�� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />�igarette/Tobacco Products License Application <br />Business Name <br />Business Address <br />Business Phone <br />Email Address <br />� � ��r�� '�% � � �� <br />� R�, , <br />i ��� ! _ ��.�i'� �.e.� ��.���¢��� ���.� . �`�n.� �� 1 I :� <br />�� F <br />�L�iF ��L� T � L+"FJL� _ _ • •�• <br />, � -�� <br />��{ � — � <br />� � CJ <br />Person to Contact in Regard to Business License: <br />Name <br />Address <br />Phone <br />r <br />� � � �,�e��� � � � [�`A�� <br />ti <br />� - .# �' � �� � <br />��� � _.�r, � ��s '- <br />I herehy anp for the following lioense(s} for the term of one year, beginning �`�'u �� 1��, and ending June <br />30, �� in the City of li.oseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Cigare�te/Tobacca Products <br />Eee <br />$100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation a s <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota $tu�u� �' I 7� �$�, <br />� .� _ � �: ; f <br />. f r� <br />Signature ��� ` �' � �> � ��'' � <br />� <br />. � <br />L}at� :i ��° �•``� <br />If completed license should be mailed somewhere other than the business address, please advise. <br />