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����� . <br />.�r�' / <br />City vf Roseville <br />Finance Department, License Division <br />2GG0 Civic Center Drive, Raseville, IVIN SSI13 <br />(651) 742-7036 <br />Gasoline S�a�ion Lice�se Applica�iar� <br />r �/j 1 � <br />Business Name _�� s /`�"��( �.v-�-d7 � a�--� <br />$usi�less Address � � ,��r � � -__... _. . f.- .. _ _a _ � <br />Business PE�ane �.�/ y / �� ��G ,� <br />E�nail Address <br />Person 10 Ca�ztact in Regard ta 13usiness <br />Name <br />Address ��`'�'� <br />Phone <br />�� <br />� ilare6y app€y for the following iicense(s} For the term of oi�e y�ar, beginning July 1, �c� , and <br />endir�g June 30, D O, iit tf�e City of Rosevi]Ie, County af RaEi�sey; State of Minnesota. <br />License Eteqi�ired �'�� <br />Gasoline Station �130:04 <br />The undersi�ned appiicant �nakes tllis �applicatior� pursuank to.all the laws af tE�e 9tate of M�nnesata�aac�� ��;�,;��f <br />re�ulation as tEie Councii'oi'tf�e CEty-nf Ras��illz may from t�rr�e to time prescri�ie, incl�d�"" '��n�iesut,� iatue <br /># i 76.182. �7 f <br />Sigoature <br />Date I ! O' �// � <br />A tire inspection is_��equi�•ed before issuance oF a license. Please cfl�l G51-79Z-734d to set u� an <br />inspectia[�. <br />If completed license should be rnailed son�ewhe�•e oth�r fhan t�1e business address, please advise. <br />