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Business Name <br />Business Address <br />Business Phone <br />Email Address <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 5511.3 <br />(651) 792 -7036 <br />Gasoline Station License Application <br />)?0 Tk'O E U d Z6 3fl �Rose�..�� W%,Mffi eL <br />X2163 Al, 5me�a A2o5 ..� 14P 5�1r3 <br />3 �C�76 <br />Obfoo'r,7720L E <br />V <br />M N1� r" <br />Person to Contact in Regard to Business License: <br />Name �l _ � F J � J, en V � Uj 14 rJ ._ <br />Address <br />Phone <br />I hereby apply for the flying licenses for the term of one year, beginning July 1, _.. aW 14 and <br />ending June , in the City of Roseville, County of Ramsey, State of Minnesota. <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 <br />regulation as the Council of the City of Roseville may from time to time prescribe, including Minnesota <br />Statue # 176.18 2. <br />Signature . <br />Date — a? -- a" �A <br />fire inspection is required before issuance of a license. Please call 651 - 792 -7341 to set up an <br />inspection. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />