Section 1 of 4 in this document

Thank you for submitting your application. There are three ways to pay for your license:

Online with a credit card - a fee will be added to this payment
Call 651-490-4600 to pay with a credit card
Send a check to city hall (attn: administration)

Filling Station License Application

Applicant information

Phone Number

Section 2 of 4 in this document

Business information

Business name

Name and address where license should be mailed

Business phone number

Business email

FEIN, MN Tax ID, or SSN

Number of gas storage tanks

Enter number of pumps

Total fee for all pumps

Please upload your proof of insurance and certificate of compliance for Minnesota workers' compensation law.

Section 3 of 4 in this document

Corporate information

Corporate name

Corporate phone number

By signing this application, I:

Swear that all statements by me on this form are true and complete to the best of my knowledge
Have read and understand the conditions set forth for filling station licenses as outlined in chapter 10, article VII of the city code
Understand that false statements or omissions shall be sufficient cause for rejecting my license
Authorize the City of Shoreview to use this information to determine my suitability for obtaining a license.

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

The undersigned applicant makes this application pursuant to all the laws of the State of Minnesota and such rules and regulations as the City Council of the City of Shoreview may from time to time prescribe.

Filling Station License Application

Applicant information

Name

Address

Business information

Business address

Total fee for all pumps

Please upload your proof of insurance and certificate of compliance for Minnesota workers' compensation law.

Corporate information

Corporate address

Sign Here