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r <br />Departrmant of Environmental Management <br />Wastewater Division, County of Hawaii <br />Application For Sewer Extension <br />Part A. (must be completed) <br />Project Address: 77 -AM Drive <br />TMK No.,: (3) 7-7-004 : 057, 059 <br />-Applicant Information: <br />Name: Larry R. Smith <br />Address', 77-62393 Alli* Delve. Kailua-Kanal, H1 96740 <br />Company: Royal Alii LLC <br />Date 04 September 2020 <br />Contractor Information: <br />Name: SAME <br />Address: <br />Company: <br />Phone No.: 808-937-2300 Phone No.; <br />Check applicable box. -Z Sewer Main I nstaKation (Indicate reason for work and complete Parts B & C.)14A r- Osrr <br />ED Sewer Lateral Install.ation (indicate reason for work and. complete Part G) <br />r, -6,i^ 4f Tim. -0 0 ) -t- - 0�0 +; V Z -V <br />Reason For Work* Provide sewer for 19 new lots created � Planned. Use Develoment (PUD -05-005) <br />REF: SUB NO. 07-000602- SMA 05-007 <br />471wil't-1 <br />Sewer extensions are subject to HawaVi County Code, Chapter 21, Division 4, Extensions. The APPLICANT shall boa <br />responsible fbr draftin-a the resolution and gubm-itting it and supoortino materials with the Application for Sewer <br />Extension. Final documents will be submitted, to gounty Council by the Department of Environmental Management <br />Select one of the following methods of payment for cost and construction: <br />(Note: reimaursement refers to payments collected by the County from properties connecting to the -extension) <br />Section 27 28(a): <br />Section 21-28(b) (1): <br />Section 21. -28(b)(2). - <br />Estimated Start Date <br />Applicant constructs and pays. <br />County Constructs, applicarit pays, <br />County constructs, applicant and County share cost, <br />Estimated Completion Date <br />Part C. C, -- <br />1: <br />I hereby certify fila all work reques a e =evil) Co, <br />iorm to, appropriate sections of the Hawaii County Code. <br />T <br />? -611 <1�1, JM, Date: 04 September 2020 <br />Owner Sigrature, <br />Approved by: <br />Department 6 Environmental Managamen t, Wasteem ater Division <br />Wasttewater DIVIS' Chief <br />PH <br />Approved by: <br />Director W E0fronrnental Management <br />V <br />Date: <br />Note: 1) Approval of the Application for Sewer Extension does NOT constitute approval for construction. <br />Approval for construction is provided by an aooroved Permit to Perform it on the Public Sewer <br />System pending final approval by the HawaVi County Council in accordance with Section 21-26.1 of1he <br />Hawal'f County Code. <br />2) Filing of Sewer Extension Resolution is not required four sewer lateral insWiations. <br />Pawrgi'i CWnty- is. an: Sabal Opportunity ProWdzr and 9-mp)byti- <br />Exhibit A <br />