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� ' �►1 / <br />�"�J��� - � ' � II Il <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 />— - ---__ --------------_---------- __ ----- --a <br />Business Name <br />Business Address <br />Business Phone <br />�VVY��� ` (�Y�:11Y� �. � ���: ` ��Y��UY� � � <br />2785 I�i HAM.Il� AVE <br />Ii7�7VILIE, MJ 55113-1755 <br />651-631 121+1 <br />Person to Contact in Regard to Business License: <br />Name �II�P1S AIkX�iIIt foic' �TAY 3�RANFRI�CA II� <br />Address <br />Phone <br />�� :�� :� •o .� �a� �•� i r �a � � i � � :� <br />937�8G3-6473 <br />I hereby apply__for the following license(s) for the term of one year, beginning July 1, �`+ , and ending <br />June 30, �5 , 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 time to time prescribe, including Minnesota Statue #176.182. <br />Signature��� License Coordinator <br />Date � �'/�%/ �9- <br />�- <br />If completed license should be mailed somewhere other than the business address, please advtse. <br />�. �a� � � i• a• � �• � � <br />� • :�� :1 [MD , r�• <br />�.. � r i� �� i� � :� <br />