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� ��� � <br />k <br />��� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55ll3 <br />(651) 792-7034 <br />Gas Pumps - Private License Application <br />Business Name ��t ,d /G n � �� ���} � � � � �,�17 �j <br />Business Address �� � % � ��+a'� �� <br />Business Phone � � � � � � �' � � �� <br />�znail address <br />r <br />� <br />Person to Contact in .T� ard to Busaness License. <br />�-- <br />� <br />N,�'I� --- � �F.. �`�- �d �J� <br />Address � V� 1 �`'~�+Ftir .�� � ��E4+r �'i. %�/V �S1 �� <br />� <br />Phone _� � � " � � � - � � �� <br />I hereby apply far the following license(s) far the term of one year, beginning July 1, .Z �(.a % , and ending June <br />30, 2[�0 � , in the City ofRoseville, County of Ra�nsey, State ofMinnesota. <br />License Required Fee <br />Gas Pumps - Private $60.00 <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Cou��cil of the City of Roseville may from time to time prescribe, inel�din� Minnesota Statue �1'76.1$Z. <br />Signature � J r� � "� '- <br />-� — ��~ <br />Date � � � � - � � � <br />A fire inspection is required befare issuance of a license. Please call 651-792-7341 to set up an inspection. <br />If completed license should be mailed somewhere other than the business address, please advise. <br />