SPIN2012-35 Email to SPIN Representative - Meeting Request Form%►A*
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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.)
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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:
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