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515 Little Canada Road, Little Canada, MN 55117-1600 <br />(651) 766-4029 / PAX: (651) 766-4048 <br />www.cidittle-canadaann.us <br />APPLICATION FOR <br />GENERAL TOBACCO SALES & DISPLAY LICENSE <br />MAYOR <br />Bill Blesener <br />COUNCIL <br />Rick Montour <br />John Keis <br />Michael McGraw <br />Shelly Boss <br />ADMINISTRATOR <br />Joel R. Hanson <br />Business Name: -.3 `stnCcSSio1\2\ L.t(0)c., <br />Business Address: 027R0 ,t cam- S\ ( 1 _r\ -1,-(c, `4,,N-Qr No <br />Business Phone: <br />Federal ID No: 7L: 7.3S5 a34 <br />MN State ID No:31(> 3 7:2)-N <br />Licensee/Owner Information: <br />Name:\ j,C \c,„„( L SAc:K. �1 <br />Address: 1-7'-1 GcAA1 e t- jA dx'.V t (/e iv S t l 3 <br />Phone: (vt Z'" 2& Cr -7S'-( <br />Please describe the nature of the business, including products sold, hours of operation, <br />etc • <br />• <br />Ll(.2(y.)or <br />Cr^ cr( 4- 5 <br />Skb (. e s <br />o 9 <br />Ake ,kArkc�C(QPiacTrJu<Xc <br />(Over) <br />4 <br />