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I understand that this application, if approved, applies only to naming or renaming or commemoration of City -owned <br />properties, including streets, or building facilities and interior spaces thereof, and is not approval or assurance of <br />compliance with any other City regulation, code, or ordinance. Any information, technical assistance, or review <br />comments by any City official are intended solely as information guidance, and are neither a determination of <br />compliance nor binding on any agency with code enforcement responsibilities of the City. <br />Company: <br />Petitioner Name (Print): <br />Signature: <br />Date: Phone: <br />Address: Email: <br />City <br />(Please complete below if owner is different than above) <br />Company: <br />Petitioner Name (Print): <br />Signature: <br />Date: Phone: <br />Address: Email: <br />City <br />Office Use Only <br />Submittal Date to Planning Office <br />Application Category <br />❑ City -Owned Property <br />❑ City-Owned Street <br />❑ City -Owned Building Facility <br />❑ Commemoration <br />General Location or Street Address: <br />Checked by: <br />Application Reviewers Review Date <br />❑ Library Board Date <br />❑ Parks Board Date <br />❑ Street Naming Committee Date <br />❑ City Naming Committee Date <br />City Council Disposition <br />Date <br />Final Action (Approve or Deny) <br />Ordinance No. <br />Resolution No. <br />Effective Date <br />Acknowledgement <br />I:\AD \025 \01 \1 E25 \1 E25108.docx 6 <br />State Zip <br />State Zip <br />Recommendation (Approve, Approve with Stipulations, or Deny <br />