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SPECIAL PERMIT APPLICATION <br />COUNTY OF HAWAII <br />PLANNING DEPARTMENT <br />(Type or Print the requested information) <br />APPLICANT S�GA. <br />APPLICANT'S SIGNATURE: <br />DATE: <br />LIST APPLICANT'S INTEREST IF NOT OWNER: <br />TELEPHONE: (Bus.) (Home) (Fax) <br />REQUEST: <br />TAX MAP KEY: s — C -) LA I % l ci C) ZONING: <br />AREA OF PROPERTY/AREA OF REQUESTED USE _1 Gj't= iN%J [-v, "zL—_ �! <�� �C• �•�� <br />LANDOWNER: <br />LANDOWNER'S SIGNATURE: DATE: <br />(May be by letter) <br />1 1'� <br />LANDOWNER'S ADDRESS: <br />AGENT: <br />ADDRESS: <br />TELEPHONE: (Bus.)SM' 301 -03a'7 (Home) Prr�x .3 -Q 7(Fax) <br />Please indicate to whom original correspondence and copies should be sent to: <br />ORIGINAL COPIES: <br />