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2004_0510_Packet
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2004_0510_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) 792-7032 <br />(��gare�ie/'Tabacc� Products License Application <br />131i�iiti�ss C��tm� '�,k,��:.� � ;�� <br />�3 usir�ess t1d�r�Ss 1 � `1 � L��3` •��y �r�� �,,.� <br />�+�3+f.�',��?�,� �� 1 l?s _ _ . - — <br />� <br />:��,�fi:�,t��C r,'s7!I� �.<Y,� �..� � - �h`���._. _---- <br />Pet�so�z to Contact �r� Regard to Business License: <br />�tl;;'.l' <br />Address <br />�i f <br />� .i7' �} �'�" d�'�f {r _:.�� yl - - � ��� 4,:[:!f � i�-._ ��� � <br />� <br />�� L?r� ��..? 1���'" �tsSU ,�.. r4� �I.i —���7 <br />�f[{1RC �L-�� _��.73� - - <br />� <br />I hereby apply for the following license(��or the term of one year, beginning July 1, A��c.,<� , and ending <br />June 30, ��+t� •; , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License IZequired <br />Cigarette/�'obacco Products <br />Tiee <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 prescribe, including Minnesota Statue # 176.1$2. <br />%� i '' <br />�r K, ; /F `� . . <br />Signature • �� , �°r r <br />.f <br />� t ✓. <br />Date ;��. � � _� .i <br />If completed license should be mailed somewhere other than the business address, please advise. <br />
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