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2004_0614_Packet
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2004_0614_Packet
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12/14/2009 1:41:34 PM
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� , r� � <br />-- _ _. � f � <br />City of Roseville <br />Finance Department, License Division <br />2660 Civic Center Drive, Roseville, MN 55113 <br />(651) 792-7032 <br />Gas Pumps � Private License Application <br />Business Name <br />£i � �i.it•�s r�ticlxsx , . <br />� <br />����fL{����� x �}I�i4-,� T� '� ��� �'ri` <br />f <br />�._�_ ��� ��� ��� ��� � <br />' �' �4 <br />�' . �- � � �' � � � <br />� � �r '.`� � � �� � � { <br />Business Phone �.� �� �� k� �'� � �� �, <br />Person to Contact in Regard to Business License: <br />Name ����� �k <br />AC1C1T'eSS ��� ��Y--'L yF`�� '�� ��' � ����� � r <br />�� -_ <br />•�� rl <br />f ��� � � r �� <br />Phone <br />I hereby ap�pl� for the following license(s) far the term of one year, beginning July I, �� � , and ending June <br />30, ��, in the City of Roseville, County of Ramsey, State of Minnesota. <br />License Repuired Rre <br />�• � <br />Gas Pumps - Private $��.��� <br />The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and regulation as <br />the Council of the City of Roseville may from time to time p��s� ri�, =�,�; in� twfinn��uia� n,e � f 7� � R� - <br />Signature ��"�� <br />9�aie �� � � � �+ � _ <br />If completed license should be mailed somewhere other than the business address, please advise. <br />For o 'ice use onl : <br />Receipt # _ _ _ __ <br />
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