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— REFERRAL of SIGN VARIANCE APPLICATION for KVDC REVIEW — <br /> To: KAILUA VILLAGE DESIGN COMMISSION, do PLANNING DEPARTMENT <br /> From: DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION <br /> SITE TAX MAP KEY NO.: (3)1 04-,W) <br /> STREET ADDRESS: 1 '-'10 00 4eINN KAILUA-KONA, HAWAII <br /> NAME OF APPLI : ° Aff. 114&1 NNk1.1 oltAc• <br /> SIGNATURE: <br /> DATE: N#2-1 I I <br /> MAILING -100D 44er■N kciei 2Do Ow, (W140 <br /> TELEPHONE NUMBER: L321-k94-ID <br /> APPLICANT'S INTEREST, if not owner of business related to sign: <br /> BUSINESS RELATED TO REQUESTED SIGN: <br /> NAME OF OWNER(if same as Applicant,write"Same"): -OW/ <br /> SIGNATURE: DATE: <br /> MAILING ADDRESS: <br /> * NATURE/TYPE OF BUSINESS: TELEPHONE NUMBER: <br /> OWNER OF MASTER L. SEHOLDI INTEREST(Master Lessee), if land ownership is not fee simple: <br /> yt, 41- n <br /> NAME OF MASTE7 LiE4SEEv -.A „r\e,L-C, <br /> SIGNATURE: il -3-1/ 74:4:-/f/ DATE: <br /> Print name of,S4nator if not same as titled Master Lessee: 10k 9Iii4w <br /> MAILING ApfoRESS: CIO VOC ext.&Y- (2-inai,Delo 6.-te4o2_4.*noor Deofi 00 CA <br /> TELEPHONE NUMBER: (( )20c1 2( 4210$v* (.6• <br /> • <br /> RECORDED LAND OWNER: kit190.461,bokreoguiki c.A rece <br /> n ,( 1)1-61 0 tei E <br /> Vito <br /> Land Title Holder) 4) <br /> OWNER'S SIGNATURE: ,l , itt/ DATE: <br /> Print name of signator if not semis title holder: 1A,11.e.,ANN VI(ot10 <br /> MAILING ADDRESS: Po Wv 1201 Y..a.thAa- YDW, 44 I (4014-& <br /> TELEPHONE NUMBER: ( 00) Cge0 <br /> Please include the original plus ten copies(eleven(11)sets total)of the following documents for KVDC review: <br /> (1)this Referral form with all signatures; <br /> (2)the attached Checklist completed and signed by both the Applicant and Business Owner;and <br /> (3)the sign variance application form with all attachments pursuant to Section 3-22(b)of the Sign Code. <br /> FOR OFFICIAL USE ONLY: <br /> DPW Comments: Proposed sign meets basic Sign Code requirements for placement in Kailua Village except as <br /> requested in attached variance application (type and number of signs,Ietterilogo height,sign area,&placement) <br /> Confirmed by: Date: <br /> * Planning Dept.: County Zoning District; <br /> C.11leeraVyoungZesktap1Sign VARIANCE NW:cation Referral 4-2-2012.d0a March 2012 <br />