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���� <br />� <br />City of Roseville <br />Finance T}epartment, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(b51} 792-7036 <br />Gasoline S�ation License Application <br />Business Name �?'��,f �� <br />8usiness Address <br />Business Phone �p� <br />f7 /. --- <br />Email Address <br />_ , <br />� � tb�� <br />�.� - � <br />� 7� <br />e <br />Perso� to Contact in Regarcl to I3usi�ress License: <br />C' /_ � � n /' <br />Name <br />_ _ : „ <br />Address • y .� � .. — .. <br />- _ ✓r � ll f <br />. <br />Phane �..... - — ,•—�.—� . ..._. <br />I l�ereby apply for the fol�owing license(s) for the term of ane year, beginning Iuly ], ��� , and <br />ending 7une 30, �� �? , in the City of Roseville, County of E�amsey, State of Minnesota. <br />License Required <br />Gaso�ine Station <br />Fee <br />$ l 30.00 <br />T'he ui�dersigned applicant makes Yhis application pursuant to ali the laws of fhe Sfate of Minnesota and <br />reguEation as the Council of ti�e CiEy of Roseville may fram time to time prescribe, includin ivlinnesota Statue <br />#l'16.182. <br />Signature � � . <br />Date - / � � � <br />A fire inspec;ion is req�ire�l befare_ issuance of a iicense. Please call GS1-792-;73q1 to seE up an <br />inspection. <br />If con�pleted license shou[d be mailed samewher� ather than the business address, p�ease advise. <br />