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Page 1 of 1 <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 />���Ifl�$ ��fi� _� � � � � � ' }� � � � c �s rrt •+lrr s � � � �f } - <br />Business Address r_� � � � � �I ��� �� � � � �'.� �_. „ . <br />�� <br />�� ����.��..�. � ���� <br />Business Phone �� � " i'l � J •— � � .'7 � <br />Person to Contact in Regard to Business Licerrse: <br />Name , �� i � � L � �� 1� �� �U �' <br />. <br />Address _ . r <br />Phone _ <br />� <br />I heret•r aF�, � for the following license(s) for the term of one year, beginning July 1, '� , and ending June <br />30, _'�, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired Eee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Mimlesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue #176.182. <br />Signature <br />Date �#��I � � � � �.� �r <br />I f completed license should be mailed somewhere other than the business address, please advise. <br />�� �€��. �'''�°`� i � �'�--� � ���� ��� � i � �� �' �,� ��-,� � �,Y Sm � �,� <br />�,��,.'�trt��� �X �'� €�,� �v� � <br />http��Iwww_�i_����ill�,�.us�f�na�cr�liucnsc��as_st�li�,p�df ���?�� <br />