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��,����x� ���,� <br />�+u�171�55 �5t1{jC�C55 <br />� slltil'It5�4 ��' � I:t <br />En-�ail Address <br />����4� <br />�,,..�_..- � , ,� � � � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7034 <br />Gasoline Station License Application <br />�� ��+��z�� uc � �t�.4��� � :�r i � <br />�� �TF[ � f�1t�L��'C A�.�L[+C� F+��7+�, M+1 5�113�1 � i� <br />Cx�l�?1-7�,1 <br />Person lo CQrttact irz Regard to Business License: <br />Naiuc <br />Address <br />Phone <br />�=�}'� �'�L]�?�'4��: for ;��{w'��( ��l��i�1�1��'� TT� <br />P.a. �X 1�80 LICIl�E IEPI' ��.T[V�'�7�, �CO 45501-1580 <br />937-863-6473 <br />I 1�ereby apply for the following license(s) for the term of one year, beginning July 1, -�� , and <br />ending June 30, �� ,:i� the City of Roseville, County of Ranisey, State of Mimlesota. <br />License Required <br />Gasoline Station <br />r'ee <br />$130.00 <br />The undersigned applicant n��kes this application pursuant to all the laws of the State of Mimlesota and <br />regulation as tt�c Council of the City of Roseville may from ti�n� to time prescribe, including Minnesota Statue <br />#176.182, � <br />signature �� ����.�� �.ic���� Coordina�or <br />a r <br />r}�LIL" ��� <br />A fire inspection is required before issuance of a license. Please ca11651-792-7341 to set up an <br />inspection. <br />If coiiipieted license should be maiied somewl�ere other Gl}ai1 the business address, please advise. <br />SPEC�t+�f;Y SfJf'CR AMERICA LLG <br />�r.. FiDx 1580 '.I�Gh'�"� �-1a� <br />SPRINGFIEI,U, 0l�I 45501 <br />