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Draft Property Declaration Form.pdf
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Draft Property Declaration Form.pdf
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7/30/2021 3:06:10 PM
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AGENT NAME <br />MAILING ADDRESS <br />PHONE NUMBER <br />EMAIL <br />AGENT NAME <br />MAILING ADDRESS <br />PHONE NUMBER <br />EMAIL <br />I hereby certify that I am the primary owner of the property listed above and all information provided is <br />accurate and complete. I understand that all contacts listed above will receive communication regarding <br />my permit application and plans. <br />PROPERTY OWNER (PRINT) <br />PROPERTY OWNER (SIGNATURE) <br />CHECK HERE IF <br />PROPERTY OWNER <br />INFORMATION ABOVE <br />MATCHES RPrS DATA. If <br />no, proof of ownership is <br />required. <br />.L.J_QK.._Ij_EEE._T0._ovIRJJ..Y. <br />PROPERTY OWNFRSFIIP <br />Date <br />Hawai'i County is an equal opportunity provider and employer <br />
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