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���'���� .vi �. <br />� <br />City of Roseville <br />Finance Department, License Division <br />266d Civic Center Drive, Roseville, MN 551 i3 <br />(651} 792-7036 <br />CfgaretielTobacco Producis License Application <br />Business Nan�e i`f <br />BusiiicssAddress ---�/�i tS �[,� �% _��.v/���� �.'1! ��l�3 <br />Business P�ione �j j 1 -^ �'� i.�— �j�'Z, � �. • <br />� <br />Emar� Address <br />, - • ----�— f <br />Pe�•so�a to ContUCl 11� Regard 10 Ba�sir7ess Lice�rsc: <br />Name ��A'W1 .�. � � ' <br />_ + ._ .. ..-- <br />Address <br />E'ho��e <br />1 hereby apply for t��e followi�tg iiceiise(s) for tlie tenn of o��e year, begi���li��g� 1, o'LOoq , and e��ditig�� <br />30. O� , in the City of Roseville, Caunty oE Ramsey, State of Mim�esota. <br />License Re uired �'�� <br />CigarettelTobacco Products �, ] 00.00 <br />The undersigned applicai�t makes tl�is apE�]ication pursuant to all tl7e laws of the State oi Minnesota arrd regulation as <br />thc Council of t��e Cit}+ of Rose�rille may from time to time prescribe, includin iesota 5tahie #176. ] 82. <br />Sigz�ature <br />Date __.. . _-7a/!�/ i3 �. . .. — <br />If compieted license should i�e mailed sornetif�nere other ihan the business address, �lease advise. <br />��.�.'s ��a � �� � <br />�3� a � 3'� s� ' <br />-- Q�.,�t � K ,� � 5 � o � <br />�, <br />