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r. <br />terviffe <br />LvtaG` OW 1&si <br />CITY OF CENTERVILLE <br />PARKS, TRAILS, AND RECREATION DONATION AND MEMORIAL APPLICATION <br />Name of Donor: .' �/�/J/ 4�yd IX7 -7�9,V CC, <br />Address of Donor: <br />Phone Number: <br />Email: F ��% S`2 ' <br />Description of Donation: _ <br />EEC <br />Desired Location of Donation: ` { <br />3� <br />Projected Required Maintenance, if known: <br />Wording on Memorial Acknowledgement (if any): <br />Monetary Amount of Donation: <br />r' le O6J <br />If space is limited above, include necessary information in an attached letter describing the <br />donation and how the proposed donation meets the applicable criteria outlined in the City Parks, <br />Trails, and Recreation Donation and Memorial Policy. / rl <br />�/ <br />Donor: �� Date: <br />