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2004_0524_Packet
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2004_0524_Packet
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�� <br />l+ <br />����_ � � _—� � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN ���13 <br />(651) 792-7032 <br />Cigarette/Tobacco Products License Application <br />Business Name <br />Business Address � � �� �. �.� � � _ ' r <br />.. _ _�LJ��...�� � � � _ � <br />r <br />Business Phone (�� 1 ' ^7 V � ' � `�.. � � <br />Person to Contact in Regard to Business License: <br />1 . � <br />Name <br />Address <br />Phone <br />� <br />.��.1 <br />I hereby a�1}' for the following license(s) for the term of one year, beginning July 1, –��—, and ending <br />June 30, ���, in the City of Roseville, County of Rarnsey, State of Minnesota. <br />License Required Eee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this applicationpursuant 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 />� <br />� r� � . ,r <br />Signature ,� -� �' � �J � ' <br />i- <br />Date ;� ��� � � �. • �� <br />If completed license should be mailed somewhere other than the business address, please advise. <br />
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