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......:::... <br /> . .....:................... <br /> � .......... <br /> nrP..... .........F � ... �5-- <br /> '•i iii <br /> +..!��.+.•�---- - -�'------,..............------------- ..F.�•>;F`Fr.?.F...... -...s>:-Y->:2:.-.f--'"'�`"�-_r:;;?z;?t4"�' <br /> ��.>..:.::.•:..-�„pa's ,yam. .�... <br /> City of Roseville <br /> Finance Department, License Division <br /> 2660 Civic Center Drive, Roseville, MN 55113 <br /> (651) 490-2212 <br /> Gas Pumps Private License Application <br /> ................... ............ .............. ....... <br /> 6L{ <br /> Business Name <br /> Business Address - <br /> ,r <br /> Business Phone <br /> Person to Contact in Rgard to Business License: <br /> Name C.- ` <br /> -51 /Address � � <br /> r <br /> Phone <br /> I hereby apply for the following license(s)for the term of one year,beginning July 1,2002,and ending June 30, <br /> 2003, in the City of Roseville, County of Ramsey, State of Minnesota. <br /> License Required Fee <br /> Gas Pumps Private $60.00 <br /> The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation <br /> as the Council of the City of Roseville may from time to time pre 5crib including Mi esota Statue#176.1 82. <br /> Signature <br /> *. is <br /> Bate <br /> If completed license should be mailed somewhere other than the business address, please advise. <br /> For office use only: <br /> %5'E. <br />