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Attachment A <br />�'�I� . <br />City of Roseville <br />Finance Department, License Division <br />2650 Civie Center Drive, Rosev�lle, MN 55113 <br />(651} 792-7036 <br />Cigarettel'I'obacco P�-oduc�s I�icense Applicafian <br />Business Name %� � �i !�(/1`n �e a- S�; r, fs, �ijit� - �yQ %?i �/ �✓f � jt � ; �7/l / fs <br />�_ <br />Business Address % � � % �lL: t' -��'.��� ��/�,. � ���.� v�'��� �L.J� ss—�13 <br />$usiness Phone / v a ��/7.� � <br />Email Address <br />Person to Contact in Regard to Busrness License: <br />Name <br />Address <br />Phone <br />� <br />, <br />� . <br />0 <br />r hereby app[y for the following license(s) for the tert� of one year, beginning July 1, Q J, and ending. June <br />30, �,Q / � , in the City of Rosevi.Ele, County of Ramsey, St�te of Minnesota. <br />License Required <br />Cigarette/Tob�cco Products <br />Fee <br />�1oa.ao <br />T'he undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and re.gulatian as <br />the Council ofthe City of Rosevrlle may from ti7ne to time prescri , includi g Minnesat tue #176.182. <br />Signature <br />Date G �� —Q.9 <br />If completed license should be mailed somewhere other than the basi�ess address, please advise. <br />