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City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 490-2212 <br />Gasoline Station License Application <br />Business Name _��.Y �r � /1/ ��-�� <br />Business Address L� �� � .� �� r � �' � � r �•` <br />Business Phone <br />�{i y] ti L. j r� �� �4! LS~��' � f •_� <br />�/ i• {•� •r �, .i � �\, <br />��, 5�/ '� � <br />Person to Contact in Regard to Business License: <br />�larr,c <br />Address <br />P�:�n�: <br />� � r�� �' � � � � � � � �t � <br />� <br />� f �} � ��4 .'� '� ��;'�{r���'� � � �, r�' �1'�,ks' �t � � j � � r: ��' ,��'� r`� .�� .�� � �- <br />_ � <br />r <br />�t`. -� �� �- �r r�'�- - .3 �• �T `� <br />�.- — <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, ���id ending June <br />30, , in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired <br />Gasoline Station <br />Fee <br />$130.00 <br />The undersigned applicant malces this application pursuant to all the laws of the State of Minnesota � regulation as <br />the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue # 1, 6.182. <br />�' f ; <br />S�g��lurc _ ,,�-� -�� , �� �� �''" <br />DaL� � � �� - �' <br />If completed license should be mailed somewhere other than the business address, please <br />r Or tr,(f?t� �S� �PI��' <br />