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2009_1012_Packet_Exec
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2009_1012_Packet_Exec
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10/9/2009 2:40:57 PM
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�� ���s �, } � � <br />� <br />City of Roseville <br />Finance Department, Licensc Division <br />2660 Civic Center Drive, Roseville�, MN 55113 <br />(65I } 792-7036 <br />C`igarette/Tobacco Produets License Application <br />Business Name � V -e--� �U.�� 1..�-I��U��� �� � . --- <br />B�isii�ess Acidress �� �-���v� ;./� <br />Busincss Phone � � � � � � V ~' . � � <br />Email Address L, _ _ <br />... - - .� • <br />Per°sa� 10 G'orrluct ii7 Rega1-d to Busincss Lice�se,� <br />iVame <br />n <br />Address <br />-- ..._ , ,„ <br />Phone _ <br />! hcreby apply far tl.�e following license(s) for the tertn of ane ycar, begin�7ing July ]��v�.__._.�_, �pd �i��i�lg Ju��e <br />30, Z��u '� p, in the City of Rosevillc, County of Raansey, State oFMinnesqta. <br />�icense Required Fee <br />CigarettclTobacco Products �I�06.00 <br />The ui�d.ersigtied app�icant niakes tl�is application pursuant to all the laws of th.e State of Minnesota and regulation as <br />ihc Co�iucil of tf�e Ctty of Rosevii�le may from time fo time �re�ibe, y�ludin �r�aneso Statue #176.182. <br />Signatorc <br />Date _ � � � � <br />If' completed li�ense sl�ould be mailed some�vl�e�•e other thar� the business address�, please advise. <br />
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