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Business Name <br />Business Address <br />Business Phnne <br />� ', � II <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />Amusement Device License Application <br />Radisson hotel <br />2540 North Cleveland Avenue <br />Roseville MN 55113 <br />(651) 636-4567 <br />Person to Contact in Regard tv Business License: <br />Name <br />Address <br />Phone <br />Theisen Vending Company (Denise Matrious) <br />3800 Nicollet Avenue South Mpls. MN 55409 <br />(612) 827-5588 <br />I hereby ap�ly �for the following license(s) for the term of one year, beginning July 1, 2 0 0 4 , and ending <br />June 30, � , in the City of Roseville, County of Ramsey, State of Minnesota. <br />Lice��se Required <br />Amusement Device <br />Fee uanti Total <br />$15.00 4 �0 . 0 0 <br />(per machine) <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and reguIation <br />as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue # 176.182. <br />Signature <br />Date <br />../1� %'7 �l %��-_. <br />A�r�5. 2004 <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For o�ce use only: <br />