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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 />�igareti�eCTobacca Products License Application <br />Business Name <br />Business Address <br />Business Phone <br />� ���� r <br />�� � � � � ���M � <br />� �.—�. � � � •—�a�: �. �rx������ ��,c-'� �'- �i,�.�, �� T��S � � � <br />C�a.� t — 6��.� � � � I <br />_ > .. . � '� _ � .. _ .� �a <br />�rr�aii Address � <br />Person to Contact in Regard to Business License: <br />Name ��`� C� � i� �� ��t�k e�,. <br />. <br />*;�c;=, ss <br />Phone <br />�� ! � 1�1,r� : �-r_��.���� �x�i � � 1��,� �.�.�� � fx"] � .�7.� t f � <br />� �� � ��.�.� � � � �. <br />I hereby apply for the following license(s) far the term of one year, beginning July 1, ���' �, and ending ���e <br />30, °�C1 -, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Cigarette/Tabacco Products <br />F�e <br />$100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Mituzesota and regulation as <br />the Council of the City of Roseville may from time to tii�e prescribe, including Minnesota Statue � 17fi.182. <br />Signature ���'�- ��'`'�' '� �''����- <br />Date � � °�` � �' — � � ' <br />If completed license should he mailed somewhere other than the business address, please advise. <br />