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��� <br />��� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN Sa113 <br />(651) 792-7032 <br />CigaretteiTobacco Products License Application <br />,�� �� - <br />:�.;k.;i:: a ��3.i:_ �—''���-� � �'-��•�', { •� --•� �•�-- — - • <br />c. J+ �E � <br />Business Address � �,�'� . _ � �,rl..�� ��_ .�_ _ _ _ <br />r <br />- � - - ��`.�a `:_� ���� � � � �'��! ` -� � 7 I � <br />�- � :��� . e. <br />Business Phone . ��_7 �.,i� ��_� � .�_�� � � , _ : _ <br />Person to Contact in Regard to Business License: <br />T�cir� iti <br />- - - - ��--- � I�at� ��ef�IT �e�i <br />�c.��r�ss �.6�iC�. �[�� <br />7� ��:�,;�.� <br />��td� ��, ��d �5� <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, �-.�-�-�-'�'j` , and ending <br />June 30, _��f�}.�_, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required Eee <br />Cigarette/Tobacco Products $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 prescribe, including Minnesota Statue # 176.182. <br />Signature { =�� ~�� <br />Date `"�.� �' -����- .��r <br />lf completed license should be mailed somewhere other than the business address, please advise. <br />� � �� '' �5 � ��� � - <br />� <br />� � <br />