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� <br />� <br />� <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 />����� �v�t �� �: I�� �' �. _ ±��� <br />E�uskn�a� �dctnc�s � � � � �� ��`7� I� � �+��� . _� . � <br />� �._ �� � � � �� � ��_ _ � . — <br />Business Phone <br />Person to Contact in Regard to Business License: <br />Name <br />Address <br />Ph�r�e <br />�� ���� � <br />—����—� ����—� �r+� ��—��� � C-z9 � T - 7 �� - �/ � y <br />�'���. _.. �v�� <br />I hereby apply forthe following license(s) forthe 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 <br />Amusement Device <br />F� <br />$15.00 <br />(per machine) <br />uanti Total <br />� O• D� <br />The undersigned applicant makes this applicationpursuant to all the laws ofthe State of Minnesota and regulation <br />as the Council of the City of Roseville may from time to tim��, inc Lu � g Minnc�p� ���t � �'�+�. I�. <br />Signature <br />Date �����"� . _ _ . <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For o�ceuse onlv: <br />