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Attachment A <br />Cit�r of Roseviile <br />Finance Department, License Divis�on <br />2G60 Civic Ce�ter Drive, Rosevil�e, MN 55113 <br />(65l ) 490-2212 <br />Off-Sa�e 3.2 Nlal� Liquor License Applica�ion <br />Business Name ��p�Jje, ���j�j{�,�eLi���' g,�Q_ . <br />Btisiness Address ! S � � � � W� '��:, S� C� . � (���_ <br />��.��u � It �e. . M t� � S � �?� . ---�— <br />Business Phone � -�' � �j — 3 � � <br />Pe�so�r to Cnntact if� Regar-cl to I3usilress Lice,�ise: <br />Name <br />Address <br />Phone <br />� �� ���� <br />Drivers License Number <br />Social 5ecurity Nuinber <br />Date of Birtf� <br />lf yes, date and place: <br />1 hereby apply for the fol�owing liceilse(s) for the tern�� of one year, be�;inning .�tiiy I,. ZQ(� , and ending <br />Ju��e 30, ��, tn [!�e City of Roseville, Cotinty of Ramsey; Sfate of Minnesota. <br />1,icense R�c��uired <br />Off-Sale 3.2 vlalt �,igu�r Beve:-a�e <br />Fee <br />$30.Gu <br />�he undersig�ied applica�it makes ihis application }�i�i-suant ta al[ tl�e laws of the 5tate of Minnesata and re�ulatio�i <br />as the Council of the City of Rose��ille may froni time to tinle prescribe, including Minnesota Statue #176.] 82. <br />� <br />Sig��atirre � f�e�l.� � <br />Daie �.�� � �-- � C� � _.— <br />Ff completed license shau.id be mailed somefvhere other t.han the business address, please advise. <br />Fo�• oJfice use a�ly: <br />Receipt # <br />,-"- j <br />