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APPLICATION FOR LICENSE TO <br />SELL TOBACCO PRODUCTS AND <br />TOBACCO RELATED DEVICES <br />(Ordinance No. Second Series - Adopted 12/08/97) <br />Make check payable to: City of Orono <br />Mailing address: P.O. Box 66 <br />Crystal Bay, MN 55323 <br />1. <br />2. <br />3. <br />4. <br />FEE: $100.00 (February 1-January 31) <br />Applicant's Full Name <br />Ai/^. <br />X- T? <br />DATE <br />/}^ Ay <br />FIRST MIDDLE LAST <br />Applicant's Home Address <br />•;OUSE NUMBER STREET <br />/y? <br />CITY STATE <br />HOME PHONE <br />o-TAircr ' Titi f <br />Applic^t's Business <br />y/,./ /;/ <br />L■fr/ <br />MAILING ADDRESS <br />BUSINESS PHONE <br />STREET ADDRESS <br />''CITY <br />Describe how the actual physical exchange of the tobacco, tobacco product, or <br />tobacco related device between the cu^omer and the licensee or employee takes <br />Diace. 5:^/ /-7 ___________ <br />I HEREBY MAKE APPLICATION FOR UCENSE TO SELL TOBACCO. TOBACCO <br />PRODUCTS. OR TOBACCO RELATED DEVICES AT THE ABOVE LOCATION SUBJECT <br />y-y<-^ <br />Date X <br />The Issuance of a Bcense under this ordinance shall be con^dered 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 />12US7.3