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�� <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 Byerly's, Inc. <br />Business Address 1601 West County Road C <br />Roseville, MNII 55113 <br />Business Phone �S�—���_�a4g <br />Perso» to Contact in Regard to Busiriess License: <br />Name Fred Miller <br />Address <br />Phone <br />I hereby apply for the following license(s) for the•term of one year, beginning July 1, 2004 , and ending <br />June 30, 2005 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />Licease Reauired Fee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the Siate of Minnesota and regulation <br />as the Council of the Ciry of Roseville may from rime to time prescribe, including Minnesota Statue #176.182. <br />Signature v"�� l`"'� �� <br />Von P. Martin, Sr. Vice President, CAO <br />Date 4/5/2004 <br />If compfeted license should be malled somewhere other than the business address, please advise. <br />