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01-28-2002 Council Packet
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01-28-2002 Council Packet
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1. <br />2. <br />3. <br />4. <br />APPLICATION FOR LICENSE TO <br />SELL TOBACCO PRODUCTS AND <br />TOBACCO RELATED DEVICES <br />(OnUnaiict N0. IH Sccood Strl» • AdopCtd U/06/97) <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)-N <br />DATE <br />Applicant's Full Name <br />'DAOigL <br />FIRST <br />^LoyP <br />Miooti" <br />Sc hf'Sr [/ <br />LAST <br />Applicant's Home Address <br />STREET <br />____/»A0 *____ <br />‘^<2, <417^ <br />HOUSE NUMBER HOME PHONE <br />/V\^iakjD <br />CITY STATE <br />Applicant'^ Business <br />C7 MTI <br />TYPE OF BUSINESS <br />Ltr k)iS<^ d2>JC- <br />BUSINESS NAME <br />BUSINESS PHONE <br />'DR <br />STREET ADDRESS <br />r j) fit ^ a-e -P jET SS <br />CITYMAILING ADDRESS <br />Describe how the actual physical exchange of the tobacco, tobacco product, or <br />tobacco related device between the customer and the licensee or employee takes <br />place. <br />/ 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 />/^/y at- <br />Date <br />77)« iuuvK* of a (totnsa undar tfi/a onSnanea ahaO ba eonakknd a ptMega and not an absohda right of tha appSeant <br />andahatnotanllllalhaholdarloanautomaliennawalefthateanaa.
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