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CzTY OF ROSEVILLE, MINNESOTA <br />-�OR PAWN SHOP/PRECIOUS METAL DEALER LTCENSE <br />Par� � - G�neral Info�a�ion <br />fJanuary 1, 2010 �hrough Decemb�r 3�, 20�0 � <br />DireCtions: <br />Please complete with typewri�er or by prin.ting in ink. Tf the <br />application is by a natura� persan, by such person; if by a <br />corporation, by an officer thereaf; if by a partnersh�.p, by one of <br />the partners; if by an unincarporated association, by the rr�anager <br />or managing officer thereof. <br />l. Name of Applicant (name of individual, par�nership, <br />corporation, or association): <br />Pawn Arr�erica Minnesota, L.L.C. <br />(If Individual} LAST FIRST FULL MIDDLE NAME <br />2. Name under which appl.icant wil� be doin.g business, business <br />address, and �elephone number: <br />Full Name P�� ��x�ca Minnesota, L.L.C./Pawn America <br />Business Address �g� R�ver Ridge Circle S., Bvrnsville, [�V 55337 <br />Business 'relephone 9��-��6-1760 <br />3. Type of Applicant: <br />Individua�. Partnership Corporata.on <br />Associatian Limited Liability Company Other <br />4. Type of lzcense applicant �eeks: <br />Type o� Licez'a.se/Permi� <br />Fee Per Y�ar <br />Pawn Shop . $10,OQfl.00 <br />Precious Metal Dealer $�0,00�.00 <br />XXX Pawn Shop and Precious Me�al �13,000.00 <br />Dealer <br />5. A. �f app�ican� is an individual, state full name, xesidc�nce <br />and business address, and telephone numbers: <br />Name <br />LAST F�RST FULL MIDDLE NAME <br />Da�e of Birth <br />Residence Address <br />