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Business Name <br />Business Address <br />Business Phone <br />�i��ail Address <br />�� <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 />_ Radi sson Hotel <br />2540 North Cleveland Avenue <br />(651) 636-4567 <br />Tl��i ��;i V�ndi ng - �. <br />Person to Contact in Regard to Business License: <br />lvame Thei sen Vendir.� r����1�:3t.r �n��� <br />NEW ADDRESS <br />Address <br />-�- - - — <br />Phone <br />I l�ereby apply for the following Eicense(s} for the tenn of one year, beginning July 1, 7 f� 0� , and <br />ending June 30, 2 0 0 6 , in the Ciry of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired Eee uantit �0�3 <br />Amusement Device <br />$15.00 5 75.00 <br />(pe�- machine) <br />The undersigned applicant nzalces this application pursuant to all the laws of the State of Minnesota and <br />regulation as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue <br /># 176. � 82. <br />Signature . �f .. . ��� ,� _ <br />Date � � 2 O O 5 <br />A fire Inspection is required before issuance of a license. Please ca11 65 1-792-7341 to set up an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise <br />