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Department of Environmental Management <br /> Wastewater Division, County of Hawai'i <br /> Application For Sewer Extension <br /> Part A. (must be completed) <br /> Project Address: KALOKO & KOHANAIKI, NORTH KONA, HAWAII Date: August 29, 2018 <br /> TMK No.: (3) 7-3-009:057, 058, 059, 060, 061 & 062; (3) 7-3-009:019; (3) 7-3-009:032 <br /> Applicant Information: Contractor Information: <br /> Name: RCFC KALOKO HEIGHTS, LLC Name: TO BE DETERMINED <br /> Address: 555 CALIFORNIA ST, #3450 Address: <br /> SAN FRANCISCO, CA 94101 <br /> Company: Company: <br /> Phone No.: Phone No.: <br /> Check applicable box: RX Sewer Main Installation(Indicate reason for work and complete Parts B&C.) <br /> ❑Sewer Lateral installation(indicate reason for work and complete Part C) <br /> Reason For Work: TO CONNECT ABOVE PROPERTIES TO COUNTY OF HAWAII SEWER SYSTEM <br /> Part B. <br /> Sewer extensions are subject to Hawai'i County Code,Chapter 21, Division 4,Extensions.The APPLICANT shall be <br /> responsible for drafting the resolution and submitting it and supporting materials with the Application for Sewer <br /> Extension.Final documents will be submitted to County Council by the Department of Environmental Management. <br /> Select one of the following methods of payment for cost and construction: <br /> (Note:reimbursement refers to payments collected by the County from properties connecting to the extension) <br /> Section 21-28(a): Applicant constructs and pays. FKI <br /> Section 21-28(b)(1): County constructs,applicant pays. ❑ <br /> Section 21-28(b)(2): County constructs,applicant and County share cost. ❑ <br /> Estimated Start Date MARCH 2020 Estimated Completion Date FEBRUARY 2021 <br /> Part C. <br /> I hereby certify that all work requested above will conform to appropriate sections of the Hawai'i County Code. <br /> Owner Signature: Date: <br /> Department of Environmental Management, Wastewater Division <br /> Approved by: Al 'j4 Date: U1,4-11 f, <br /> Was irewiteIr i ' n Chief / - I <br /> Approved by: Date: <br /> Director of Environmental Management <br /> Note: 1) Approval of the Application for Sewer Extension does NOT constitute approval for construction. <br /> Approval for construction is provided by an approved Permit to Perform Work on the Public Sewer <br /> System pending final approval by the Hawai'i County Council in accordance with Section 21-26.1 of the <br /> Hawaii County Code. <br /> 2) Filing of Sewer Extension Resolution is not required for sewer lateral installations. <br /> Hawaii County is an Equal Opportunity Provider and Employer <br /> K\WastewaterkSeN%er Extension&Projects\Sewcr Extension Application and Resolution\SeAer Extension Application.docx <br />