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Department of Environmental Management Wastewater Division, County of Hawai'i Application For Sewer Extension Part A. (must be completed) Project Address: Kanalani Street Date: 10/14/2022 TMK No.: (3) 7-4-08:076 Applicant Information: Contractor Information: Name: Riley Smith Name: Scott Yoshimura Address: PO Box 9032, Kona, HI 96745 Address: 648 Piilani St, Hilo, HI 96720 Company: West Hawaii Business Park LLC Company: Isemoto Contracting Co., Ltd. Phone No.: (808) 936-7129 Phone No.: (808) 329-8051 Check applicable box: Ill Sewer Main Installation (Indicate reason for work and complete Parts B&C.) 0 Sewer Lateral Installation Only(Indicate reason for work and complete Part C) Reason For Work: Applicant is constructing an extension of Kanalani St. and underlying infrastructure for a new industrial development, including laterals to TMKs 7-4-008:07:91 to :99. Part B. Sewer extensions are subject to Hawaii County Code,Chapter 21, Division 4,Extensions and the APPLICANT shall be responsible for submitting a final resolution to the Wastewater Division for review. The Department of Environmental Management will submit the final resolution and supporting documents to the County Council for approval of the sewer main extension. Select one of the following methods of payment for cost and construction: (Note:reimbursement refers to payments collected by the County from properties connecting to the extension) Section 21-28(a): Applicant constructs and pays. Section 21-28(b)(1): County constructs,applicant pays. ❑ Section 21-28(b)(2): County constructs, applicant and County share cost. ❑ Estimated Start Date June 2021 Estimated Completion Date December 2022 Part C. I hereby certify that all work r ed above will co rm to appropriate sections of the Hawaii County Code, Owner Signature: Date: Department of Environmental Management, Wastewater Division Approved by: Date: b17/`a—/2-?� Wa tewater Division Chief Approved by: 1"...477--7/4".-2,,„t Date: Director of mentalanagement Note: 1) Approval of the Application for Sewer Extension does NOT constitute approval for construction. Approval for construction is provided by an approved Permit to Perform Work on the Public Sewer System pending final approval by the Hawai'l County Council in accordance with Section 21-26.1 of the Hawaii County Code. 2) Filing of Sewer Extension Resolution Is not required for sewer lateral installations. Newell County is an Equal Opportunity Provider and Employer M:\Wastewater\Plan Review\Sewer Extension Application.doc' EXHIBIT E