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City of Roseville <br />Q <br />Finance Department, License Division <br />E660 Civic Center Drive, Roseville, MN 55113 <br />(651) 490-2212 <br />Gasoline Station Li <br />icense ApplicatiOT <br />Business Name P <br />Business Address T\"11 ���� � �,� � r�j' <br />me,% <br />Business Phone '�� �' (-� C�� (. -� cs-��j 1111 <br />Person to Contact in Regard to Busines <br />i-License: <br />Name \ ((, e) <br />Address 5, <br />Phone <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, <br />3 0$ '>-06 _q , in the City of Roseville, County of Ramsey, State of Minnesota. ZLO--O� and ending June <br />F <br />License Required Fee <br />Gasoline Station $130.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time prescribe, incl 9 nesota Statue 9 176.182. <br />Signature <br />:V <br />Date <br />Off Ems <br />If completed license should be mailed somewhere other than the business • address, plesse advise. <br />For q <br />.fice use only <br />