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APPUCANT <br />Legal Name: Pnako Community <br />Street Address: P.O. Box 44345 <br />City. State and 21p+4 Code:. ~-siiYSe. Fll %743 <br />Mailing Address: P.O. Box 44345 <br />City, State and Zip+4 Coder . HI %743 <br />Contact Perscm8 $ Title: Rob Slrallenbereer. President and e_1y <br />Phone No.: j808188U-9211 Fax No.:Ln/a 1 <br />Email: frviiila~hawaii.tr.com <br />interest in Property: Prsa~o~sl Easement Holdec~ <br />'If for a <br />officer. <br />or <br />signed by an authorized <br />AGENT <br />Name: Ron Terry. Geometrician Associates <br />Mailing Address: PO Box 3 <br />City, State end ZIp+4 Code: Hilo HI %7~~ <br />Contact Person $ Position: Ron Tenn <br />Phone No.:(808,~ %9-T090 Fax No.:(866)~16-6988 <br />Email: <br />Signature Date ~~%~ "" <br />PROPERTY OWNER(S) (If other than the appl6cant) <br />legal Name: State of Hawai`i/Mauna I.aai Resort (Ooerationl. Inc. (I.esseel <br />Street Address: 68-1400 Mauna I.aai Dr.. Ste. 102 <br />City, State end Zip+4 Code:~smuela HI 96743 <br />Mailing Address _see above <br />Contact Person $ Title: <br />Phone No.:,(~Q$) 881-7916/881-7050 Fax No.:f8081 881-7998 <br />EmaN: atoba(8lmaunalanLoan r+e~tlonship to applicant: nor et <br />CONTRACTOR Note: No contractor has yet been setecl~sd. <br />Name: Contractor I.D. # <br />Scope of Work: <br />Mailing Address: <br />'; Contact Person $ P~itlon Title: <br />Phone No.:! ,~ Fax No.:! <br />Email: <br />Emergency Corttad Infonnatlon <br />' Company/OrganizaBonName: <br />Contact Person and Tits George Frv <br />Phone No.:j$Q$)„ sso-9211 Phone No.:! <br />Coaseavalton D-aaict Uae.~pplkattoaa Perko Bnaerge,xy Road <br />