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`. <br />° City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 490-2212 <br />Amusement Device License Application <br />[3usiness Name .��-r� %�I ���P,+ �%(�,� �/i�� i' <br />Ciusiness Address �!%�i��+ � ! i 1 �l i'` � i'� iP `�'1 �f' �r ��1�� 1)P J <br />a � .a —,- � � <br />��]�l l� ��1Mrt 1 <;�1�3 <br />� ,� � , , , <br />Rusiness Phone /n ) � — � � '=� — ,� %l^ � <br />Fer�an �o L�oi�lC7CI in Regard to Business License: <br />N a m e �!' (7t2:r ('a �l,l�� <br />� ..., <br />Address _ <br />Phone � <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, �(1��? n d ending <br />June 30, �(J , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Req uircd Fee Ouantitv Tot:il <br />Amusement Device $15.00 �_ �• ° -G�(/ <br />(per mnchinc) <br />��—. <br />"{�Ite undersign�d appliCaitt makes this application pursuant to all the laws of' the State of Minnesota apd regulation <br />`as the Council of the City of Roseville may from time to time pres , includin�Minnesota Stalu� # 176.182. <br />Signature d'�� ��{'-� <br />Date ���i�L7� <br />If completed license should be mailed somewhere other than the business address, please sdvisc. <br />Foro,�,Jice use only: <br />h ,Fs n n � �+ .J. ' .�' hh � + �. <br />� $� � r � <br />r f�p �`v"��°`"� ���;?�Zt�f Fn r �����n����t <br />�vtza.s� x��M<'" �'6 ,.'. � � 1 {4. , <br />