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����� <br />�,j�r,_- � . �� J_—_�—J <br />City of Rosevitle <br />Finance Department, License Divisian <br />2660 Civic Center Drive, Raseville, MN 55113 <br />(651) 792-7034 <br />CigarettelTobacco Produc�s License Applica�ion <br />Business Name � <br />Business Address � �- � � � f { l �'' <br />�''l C ��� f�V� r Vi f sf7� c�S `���'r�'ss�' ��-e�Y <br />Business Phone J�-t%5�� � � �, ��. �� �5 � �� <br />Email Address CO �� � �` (U . � — �J �j C„�� <br />� <br />Pers�n to Contact in Regard to Business License: <br />Name l�1Cs� <br />Address <br />Phone <br />I hereb appl for the following license(s) for the term of one year, beginning July 1, ��.� , and ending June <br />30, __� ��, in the City of RoseviIle, Caunty of Ramsey, S#ate of Minnesota. <br />License Re �ired <br />Cagarette/Tobacco Products <br />Fee <br />$100.00 <br />The undersigned applicant makes this application pursuant to,ali, the laws of the State of Mir�nesota and regulation as <br />the Council of the City o�Raseville may from time to time prescri�e, incfuding'i�rf�i esata Statue #17b.182. <br />� . <br />Signatur� `w-�_-+��..�- .,, .,._,_ <br />�a�� � ��� f � �_ <br />If completed license shouid be mailed somewhere other than the b�siness address, please ad�ise. <br />.�. , , � <br />