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� �� � 1M�. 4 A I <br />� �' ' ���i��/ <br />City of RoseviUe <br />Finance Department, Liceese Division <br />2660 Civic Ceater Drivt, Rosevi�e, MN 55i13 <br />(651)792-7032 <br />Gasoline Station License Appiication <br />�"� ��i .c. <br />Bus ness Name ab°` ' �o <br />Business Addrecs ,� Y�� /f�, S' q i r'!/%P_LC L <br />�Po��� lk , M�/ „�.S/�3 <br />Business Phone ( s/— 6 �� — ���_ <br />Person to Contact in Regard to Business Licerrse: <br />Name <br />Address <br />Phone <br />�Ga.v Sl, pw a /7'Pr <br />I hereby appA�y;fmr�e �v�.lic�nse(s) for the tam of one year, beginning July 1, �QQ�, and ending <br />June 30, �D� S, in i�e City of Roseville, County of Ramsey, State of Minnesota. <br />License Reauired Fee <br />Gasoline Station $130.00 <br />The undersigned applicant makes this application pursuant to all the.laws of ths.State of biianespta�ud ragulatic�tr �- ° <br />as the Council of the Ciry of Rosevilte mr.y from time to time prwcribe, including Minnesota Statue #176.182. <br />Signature <br />Date 5�/9 �ey� <br />�/-. <br />�— <br />If completed license should be msiled somewhere other than the business addreas, plesae adviae. <br />For o„�Sce use only: <br />