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2004_0614_Packet
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2004_0614_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 />Cigarette/Tobacco Products License Applicati�� <br />Business Nanie � � �'�+ � � � k � �TM_ ���I ' �, r-� � ,�- <br />L _ i � `}� <br />�,LJSIlYi�R i���14SS �- �-j�. �- �� _ �'� s�{vT � L '_},� � ,�-� r 1'� r ��� <br />� I �,_r�� }�_ � <br />�_ �� ��• �_ _�r � r �� � � �r� F-��. •• - � � � <br />�" � - -----.� <br />Business Phone ��� � `_'>� 1 --- �� � � " � r �_ �� _ __ <br />Pe�son to Contact in Rega�d to Business License: <br />Name I�' �� (/�r-_I � k�'� M���=� ��-t-.--�. <br />��dre�s '�- � . -a �i . �'_ c -� � �_-�; � � ������ i�l �� �� <br />. _�,. <br />� <br />Phone �-� '- � �-.�w� � t_ �� , �� �� �� ��� t 1 Z_ - <br />�_�' a y — �,�},�� — c'_�I �.: � � . <br />I hereby apply for the following license(s) for the term of one year, beginning July l, ���-�` �, and ending <br />June 30, ����� , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required <br />Cigarette/Tobacco Products <br />Eee <br />$100.00 <br />The undersigned applicant makes this application pursuani ic� .� I I iho I a�+� oi i�7c �iak� u� M i nn�so�,i �,nd re�ul��ioi7 <br />as the Council of the City of Roseville may from time to ti���c �r�s� i i , ia�lu�ingr�iiflr� � ��]��, I 8�. <br />�.._ �. <br />Signature 1 �` ' ?�_ . � <br />Date : "_- ' :� �� _k"�. �� ' , <br />If completed license should be mailed somewhere other than the business address, please advise. <br />
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