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APPLICATION FOR LICENSE TO <br />SELL TOBACCO PRODUCTS AND <br />TOBACCO RELATED DEVICES <br />(Ordbuiin No. 1«4, Stcood Scries • A'dopicd U/M/97) <br />Make check payable to: City of Orono : •-•sO <br />^.1;*! I y <br />Mailing address: P.6. Box 66 ’ . <br />Crj'stal Bay, MN 55323 ->-.0 <br />1. <br />2. <br />FEE: $100.00 (February 1-January 31) <br />Applicant's Full Name <br />HJjAm _____W, <br />FIRST MIDDLE <br />Applicant’s I- ome Address <br />rlaoKhpyf^ Hj <br />HOUSE NUN <br />_=£iC3 <br />CITY <br />.'.9ER <br />UlXL <br />STREET <br />55354: <br />STATE ZIP <br />DATE <br />Id LAST <br />4>).'3-4^3-4cgo <br />HOME PHONE <br />3. AMlicant’s Business ri4-_i . <br />I on\nekit 4 S QaXUjfl <br />4. <br />TYPE^ BUSINESS f) ^ <br />Qrrnr, Sfc- 4- ^xm <br />BUSINESS PHONE <br />BUSINESS NAME — <br />Rt'.RiOX <br />Lr;iU<, IflKg- <br />ING ADDRESS <br />STREET ADDRESS <br />M <br />MAILING ADDRESS CITY <br />Describe how the actual physical exchange of the tobacco, tobacco product, or <br />tobacco related device between th^ustomer and the licei^ee or employee takes <br />piace._4 r r-b n t-e JbU OSS------------ <br />f iTdKl^Vp'ft- AV^r- UhinH -thf . fl ----------- <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 />Date <br />The Issuance of a license under this ordinance shaft be considered a privilege and not an absolute right of the applicant <br />end shall not entitle the holder to an automatic renewal of the license. <br />131197 3