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1 hereby apply for the following license for the term of one year, beginning July 1, 2012, <br />and ending June 30, 2013, in the City of Little Canada, County of Ramsey, State of <br />Minnesota. <br />License Required Fee <br />Tobacco Store License $250.00 <br />• Provide documentation that that shows more than 90% of <br />gross revenue is derived from the sale of cigars, cigarettes, <br />loose tobacco, cigarette or cigar lighters, and tobacco- <br />related devices (any pipe, rolling papers, ashtray, or other <br />device intentionally designed or intended to be used in a <br />manner which enables the chewing, sniffing, or smoking of <br />tobacco or tobacco products). <br />General Tobacco Sales & Display License $250.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of' <br />Minnesota and regulation as the Council of the City of Little Canada may from time to <br />time prescribe, including MN Statute #176. <br />Signature: <br />Date: <br />7 <br />3 <br />