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� ��� � <br />��� .� .� � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Gas �umps - Private License Application <br />f ;� r� <br />Business Name �t .�.� ��� � � ` ' f � �_ I f s1 � � _ ____ , <br />� <br />Business Address F;�t �� �` �� ��iJ� � �.��� _ _.' ��# �� <br />, �' +. <br />I�t�ki ..�k� PI::,�.: .._.��_ ± .. _ __4.,���.�.f'--'1 `� a��{ — --- -- •- <br />E�nai1 address <br />Persof� la Colatact in Regard to Business Licerase: <br />�l��;:L _ �� ��_•� __ � �������`� �� {� , { . <br />J"L�N�C{S ____ ����... �_�'• � �.■ !���_ � ��'IL� .J L ' 1 <br />l <br />� <br />Pltone , ` <br />���•_� � � � _�'�_�� .' <br />�j„�; ~ - � i <br />z. {� <br />I]lereby a�ply for the following lice�ise(s} for �l�.w terni of one year, beginning July 1, _�� �_, and ending June <br />30, •�1�. _ 1�.tJ, in the City of Roseville, Coui�ty of Ramsey, State of Minnesota. <br />License Required Fee <br />Gas Pumps - Private $60.00 <br />The undersigned applicant inaices this application pursuant to all the laws of tlie State of Mi�inesota aiid regulation as <br />the Council of the City of Roseville may frotn time to ti�le ;:-.:{!� il�ti. i�claLa7{ A�1i��: ti:'.,� �'�i�iL ?': -F.:��. <br />� �'� r h i �:I �.'a r.I <br />Signature � � ` �' �• �.4�5 L��� ���' � �s <br />Date �- �'�� ��� <br />A fire inspection is required before issuance of a license. Please call 651-792-7341 to set up an inspection. <br />lf completed license should be n�aaled somewhere other than the business address, please advise. <br />