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2004_0426_Packet
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2004_0426_Packet
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� '� � �' ``��- ._ <br />� �,. <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 7'92-7032 <br />�::-:'S ^' .L:. <br />Cigarette/Tobacco Products License Application <br />.__.___ <br />Business Name <br />Business Ad�ress <br />Business Phone ,�0 ��—�c� �' 1 I V' <br />Perso�: to Contact in Regard to Business License: <br />Name <br />5� <br />. <br />• �� <br />� • . .0 <br />Address �d �� 0 � �� �K%h t J-- (�'C�6x . VJ� / � �.J�� <br />Phone l �� ` �� � GlS� <br />I hereby a ly for the following license(s) for the term of one yeaz, beginning July 1, ,�, and ending <br />7une 30, ��, in the City of Roseville, County of Ramsey, �State of Minnesota. <br />License Repuired <br />CigaretteiTobacco Products <br />Fee <br />5100.00 <br />The undersigned applicant makes this application pursuant 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 prescribe, including Minnesota Statue #176.182. <br />Signature <br />Date � � � o� 1 <br />If completed license should be mailed somewhere other than the business address, please advise. <br />�0' � �o(�a- <br />.� �..�e►. � �53� <br />
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