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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN SSll3 <br />(651) 792-7032 <br />Theater License Application <br />� _ <br />Business Name �+� � I _ �-�,�+-f� r � <br />Business Address '�' + <br />IYJ-+�� <br />J <br />`�-�'� � ��� � <br />��� ��� _���� �� - �� �� .. . . _. <br />Person to Contact in Regard to Business License: <br />Name l�+�t�P� �" � � ���+' � _ _ `#� �� . ���� ��-+�Tr � <br />_� <br />Address _ � �� � �.'� �?�� <br />� � - - --- <br />Phone _ � !-�� ��� _ � F � � � _ <br />I�t��w �:}' f the following license(s) for the term of one year, beginning July l, �'� "' and ending June <br />��, �,�in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Repuired <br />Theater <br />Fee <br />$70.00 <br />(per screen) <br />u a tLt+� To[�E <br />— ��� <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time prssc ' e, including Minnesota Statue #176.182�.. <br />Signature ����� _. . , <br />1��. <br />Date ' � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For office use only: <br />€��cipt � — - -- <br />