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�h�Si�rC9� �nme <br />Business Address <br />Business Phone <br />� ' � � <br />� f� <br />��L�. T � � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />Amusement Device License Application <br />������ <br />� � / � �..r� , �.1.,�.� ��� �4-[� . <br />� S�� r �� �,. �� ;�� a 3 <br />�4 r ��i�� �#r��� <br />Person to Contact in Regard to Business License: <br />��mt� � �����a <br />Address � � � � � � ���f ���� <br />�I it��7t. ��> r � � '� �. . � �; t, �r <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, '�� �, and ending <br />7une 30, �..v� �, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Amusement Device <br />Fee <br />$15.00 <br />(per machine) <br />uantit Total <br />� ��8� <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 />I�a[e � �� ��� <br />If completed license should be mailed somewhere other than the business address, please advise. <br />. •r � . � . <br />� � � } `� <br />F ,,�,• <br />�}�!'.4J:;I�ti rr' ' ._ � t .. �l . <br />