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SPIN2012-35 Email to SPIN Representative - Meeting Request Form%►A* 49SPIN2b #V1% Southlake Program for the Involvement of Neighborhoods Meeting Request Form Applicant Contact Information: Name: mo':� 'o_ k Business, -TV(Lr1 y, E-mail: V'? ► f c w-a oh, Work Phone. - Alternate Phone: 1Z l I - ' 'S 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.) �k(y Ct,-1-ict /+act ► .-�i 6� is.5 S Lo i Project Location: Exact Street Address: `"160 N , wC 1 vv. _► Nearest Cross Streets: Kc-A 6 AV, ON E SPIN Neighborhood: LA Additional Location Information: SPIN Neighborhood Representative Recommendation: (Please indicate Yes or No) 0 Yes 0 No SPIN Meeting Request: (Please indicate Yes or No) Q Yes 0 No Desired SPIN Meeting Date: For office use only: SPIN Case No.: Initial Contact: Recommendation: Form Received: Website: Connect-CTY: -ti- t r 1. II -� 1 3- I 4 r1 4