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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 />Amusement Device License Application <br />Business Name �c� S � f} � �� ��C. � � � �/� `2° �� � <br />Business Address � �p �p f � i � / � � � -p �� ,��� <br />�r� � �� �` ��� � . �.�! ,���� � - <br />Business Phone � ��� !�/ ,$ y <br />Person ;:� Contact in Regarcl to Business License: <br />� <br />Name � � �.' � � - s� � r�.{ _W � <br />Address - <br />--•--•- - --._._ ... �� . _.! _ <br />Phc;nt <br />I hereby apply for the following license(s) for the ternl of one year, beginning 7uly 1, ��� �, and ending <br />June 30, � G t s'""", in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required <br />Amusement Device <br />Eee <br />$is.00 <br />(per machine) <br />fD"� T�C�� <br />/D ���.��' <br />The undersigned applicant makes this application pursuant �t� all �i� �]�v��� �<<f�r �I�i� ��r �rfi���yc5�7� ;sr��9 ����,;r�iiuis <br />as the Council of the City of Roseville may from time to time r��Ti� ir��l udinb M i nnr� �L,i � a�u� � L��. i$,�. <br />� � � _��rr ���� } <br />Signature� �� � �� �� � "� � � <br />��SCL` � fF ���� �J �5 � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For otfice use onlv: <br />: ,.,. .-,�:'_...•.:•,,. . ,� SL•,'�.:����� <br />. F:,' .4,, r-t,.� � n <br />; ���'�.,-��":'?�-`.� �-�'�" ; <br />.�, ��� ���• <br />�;��,;t•�� , ���__. . a�- .� _ �� <br />