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2002_0610_packet
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Lj� <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 490-2212 <br />Cigarette/Tobacco Products License Application <br />� �� . . <br />Business Name <br />Business Address / /%%/ /.r1J � C,c% � <br />�'���"e �%� � ,�? •�.�' ,��'��3 <br />Business Phone � ��/ , J ��r:s '" ���� <br />Person to Contact in Regard to Business License: <br />,�t� � <br />Name C.� �� � • �•� <br />Address �( � �hj7 �, �.t�'.. <br />Phone ���� / ,�C� l..'`���� <br />�/�+'C�'`'�J'`�..�YI /� y �%'�t✓ J /,/�i <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, 2002, and ending June 30, <br />2003, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Required 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 <br />as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue # 176.182. <br />S igi�ature / <br />Date CJj '"" r� �,� �� � <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For o�ce :�.se only: <br />
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