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<br /> <br /> <br /> Department of Environmental Management <br /> Wastewater Division, County of Hawai'i <br /> Application For Sewer Extension <br /> <br /> Part A. (must be completed) <br /> Project Address: 605 W. Lanikaula St. to Leilani St. / Manono St. Intersection Date: April 23, 2009 <br /> TMK No.: (3) 2-4-056: 017 <br /> <br /> Applicant Information: Contractor Information: <br /> <br /> Name: Debra Fitzsimons, Vice Chancellor of Admin. Affairs Name: To Be Determined <br /> Address: 200 W. Kawili St. Hilo. HI 96720 Address: , <br /> <br /> Company: University of Hawaii at Hilo Company: ±a <br /> Phone No.: (808) 974-7595 Phone No.: = <br /> . <br /> Check applicable box: X Sewer Main Installation (Indicate reason for work and complete Parts 6~ C. <br /> Sewer Lateral Installation (Indicate reason for work and complete Part- C) 1-0 <br /> <br /> Reason For Work: The proposed parallel Lanikaula St. sewer main will convey the additional wastewater flow due to <br /> the_future _expansion of the UH-Hilo campus within the parcels: 2-4-001: 007, 2-4-001: 041, 2-4- <br /> 001: 122, 2-4-001: 169, and 2-4-056: 017. <br /> Part B. <br /> Sewer extensions are subject to Hawai'i County Code, Chapter 21, Division 4, Extensions and the APPLICANT shall be <br /> responsible for submitting a resolution to the County Council for approval of the sewer main extension. Select one of <br /> 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. X <br /> Section 21-28(b)(1): County constructs, applicant pays. <br /> Section 21-28(b)(2): County constructs, applicant and County share cost. <br /> <br /> Estimated Start Date Estimated Completion Date <br /> Part C. <br /> <br /> I hereby certify that all work requested above will conform to appropriate sections of the Hawaii County Code. <br /> <br /> <br /> Owner Signature: Date: <br /> <br /> Department of Environmental Management, Wastewater Division <br /> <br /> Approved by: a Date: "/q <br /> Wastewater Division Chief <br /> <br /> <br /> Approved by: k I Date: -7 ~3© /D q <br /> Director of EnvironmenT16 i agement <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 /> Hawai'i County Code. <br /> 2) Filing of Sewer Extension Resolution is not required for sewer lateral installations. <br /> ATTACHMENT A <br />