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1 ����' _ <br />� <br />City of Roseville <br />Finance Department, License Division <br />266d Civic Center Drive, Raseville, MN 55113 <br />(651) 792-7034 <br />Cigarette/Tobacco Products L�cense Applicatiion <br />.�----� <br />Business Name � i-� � .'`� [ t`�-.� �'q'��=r.� L...-� �� �:i��`'i=� <br />,: � '� ���`tN <br />BusinessAddress �Z��:� --- ►� �:i`�:���;' ��1z!�t�i'~f �--E`�e�.� E-�� ��-'`�-�=ti'rr-��.� ��_.�if'Z._ <br />Business Phone �'�`� ^ �, a`� �° ��' � �-�Z� <br />E�nail Address <br />Ae� son to Contact in Regard to Business License: <br />Name � 1,` , j iG.-�... i3 i� i� <br />Address 'Z--Z.�� L-, ��... Ct."����i ��>\.} �i i � �d`� ���� � i�.��=;��i �.�_C._= ���� 1�r�--_ <br />Phane �='"' `� � ""_ � J? a�`t -- �' ' r 2.�2--. <br />I hereby app�y for the following license(s) for the term of one year, beginning July I, ���?°� , and ending June <br />30, Z-�"�`�C-_z , in the City of Roseville, County of Ramsey, State oiMinnesota. <br />License Repuired Fee <br />Cigarette/Tobacco Products $ I 00.00 <br />The undersigned applicant makes this application pursuant to all the Iaws of the State of Minnesata and regulation as <br />the Council or the City of Raseville may frotn ti�ne to time prescri e, 'nciudi�ig M�seso.t� Stat �#37b. R$2. <br />r .� \ � 1 � `4 <br />Si nature V� ��t�L..�, , r�� �'�....4-��t,_�. f <br />g. _ __._.. <br />Date c.�� , . (�, • - .'.�.^c��,,..�'" <br />If completed license shauld be maiied somewl�ere other t�an the business address, piease advise. <br />