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Rv roan v-69 fr/eo COUNTY OF HAWAII <br /> oevt or Fmenc• gEAL PROPERTY TAX DIVISION <br /> DEPARTMENT OF FINANCE <br /> 665 Piileni Street <br /> Hilo, Hawaii 96720 <br /> Return and Claim for Real Property Tax Exemption <br /> Building Improvements Pursuant to Rehabilitation Projects or Code Enforcement <br /> c F/il~e o'n~IOr before December 31 for the succeeding tax year <br /> FR1Z~C1 Y~ Z S PLAT PARCEL HPR <br /> Tax Key L,2. 3 Q $ Z <br /> County ~7 ~ ~ ~ ~ ~ /~C <br /> tFILE IN OUAURUPLICATEI Bldg. Address 7 ~ L ~ S T ~ _ <br /> 1. Rehabilitation Projects: Provide project name / / ~ ~ o ~ ~ ~TQFj~= ~ /t'1_ B <br /> Do you occupy or use part of the building? ~ yes ? no <br /> 2. Code Enforcement Cases: <br /> Citation Number Date/of citation <br /> Is building a single family residenceT lXJ yes ? no <br /> Do you occupy the entire building? yes ~ no <br /> 3. Describe improve ntssofbvuild'ng:CO /Pt'FTE (3u.fLj~ifv~'" F>eTi=R10RrkNb //.+~i'FRIaR <br /> <br /> aE.NOVATtOA! ~t A ~ G''~~ 9'3t. <br /> 4. Floor area improved:~(It nn~ nnsq.ft. ~ ~ ) <br /> 5. Cost ofimprovements$~-d-~=-9U 6. Date improvements completed /"Q~'`~ v~~N"`~~~~ <br /> Exemption from increased valuation due to the above improvements is hereby claimed. I hereby certify that all statements in this <br /> claim are true and correct to the best of my knowledge. <br /> Date ~ I <br /> a~ Owner's Signature ~~"I ~ - <br /> 1 Address QN~~ L <br /> Phone No.~-! <br /> RP Form R6a <br /> FOR OFFICE USE ONLY <br /> I. For Building in Redevelopment, Rehabilitation or Conservation Areas <br /> The above designated building is in an officially designated rehabilitation project. The improvements to the building were made <br /> and satisfactorily comply with the rehabilitation project standards. ~ _ <br /> Certified by: ~ ' ~ f , <br /> ~ ~ - <br /> - L-=- - <br /> Chi gineer <br /> II. For Building Maintained or Repaired Under Other Governmental Code Provisions <br /> The above designated building was inspected on - , 19 - and found to be substandard under the <br /> _ cote. Maio:enance or repairs to the buildings were made and satisfactorily comply <br /> with the code standards. <br /> Certified by: <br /> Chief Engineer <br /> Reasons for Non-certification Exemption approved: r <br /> ? Not in rehabilitation project area. <br /> ? Not substandard under any code. <br /> ? Improvements have not been made. for county council <br /> Received by <br /> ? Improvements do not comply with standards. <br /> ? Others: Specify _ <br /> Director of Finance <br /> Date <br /> <br />