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1. <br />2. <br />3. <br />4. <br />F)C^. <br />APPLICATION FOR LICENSE TO <br />SELL TOBACCO PRODUCTS AND <br />TOBACCO RELATED DEVICES <br />(Ordiiuocc No. 164, Second Sertei • Adopted 12A)8/9t) <br />Make check payable to: City of Orono <br />Mailing address:P.O. Box 66 <br />Crystal Bay, MN 55323 <br />FEE: $100.00 (February 1-January 31) <br />DATE <br />Applicant's Full Name <br />CO ifK-t.'-/ <br />FIRST middle last * <br />Applicant's Home Address <br />a O g.-/g-y fiJj/'A.Jl <br />HOUSE NUMBER <br />k <br />ME PHONE <br />CITY ^ ZIP <br />Applicant's Business <br />Bs^tr_____‘i^X • J-75^ <br />TYPE OF BUSINESS <br />Pit 010 9 <br />BUSINESS NAME <br />BUSINESS PHONE <br />r-3 90 V Of. <br />ST^ET ADDRESS <br />MAILING ADDI^SS^ ^ <br />Describe how the actual physical exchange of the tobacco, tobacco product, or <br />tobacco related device between t^e customer and t^ license^r ^pioyee^kestobacco related device between the cus <br />place. <br />+ n /- /j- \ _________________ <br />I HEREBY MAKE APPLICATION FOR LICENSE TO SELL TOBACCO. TOBACCO <br />PRODUCTS. OR TOBACCO RELATED DEVICES AT THE ABOVE LOCATION SUBJECT <br />TO THE LAWS OF THE STATE OF MINNESOTA AND THE ORDINANCES OF THE CITY <br />OF ORONO. <br />/x~X7-e>y <br />Data <br />lh% issuance of a license under this ordinance shaB be considered a privilege and not an absefute rfght of the appB&nt <br />end shall not entitle the holder to an automatic renewal of the Itcense.