Item 6A Notification Response Form
Direct questions and mail responses t
ZAl2 -076 City of Southlake
Meeting Date: October 4, 2012 at 6:30 PM Planning if, Development Services
Notification Response
Easley, Paul M Etux Amy W 1400 Main St; Ste 310
903 Emerald Blvd South lake, TX 76092
Southlake Tx, 76092 Phone: (817)748 -8621
9765 5 1R Fax: (817)748-8077
PLEASE PROVIDE COMPLETED FORMS VIA MAIL, FAX OR HAND DELIVERY
BEFORE THE START OF THE SCHEDULED PUBLIC HEARING.
Being the owner(s) of the property so noted above, are hereby
in favor of opposed t. undecided about
(circle or underline one)
the proposed Site Plan referenced above.
Space for comments regarding your position:
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Signature: Alta _ _ � , Date: 41
Additional Signat► e: OF P Date:/c/,,
Printed Name(s): / as -
Must be property owner(s) whose name(s) a e pr ed at top. Otherwise - c4 ntact the Planning Department. One form per property.
Phone Number (optional): c al- -- (41 - 5 -17 . C 9