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SPIN2011-17 Meeting Request FormVIk tft Southlake Program for the Involvement of Neighborhoods Meeting Request Form Applicant Contact Information: Name: `5 0 r O"KA Business: V5L AW O AP% s roL E -mail: „ "V-FL AWL” Q VF.I 11, 9 0J - N XT Work Phone: 8 1 - 7 - +S S -- 9 317 Alternate Phone: Proposal Description: (Short, 2 -3 sentence description of propose project. This information will be used on the advertising for the meeting_ EX_ 11,000 sq. ft office building on 2.5 acres located at 100 Southlake Boulevard.) (-%.a% o i U I L'01 c, tS Project Location: Exact Street Address: ^ G 161 5 D uTH " 13iyo` Nearest Cross Streets: e�L�T SPIN Neighborhood: Additional Location Information: "OLy r V O r W ilgrK+ Y.I H IME SPIN Neighborhood Representative Recommendation: (Please indicate Yes or No) X Yes ❑ No SPIN Meeting Request: (Please indicate Yes or No) A yes ❑ No Desired SPIN Meeting Date: For office use only: SPIN Case No.: — � Initial Contact: Recommendation: LILk OA u iGt ft t4t Form Received. Website: Connect -CTY: