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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />PooUBilliards License Application <br />Business Name O 1 d Ch i c a g o <br />IIusiness Address 2100 N Snelling Ave <br />Roseville, MN 55113 <br />Business Phone ( 651) 639-0303 <br />Pe�son to Contact in Regard to Bi�siness License: <br />Name Stephanie Devine <br />Addcess 248 Centennial Pkwy, Louisville, CO 80027 <br />Phone ( 303 ) 664-4083 <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, 2004 , and ending <br />June 34, 2 0 0 5 , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required F�e unnti Total <br />PoolBilliards $70.00 (first table) �_ <br />$20.00 (each addirional table) <br />The undersigned applicant makes this application pursuant to ail the laws of the Sta Minnesota and regulation <br />as the C�uncil of the City of Roseville may from time to time prescribe, in � i esota Statue #176.182. <br />Signatur / <br />Date <br />If completed license should be mailed sornewhere other han th usiness address, please advise. <br />For• o�ce use only: <br />