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fCtli. a dz2e ceanath <br />515 Little Canada Road, Little Canada, MN 55117-1600 <br />(651) 766 -4029 / FAX: (651) 766 -4048 <br />www.ci.little- canada.rnrl.us <br />APPLICATION FOR <br />CIGARETTE /TOBACCO PRODUCTS LICENSE <br />Please check appropriate license category for your business. <br />Tobacco Store License: <br />General Tobacco Sales & Display License: <br />Business Name: <br />Business Address: <br />Business Phone: <br />lr✓Lee cocci oae 2NC. <br />MAYOR <br />Bill Blesener <br />COUNCIL <br />Rick Montour <br />John ILcls <br />Michael McGraw <br />Shelly Boss <br />ADMINISTRATOR <br />Joel R. Hanson <br />+c c) Q is e s--1-4 ee/ Li'! /u cC 1 Mai s//3 <br />65/- qfv -, L 7-- <br />Federal ID No: `/O - 01(1/3 Sf MN State ID No: _ 5 6 5 / 12. <br />Licensee /Owner Information: <br />Name: <br />Address: <br />Phone: <br />L k �i t eau j Uct_ti5 <br />42_f 1)15' 4UC ME 13140-Ne ,ht) 5' 413V <br />3o 3TY9 - fl ?L <br />Please describe the nature of the business, including products sold, hours of operation, <br />etc.: <br />CdFE- SAIe L: X0,2 SfoA5) <br />(Over) <br />3 <br />