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� ��y �l I <br />' ■IIIi <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 />��;���.i ' 14�;;4�; i. ; .;.: �.a::��: [ _ � <br />.1 ��i H 1 • <br />�I1TTF.� M�T 5$�.�,.�F�.] <br />651-�+8�}1108 <br />Persoir to Contact in Regard to Business License: <br />Name �'�S �i�R fo�' 3�Y S�RAMRIC'A ILC <br />Address <br />Phone <br />•� :�� c� �a , ra� ��� i r �� �� i � � :� <br />.r� ;��+i� <br />�—'�'-- �:��e�� <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, �4 , and ending <br />June 30, �05 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Cigarette/Tobacco Products <br />Fee <br />$100.00 <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 rime to time prescribe, including Minnesota Statue #176.182. <br />Signature �,-��� License Coordinator <br />�— <br />Date �l�i- �O <br />� <br />If completed license should be mailed somewhere other than t6e business address, please advise. <br />�•�5� �� � i•a� � a� i � <br />� � :�� :� t�a , �a• <br />��' � r �9 � � � 1 1 `:1 <br />