SPIN2012-29 Meeting Request Form41X 'I
Southlake Program for the Involvement of Neighborhoods
Meeting Request Form
Applicant Contact information:
Name: r
Y
1 ii b
Business:
E -mail: dA.V% e- D a-01, C 9 114-11t _
Work Phone: #4
Alternate Phone: r 41
Proposal Description:
(Short, 2 -3 sentence description of propose project. This information will be used on the advertising for the meeting. Ex:1 // 1,000 sq. ft
office building on 2.5 acres located at 100 Southlake Boulevard.) � � � a�secd / � /O/
Prolect Location:
Exact Street. Address: i&o &AA1-dy ! l ' ! �'I 4 fle
Nearest Cross Streets: flr ;1 Z h
SPIN Neighborhood: `
II
Additional Location Information AA I ace-v� - Pb d A Y C < gAi G/ S it
SPIN Neiahborhood Representative Recommendation:
(Please indicate Yes or No)
y Yes ❑ No
SPIN Meetina Request:
(Please indicate Yes or No)
Yes El No
Desired SPIN Meeting Date:
Ale //
For office use only.
SPIN Case No.: •x J'1 L(�V����
Initial Contact: tlrP �(Z
commendation:
Form Received:
Website: 4 5 7 ' C' - �
Connect -CTY: