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���� <br />�.r►� .. J , � � 1 ..1 <br />City of Roseville <br />Finance Depar�ment, �icense Division <br />2660 Civic Center Drive, Raseville, MN SS113 <br />(651) 792-7036 <br />Gasoline S�a�ian I�icense Applica�ion <br />8usiness Name <br />Busin�ss Address ��.�< ���/��„�� .,� , ... .- <br />Business Phone � ��� ��� '` <br />"° - - d � <br />Email Address � ....d.� � <br />. �. � <br />Pei°sorr lo Contact in Regard la 13usfness License: <br />Nanie �� � �i/ ��G'�.�°' �f �� / . _._ <br />Address �� �� �.�. �' �e� :�-� _ <br />_ _ �� .� _ .� � <br />Phone <br />I liereby apply for the foll wing licens�(sj far €Ete term of o�ie year, beginning July 1, �; and <br />ending June 30, d�� in the City of Roseville, County of Ramsey, State of Minnesota, <br />License Reqaired Fee <br />Gasaline 5tati.on $130.00 <br />The ui�dersigned applicanY makes this appl'tcation pursua�7C to all the laws of the State of M.in��esota and <br />regulation as the Council of the City c�f Rosevil�� may from lime to time prescribe, including Minnesota Statue <br />#176.182. � � � <br />Signature `�� -�� <br />Date <br />A fire ins ection is i�e uil•e�i before issuance of a license. P1eASe call GS1-792-7341 to set � an <br />i�ispection. <br />Ef campleted license should be mai[ed somewhere ather than the business address, please advise. <br />