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City of San Leandro Parklet Program <br /> <br /> <br /> <br />8 <br /> <br />PARKLET APPLICATION <br /> <br />Address of Proposed Parklet: _______________________________________________________________ <br /> <br />Cross Street: __________________________________ City Council District #:_____________________ <br /> <br />Sponsoring Business or Organization Name: _________________________________________________ <br /> <br />Contact Name: ___________________________________________________________________________ <br /> <br />Mailing Address (if different than above): ___________________________________________________ <br /> <br />Cell phone: _________________ Alternate phone: _________________ Email: _____________________ <br /> <br />San Leandro Business License No. ____________________ OR Driver’s License # ________________ <br /> <br />Name(s) of Property Owner: ______________________________________________________________ <br /> <br />Property Owner Address: _________________________________________________________________ <br /> <br />Phone:______________________________ Email:________________________________________ <br /> <br />Designer Firm: _____I don’t know yet Name of Firm: _________________________________________ <br /> <br />Phone:______________________________ Email:________________________________________________ <br /> <br />Anticipated Construction Schedule:_________________________________________________________ <br /> <br />Parking Information <br /> <br />No. of parking spaces to be occupied: _____ _____Parallel _____Angled/Perpendicular <br /> <br />No. of parking meters to be removed: ____ Colored curbs in proposed location? ___Yes ___No <br /> <br />Color: ____Yellow ____White ____Green Length:____ <br /> By signing below, I acknowledge the provided information is true and correct. Further, I <br />acknowledge that I will be responsible for provision of liability insurance per the City’s <br />requirements and financing design, construction, maintenance, removal and restoration of this <br />parklet. <br /> <br />Applicant Signature: _________________________________________ Date: ____________________ <br /> <br />Property Owner Signature*: ___________________________________ Date: ____________________ <br /> *Property owner signature required if applicant does not own property where business is located. <br />95