Laserfiche WebLink
k� f,�. <br />L �� � <br />� ; � 7 � �� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />Massage Therapy Establishment License Application <br />Business �#t� �-�'J_ �������? .�1�� � . - -- -- — - -- - <br />Business Address �� � ������+ . � <br />Busniess Phone �, � �r� � �� � �l� � ,� �, . _ , _�, , , <br />Person to Contact in �� to Business License: <br />L�airac � �� � � �� <br />��- <br />Address � �� ��� i� � -����}„� ��_ <br />,� ���� <br />Phone c��� ��„' _��,�� Date of Birth � <br />. , .-. <br />Drivers License Nuniber _ _ <br />Social Security Number f �� <br />. � <br />U.S.Citizsn? ' ��95 No Naturalized? <br />If yes, date and place: <br />�5 No <br />I hereby �pply for the following license(s) for the term of one year, beginning July 1 ���� and ending June <br />31, �'��=,;- in the �t}� of Roseville, County of Ramsey, State of Minnesota. <br />License Required <br />Fee <br />Massage Therapy Establishment $300.00 <br />$150.00 Background Check <br />(new license only) <br />�IM4 undersigned applicantmakes this applicationpursuant ta �1i rha �aw� o�F t4� ��hG o�f' I►+li�v�enra an� re�u3eti�i� a�s <br />the Council of the City of Roseville may from time to time �er�, i�c 5 � �?f�_18�_ <br />Signature <br />Date � � _• �� <br />i�' completed license should be mailed somewhere othet'than the business adtJre�s, please advise. <br />