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— REFERRAL of SIGN VARIANCE APPLICATION for KVDC REVIEW — To: KAILUA VILLAGE DESIGN COMMISSION, do PLANNING DEPARTMENT From: DEPARTMENT OF PUBLIC WORKS, BUILDING DIVISION SITE TAX MAP KEY NO.: 7-5-007-009 STREET ADDRESS: 75-146 Sarona Rd KAILUA-KONA, HAWAII NAME OF APPLICANT: Ina Custom Signs I SIGNATURE: DATE: 4/ 1 /4 MAILING ADDRESS: 730 Kilauea Ave Ste 1 Hilo,HI 96720 TELEPHONE NUMBER: 808-935-4491 APPLICANTS INTEREST, if not owner of business related to sign: Sign Installation BUSINESS RELATED TO REQUEST • SIGN: NAME OF OWNER(if same as A• • icant,write'Same"): Kona Hospitality SIGNATURE:�._ i DATE: 3IZ 7.7/ MAILI ADDRESS: 2200 6th A 20 Seattle,WA 98121 • NATURE/TYPE OF BUSINESS: tel TELEPHONE NUMBER:206-497-2489 OWNER OF MASTER LEASEHOLD INTEREST(Master Lessee), if land ownership is not fee simple: NAME OF MASTER LESSEE: SIGNATURE: DATE: Print name of signator if not same as titled Master Lessee: MAILING ADDRESS: TELEPHONE NUMBER: RECORDED LAND OWNER: Ko = Ho •itali (Fee Land Title Holder) l / OWNER'S SIGNATURE: '. / ,i / I DATE: 3>/Z 7` / Print name of signator • - w me as title holde' ' MAILING ADDRESS: 2200 6th Ave#520 Seattle WA 98121 TELEPHONE NUMBER: 206-497-2489 Please include the orioinal plus ten copies(eleven(11)sets total)of the following documents for KVDC review: (1)this Referral form with all signatures; (2)the attached Checklist completed and signed by both the Applicant and Business Owner;and (3)the sign variance application form with all attachments pursuant to Section 3-22(b)of the Sign Code. FOR OFFICIAL USE ONLY: QPW Comments: Proposed sign meets basic Sign Code requirements for placement in Kailua Village except as requested in attached variance application (type and number of signs,letter/logo height,sign area,&placement) Confirmed by: Date: •Plannina Dent.: County Zoning District: C Uwnvyoun Dwklop∎S.gn VARIANCE Appecason Referral 4-2-2012.dac Made 2012