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^CEIVS d <br />APPLICATION FOR LICENSE »2 ms <br />SELL TOBACCO PRODUCTS "an6'^°'^° <br />TOBACCO RELATED DEVICES <br />(Ofdliiiinca No. 164, Socoiid Sorlnt - Adoptad 12/06/97) <br />Make chock payable to: City of Orono ' <br />Mailing address: P.O. Box 66 <br />Crystal Bay, MN 55323 <br />1. <br />FEE: $100.00 (February 1-January 31) <br />Applicant's Fuli Name <br />_Von <br />HMsr <br />Piml <br />MinOLL <br />2. Applicant's Home Address <br />-^425 CuunLy Kaiul l^iU____ <br />HOUaU NUMlil H niKFiI <br />j;iiaoka <br />CITY <br />MM <br />»IAII! <br />55318. <br />/IP <br />.Innunry 7, 2005 <br />i)Air. <br />Martin <br />LA!U <br />952-/|/ia-5‘7‘Ki___ <br />HOMI- I’HONI <br />3. Applicant's Business <br />Krtdll Crot't’iy <br />IVIM: (H (UnilNIrSii <br />Uiukxi Hurkct <br />UUUINLOS NAMt <br />ou:jiNir.r.i*iioNJ- <br />. 3311 aiitii I'.riMl! Drlvn _ tiiMi I I ADDin sn <br />Nnviirn* <br />CIIY <br />55192 <br />211* <br />3‘M:i Went 50tli Strcut Sullo H-102 <br />MAJUNOAnoREns <br />Describe how the actual physical exchange of the tobacco, tobacco product, or <br />tobacco related device botwoon the customer and the licensee or employee takes <br />place. A want li>(^ to purclwmu tohiuTu ^>rjj«liu'l n imiHt miiioHt tlio i>r*>— <br />tluft from an fiiiployt«n. tIiw fitn>Utycc tluMi K«to prmlm^T~Toi t lu* cuHtirnior <br />LU- pUfLlm.-m..____ <br />/ ni miiY MAKt- AirucArioN roR ucensh to sru iouacco touacco <br />/ ‘liODUaiS, OH IOHACCO HI IA IN) 01 VICTS A T TIIL ABOW. I OCA TION HUBJ£CT <br />lO mriAWSOT IHL aiAlt-OhMINNTSOIAANn TUT OHOINANCLSOf TffTCITY <br />Of OHONO. <br />Jamiary 7| yPOj <br />DataGiyiiiiiuio Voii !’• Martin <br />•Saillor Vico ProNldont, (*AO <br />TTw (TkMionLO ut« iM wHhf IhiM iWiMfmth • lUm/l tm ciWMtJ&imt • prf\4hg9 mx! not an abaoMa of ttm OppSQm^t <br />9htU! not anm (ba ho/iiaf to an autonrnm ranawai of tha Hcanaa, <br />t avniiw.. i.r«.v?'r7’r.u«v 2a ir«;tiL4 w, < i c.tw