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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 />(Ordinance No. Id4, 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 />FEE: $100.00 (February 1-January 31)C - 7-9^ <br />DATE <br />A^licant'u Full Name <br />_________________ <br />FIRST ! <br />K. <br />MIDDLE LAST f <br />Applicant's Home Addres s <br />3to DAt frAauC. PI. <br />HOUSE NUWER <br />OsJ.MaL <br />STREET HOME PHONE <br />CITY STATE <br />Applicant's Business <br />&>IS Clufi ___ <br />TYPE OF BUSINESS <br />hbll Ay/'f Cl(^8 <br />BUSINESS NAME <br />'7<35^^644.A4y H4_(^____ <br />All AnnprcQ f <br />(s(3 - H2I=J^o6 <br />BUSINESS PHONE <br />fil (o <br />STREET ADDRESS <br />MfjyOb <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 or employee takes <br />place. Pxe^nBei _QA4^eyui_^ <br />I HEREBY MAKE APPLICATION FOR LICENSE TO SELL TOBACCO, TOBACCO <br />PRODUCTS OR DEVICES AT THE ABOVE LOCATION SUBJECT <br />TO THE LAm^^ ordinances OF THE CITY <br />OF ORONO. . <br />Signature <br />~C.tuA <br />Date <br />77>e issuance of a Bcensa tmder this ordinance shall be considared a prMlaga and not a^bsolula right of the applicant <br />and shall not enb'tle the holder to an automatic renewal of the Ocense. <br />1211ST.3