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SPIN2014-10 Meeting Request Form (2) Southlake Program for the Involvement of Neighborhoods Meeting Request Form Applicant Contact Information: 'LVMWX],EQQSRW Name: +VIIR[E]-RZIWXQIRX'SQTER] Business: GLEQQSRW$KVIIR[E]MRZIWXQIRXGSQ E-mail:  Work Phone:  Alternate Phone: 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.) 'EVVSPP4SMRXI)PSRKEXMRKX[SGERSTMIWERHEHHMRKEKIRIVEXSVIRGPSWYVIXSFYMPHMRK%XS GSQTP][MXL7XEXIVIKYPEXMSRWJSVER)PMXI'EVI Project Location: )EWX7XEXI,MKL[E]7SYXLPEOI8I\EW Exact Street Address: 'EVVSPP6SEHERH,MKL[E] 7)' Nearest Cross Streets: 1EXX7GLMVPI SPIN Neighborhood: Additional Location Information: SPIN Neighborhood Representative Recommendation: For office use only: (Please indicate Yes or No) Yes No SPIN Case No.: Initial Contact: Recommendation: SPIN Meeting Request: (Please indicate Yes or No) Form Received: YesNo Website: Desired SPIN Meeting Date: Connect-CTY: