Laserfiche WebLink
� ���� <br />� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651)792-7034 <br />Amusement Device License Application <br />������ ���r ����� � � ����.�� � ��� � ������ <br />I Siuinc2s A�iFr��s � � �� � Y D � ��. �_�-�' � � � r _.� � <br />���� . � � �� - <br />Business Phone ��� � �� �'�� J����%,.� � �� �� �- �� f� <br />��ait Address <br />Person to Contact in Regard to Business License: <br />T�;irr�. � <br />Address i <br />Phone — <br />I hereby apply for the following license(s} for the te�. of one year, beginning Juiy 1, %� cs� and <br />ending June 30, ,� 6o h, in the City of Roseville, County of Ranr�sey, State of Minnesota. <br />License Reauired � �a� T��Z <br />Amusement Device ��� <br />$15. 00 � .. �� _ <br />(per machine) <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and <br />regulation as the Council a�'the City of Roseville may from S: i�i� to'ii_����s�rif,t�, including Minnesota Stat�e <br />�i? a.Ti'��_ I <br />�If�i:�Ftf r� • � ���#����Y �'�,,~�. <br />Date � - � .�' — � •� <br />A fire lnspection is required before issuance of a license. Please cali 651-792-7341 to set up an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />