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��� , � <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 />- , I . � . _ �.. <br />:}.:.ti�.l.:�.3 �t]�71•.' ___ 4�-"'ti'��• '.ti . ..�s� . i 5 �L� � y�� <br />F1 �a51 OCS5 �4�{I r�8� .� �- � I � ,� ��F� f . i ���, '�I 1�r f� • <br />I <br />� � ��-„�� : R . I t� ��' a�+' .,�t , �,. �- � - � - <br />� � ' '`� - � � �� <br />13�;��a�;w FI7�I71: . _ .,.� �� I " k., � � � <br />Person to Cvntc�ct �r� Regar�ct to Ba�siness License: <br />a- <br />�'.y. �5•.• � ` � ��� ��, ��� � • � � �ti �'�1 <br />- - --. .. -- — �. .--• •- - <br />Address <br />i ii� � L <br />�— ; <br />� r <br />' i'�-� '—•i�l'��'��•i����'� <br />��j � � — � 5 : � _ �1� � �, _ <br />1 <br />� I �;_. r . , _ ,_ r� � <br />I_ � r , �,i �k�—•�i��', :T....��51�:--�4 _•_r;—� — <br />I hereby apply for the following license(s) for the t�{ IS3 of one year, beginning 7uly l, _? �: �.� • i- , and ending <br />7une 30, .�.';r � , in the City of Roseville, ��u�itv of ]�ar��RCU, State of Minnesota. <br />License Repuired <br />Cigarette/Tobacco Products <br />Eee <br />$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 of the City of Roseville may from time to time-pres�,�ih�, including Minnesota Statue #176.182. <br />� � r � <br />Signature ��..�_- � �r-- _— <br />_ - r � <br />� <br />Date r;��..rr r� �� <br />'i ' 1 <br />Zf com��leted license should be mailed somewhere other than the business address, please advise. <br />