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.� <br />wi� <br />��� -,� �•� ' <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 />�3usines�Name ��'����'� <br />�17�i�ss Address � ����' } �� � • • - <br />Bti�; r: fs P'!��•�� �Y � � � � � � -� �� � <br />�n�ail Address <br />Person to Contact in Regard to Business License: <br />Legal Name � r '��' `�—� ��� fi' �. <br />Address � �j,'r�F�_���,���+,, �. <br />Phone ���4�#' Date of Birth �{-�� <br />Drivers License Nu��3ber_ _ , _ <br />I hereby apply for �h� following lice€�se{s) far the term of one year, beginning July 1, �'�� , and ending June <br />31, ��'�� �� , in the City of Roseville, County of S�an�sey, State of Minnesota. <br />License Repuired Pee <br />Massage Therapy Establishment $300.00 <br />$150.00 Background Check <br />(new license only) <br />The undersigned applicaz�t males 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 ti=��c :� lime ���n�, i�i�li��in� h�i �ri��c���= �ka-u� i� 17� •`- �? • <br />�� � ; r <br />S�i�l,rr� �,� ��-- � l� <br />��1� �-o� �� ..-� -- <br />If completed license should be mailed somewhere other than the business address, please advise. <br />