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g� <br />.�.. <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 Walgreens#02936 <br />Business Address 2635 Rice St. <br />Ros�ville, h�T 55113 <br />Business Phone 651/483-3673 <br />Pe�so�i to Contact in Regard to Business License: <br />Name ' Beliixl�_ Dar�cv, Tax Msnager_. <br />Address P.O. Box 901 Deerfield IL 60015 <br />Phone 847/914-5413 <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, 20Q�� , and ending <br />June 30, 2�5 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired Fee <br />Cigarette/'Tobaceo Products $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 ofthe City ofRoseville may from time to time prescribe, including Minnesota Statue #176.182. <br />Signature v"'L'��t�- rc.�-ti '� � <br />Bel.inda Dancy, Tax er <br />Date 4/9/2Qpl+' � <br />If compieted license should be mailed somewhere other than the business address, please advise. <br />