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A. <br />� I <br />City uf Roseville <br />Finance Depart�ent, Lice�se Divts�un <br />2660 Civic Center Drive, ltoseville, MN 55113 <br />(651)792-7032 <br />Cigarette/Tobacco Products License Applicati�n <br />Business Name <br />le. <br />Business Address � 7 7 �� ! l!/� L�r/ /yy�. <br />i2a <br />S, <br />Business Phone �o s � � �.6- y�q � _ _ _ <br />Person to Contact in Regard to Business License: <br />Name i��.n/ sritowQ ��'� <br />Address �- y�f � � T a � ��1�i2/ti <br />Phone <br />I hereby apply for the following license(s) for the tcrm of one year, begianing July 1, ,��, and ending <br />Juno 30, �, in the City of Roseville, County of Ramsey, State of Minnesota. <br />Licenae Reauired Fee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursusnt 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 pres ribe, including Mi ota Statue #176.182. <br />Signature <br />Date �/��l%y <br />If completed licen�e should be mailed somewhere other thaa the business addresa, please advise. <br />