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SPIN2012-22 Meeting Request Form% A .f JO V A Southlake Program for the Involvement of Neighborhoods Meeting Request Form Applicant Contact Information: Name: South Village Watermere Business Integrated Real Estate Group E-mail: klombard.i @integratedreg.com / rsimmons @integratedreg.com Work Phone 817 -742 -1851 Alternate Phone: Proposal Description: {Short, 2-3 sentence description of propose project. This inrarmatlon will be used on the advertising for the meeting. EX: 11,000 sq. ft office building on 2.5 acres located at 100 Southiake Boulevard.) , r Pr oiect Location: Exact Street Address: na rtheide of union church roadt east of pearson w/ weslem property line abutting chesapeaks place edditn Nearest Cross Streets: SPIN Neighborhood. Additional Location Information: SPIN Neighborhood Representative Recommendation: (Please indicate Yes or No) p O:No SPIN Meeting Request: (Please indicate Yes or No) Sf Q No Desired SPIN Meetinia Date: �; -AZ- ( pfiq