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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 />Cigarette/Tobacco Products License Application <br />� U31=L��5 �r]P_7l: <br />�U$I]1Crs.i �L{��T�SS <br />�Ll$Il'iL`SS ��7{}Ilt <br />--�; � ,. �� , ..� � �` � , � ., -: i�-r.��_ -�� �.� � ; � <br />� L_� � �. � �i� y� � i� � � Ll r �-J—�. <br />��:s�� . 1'� �.�- �•r {�! '�~� � 1 }� <br />ti i � I � � ` 7 <br />ti' 4��a:..�� .J �� ` � <br />{�N+•5•{}�� l0 CO)liQCl :r2 �;L'�L7�'C,� l0 BZlS1i22SS I,1C272S2: <br />Name _ •i� ��� �� � �� � r ta.� ��r���x .���� - -- �.r� ��. � � � l � � c� �,� <br />� <br />.�1�{�C�SS ��:,��. 'k. � �[L.� 1'4 t�a 4 t� �.ifx� .� ] � �,� ,- — <br />, �. —. <br />Phr�nc `�� 5 7.r - ri � �� - � � �-�- <br />I hereby apply for the following license(��or the term of one year, beginning July I, ��`� � , and ending <br />June 30, �-_ �:'� , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required <br />Cigarette/'I'obacco Products <br />Eee <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 # 1�6,182. <br />F• <br />� a <br />Signature i'.� ti�,..�_ . ���.t�:.rr��. } <br />i <br />� <br />Date �_ i��� <br />If completed license should be mailed somewhere other than the business address, please advise. <br />