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7 <br />1. <br />2. <br />3. <br />4. <br />APPLICATION FOR LICENSE TO <br />SELL TOBACCO PRODUCTS AND <br />TOBACCO RELATED DEVICES <br />(Ordinance No. 164, Second Series - A^dopted 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 />Applicant's Full Name <br />'JoH'A/ __________^iCM-AEtC, <br />U ----- <br />DATE' : <br />Su. UA-rJ <br />FIRST MIDDLE LAST <br />Applicant's Home Addr^s'^S ^ <br />PAMCL(4V\P-(x ) f ^/^) <br />HOUSE NUMBER STREET home PHONE <br />A^a! <br />rCITY~STATE <br />Applicant's Business <br />STREET ADDRES <br />e:^37 <br />/r\f <:uc.L \u A-i^As. <br />BU^fTNESS NAME <br />Pn Aok <br />MAILING ADDRESS <br />Describe how the actual physical exchange of the tobacco, tobacco product, or <br />tobacco related device between the customer and the licensee o^mployee takes <br />place. ‘TKL jrt^ . h/^—^ - <br />^JAVATen <br />CITT <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 />Signature Date <br />le Issuance of a license under this ordinance shall be considered a privilege and not an absolute right of the appicant <br />and Shan not entitle the holder to an automatic renewal of the license. <br />121197.3