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, `'l�- � ' I � Il I) <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651)792-7032 <br />Cigarette/Tobacco Products License Application <br />Business Name <br />Business Address <br />Business Phone <br />�• 5�� - �• a• ��' ..: `• �• �• .� <br />.+� � F tir�a� <br />l:J:�,/� v� 7 �IC <br />. : � <br />Perso�r to Contact in Regard to Business License: <br />Name �S AL� f�' �AY �CA LLC <br />Address <br />Phone <br />� � :�� :1 �� , r�� �•• � r� �� ► � � � 1 :� <br />� :. . <br />I hereby apply for the following license(s) for the term of one year, beginning July l, �0�+ , and ending <br />June 30, �105 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Cigarette/Tobacco Products <br />Fee <br />$100.Q0 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation <br />as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue # 176.1 S2. <br />Signature�,�,� i����- License Coordinator <br />Date Q'�l' DiO���" <br />If completed license should be mailed somew6ere other than the business address, please advise. <br />�•aa� � � i�a• � a� <br />• � :r :� ��a .� �a• <br />�^ i r �a �� �� 1 :1 <br />