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2004_1108_Packet
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2004_1108_Packet
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� <br />� } � <br /># T � <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 />a�s�i�l�arn� .����"� �. � �rp.��� <br />r� <br />1#uei�rss A�dr�� <br />T �� + � ����� <br />Business Phone ��t1.'`� . ���.����i � <br />Person to Contact in Regard to Business License: <br />� ._f� � : r <br />Name • � � � � ��-,�� <br />Address .�'r ��'� ��� ._ �����._�}�`'��� _���f <br />Phune ���� ,.��� }���� _ - <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, _��, and ending June <br />30J1�� ���_, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Repuired Fee <br />Cigarette/Tobacco Products $100.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota S�at�� �� � 182. <br />signature .�• <br />Date �� -,�.�-d��/' Ci _ <br />If completed license should be mailed somewhere other than the business address, please advise. <br />
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