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<br /> <br /> <br /> <br /> COUi._Y OF HAWAII PLANNING DEPAk.MENT <br /> APPLICATION FOR STATE LAND USE BOUNDARY AMENDMENT <br /> (15 ACRES OR LESS) <br /> <br /> APPLICANT: Andrew Kelsey <br /> <br /> APPLICANT'S SIGNATURE: <br /> <br /> MAILING ADDRESS: 65-1692 Kohala Mountain Road <br /> Kamuela, Hawaii 96743 <br /> <br /> TELEPHONE: (BUS) 881-4351 (HOME) <br /> <br /> LANDOWNER: Andrew Kelsey <br /> <br /> LANDOWNER'S SIGNATURE: <br /> TAX MAP KEY: 6-2-09:22 <br /> <br /> LAND AREA: 5.821 Acres <br /> <br /> CURRENT STATE LAND USE DISTRICT CLASSIFICATION: <br /> ~or~ It rah <br /> REQUESTED STATE LAND USE DISTRICT CLASSIFICATION: Rural <br /> <br /> <br /> THE APPLICANT SHALL SUBMIT THE FOLLOWING: . <br /> <br /> A. Non-refundable filing and processing fee of two hundred dollars. <br /> B. Original and fifteen copies of: <br /> <br /> 1. Application form. <br /> <br /> 2. Location map. <br /> <br /> 3. Preliminary site plan, drawn to scale, with all existing <br /> and proposed structures and improvements shown thereon. <br /> 4. Reasons for the requested change and written description of <br /> the property and proposed development, including but not <br /> limited to: <br /> a. The extent to which the proposed reclassification <br /> conforms to the applicable goals, policies, standards, <br /> and courses of action of the General Plan and <br /> implementing ordinances, plans and documents; and <br /> <br /> b. The extent to which the proposed reclassification <br /> conforms to the applicable district standards. <br /> <br /> C. A minimum 2-foot by 3-foot presentation map requested under B.3, <br /> above. <br /> <br /> 0400q EXHIBIT A <br /> PD 2/26/87 <br />