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Attachment A <br />��� 9, <br />C'ity af Roseville <br />Finance Depart�nent, License Division <br />. 2G6a Civic Cente�- Drive, Rdseville, MN 55113 <br />° {6S1) 792-703b <br />Gasoline Station License Application <br />Business Na�ne l� f �_ �.4�°�`f�j �_ �j.c� . � ' � �,� � ���, (� <br />! � <br />Business Address � � _ �ez �� ���; � ��� ( t � <br />Business Phone (7 �7 "` °� � � � � <br />Email Address <br />Persorr to Canlact in Regard to Business Licertse: <br />�iame /(6� <br />Address <br />Phone <br />[ here6y apply for the following license(s) for the term of oEie year, beginning 7uly 1, �� , and <br />ending June 30, �, in the City af Roseville; County of E�amsey; State oF Minnesota. <br />(.icense Reqt�ired Fee <br />Gasoline Statian $130A� <br />The undersigned applicant ma[ces this application pursuant to a!1 the laws of the Stata of Nlinnesota and . <br />regu�ation as the Council of the City af Rosevi[le may from tirrte to time prescribe, including Minnesota �tafue <br /># 176. i 82. <br />Signature �- <br />Date _�--� °� � � -�_ -..------- -- <br />A fire tns ection is re uirerl before issuance of a license. Please cail 651-792-7341 to set u an <br />inspection. <br />If completed license should be mailed somewhere other than the business ac€dress, pEease advise. <br />