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��� � � <br />� <br />City of Rose�al�e <br />�f�ance I���aarime�at, Lice�se �Di�visrmn <br />2G6Q Civi� �enter Drive, ltosevf�l�, l��i 5�113 <br />(G�.1} 792-7034 <br />�a��lin� S�ation I�icen�e App�ica�YOn <br />Business Narne _ ��i-� ��,'c,� _��_y �Q � c <br />Busi��ess Address �"� [. �'r �'�s'L.__ �� <br />l�usiness Fhone � �� � ��~ � � � <br />�mail Address <br />Person to Contact in Regard to Business License: <br />� <br />Name <br />Addr�ss ��y� � � <br />�'hane W � �`� � 'C 4 ,.' ���.��- <br />T hereby agply for t�e fo Iowi��g Izaense(s} for t1�e terz�� o�one year, beginning .iuly T, �, and <br />ending Ju:rae 3fl, `�� � , in th� Ciry of Ros�vitie, County of Rannsey, State nf Minn�sota. <br />License Rec�uired �+ee <br />Gasoline Station $130.�0 <br />Th� urtdersigined applicant naakes this applicati4�� pursuant to a�l the laws of the State of IV.€innesota and <br />re�ulation as the Cfluneil c�f tE�e Ciry c�i Roseville may froin tiine o time prescri e, incI�ding Minn�sota Statue <br />#I76. i 82. <br />✓ <br />Signature <br />Date � ��� <br />A�re ins ection is re uired before issuance vf a iicense. �leass call 651-792-73�SI to set u an <br />inspection. <br />If completed lieense should be anailed some�her� ather ti�ai� t�iE business address, please advise. <br />