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1. <br />I Ml&K <br />APPLICATION FOR LICENSE TO <br />SELL TOBACCO PRODUCTS AND <br />TOBACCO RELATED DEVICES <br />(Ordinance No. 1^4, Second Series • Aldopted 12/08/97) <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) <br />\“VcO <br />DATE <br />Applicant’s Full Name <br />^oUaJ________A I CM A&/£ui-J~IUA- aJ <br />FIRST MIDDLE LAST <br />2. Applicant's Home Addr^s <br />HOUSE NUMBER <br />!\aaPls^ <br />r^s , <br />Kki\}r,tiui c-ri.) La-aj £- (/'o I rv-S 39 9 <br />STREET HOME PHOJ^E <br />k\ fK.56,9 <br />CITY STATE ' <br />3. <br />4. <br />Applicant’s Business <br />TYPE OF BUSINESS <br />D ^/U / iu4^/^________ <br />BUSINESS NAME <br />-f--?! - o <br />BUSINESS <br />& <br />ifS3? <br />MAILING ADDRESS 'CITY ZIP <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. 0.^gaJ ^ <br />^Ji<i (Tfhu -1 ^4,^. • ^ ^-------------------------------— <br />/ HEREBY MAKE APPUC^TION 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 />Date <br />7778 issuance of a license under this ordinance shait be considered a privilege and not an absolute right of the applicant <br />and shall not entitle the holder to an automatic renewal of the license. <br />121107.3