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Business Name <br />Business Address <br />Business Phone <br />� '' N I <br />. ,' i � � � �i �►l <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />Gasoline Station License Application <br />�DWA�t 9�II�RICA IIL c�e �CA �� 4210 <br />2172 LH�T AVE <br />Ii�EVIITF� MJ 5�13-1+�� <br />651-48�1106 <br />Person to Contact in Regard to Business License: <br />Name � AtD� fAr �Y �RA�'A II� <br />Address <br />Phone <br />• � :�� :� i�� : �a• ��� i r �a � � � • � :� <br />r•� ::�'_�3 <br />I hereby apply for the following license(s) for the term of one year, beginning July 1, �J04 , and ending <br />June 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 makes this application pursuant to all the laws of the State of Minnesota and regulation <br />as the Council of the City of Roseville may from time to time prescribe, including Minnesota Statue #176.182. <br />S;��e ���� �� License Coordinator <br />Date 04"�� ��0¢ <br />If completed Hcense should be mailed soraewhere other than the business address, plesse advtse. <br />For o�ce use only: �y g�� � <br />P.O. � 158D I1C� L�PT <br />�t� n� Q� 45501 1580 <br />