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���� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55].13 <br />(651)792-7032 <br />Cigarette/Tobacco Products License Application <br />�W�irl�ss ��mc <br />�u�iness Ad�r�Rs <br />Bu��ne9s Phqrte <br />'� 5_ 1 � i •4 •'t <br />�'�'� 4 � � ' �° 4 — <br />_ �_ � ��T��;' �-+i��` � • --•• - — <br />�� � ��i�ti , L � � � r�� � • 4' �--�� � i i � .�,-.r <br />, - �� �.-, <br />��� ` _ � ���;,`��L-� _�.�_.�.�_ _ _ <br />P�r�sarr �� �`��r��cd in i�e,�ax� �r� ��r.��rt�SS �..h�,�e+r,��; <br />� il 111 � <br />� ddr� <br />Phone <br />_ �� -�'�. L� +.S �+I �/ f� 1�. �� � <br />�•� � . <br />S-� � <br />— —� 1 � � � �;' � � i� �. �t• �t�, w � � � .� 4� �• <br />..� �� � {_�� <br />��• �..•` �f' i x •f� :•k' ti' � � 1 � � <br />I hereby apply for the following license(sJ for the term of one year, beginning July 1, ��, and ending <br />June 30, :-��, ., ,� t, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Cigarette/Tobacco Products <br />Eee <br />$100.00 <br />The undersigned applicant makes this application pursuant to a11 the laws of the State of Minnesota and regulation <br />as the Council of the City of Roseville may from time to time prescrilx, i udi .�'linnesota Statue �# 176.182. <br />�~ ����� <br />Signature �-��>: � <br />„ . <br />� ' • + r. • :. <br />!]�le ��s �--„`� rf--, -- <br />If completed license should be mailed somewhere other than the business address, please advise. <br />