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SPECIAL PERMIT APPLICATION <br /> COUNTY OF HAWAVI <br /> PLANNING COMMISSION <br /> (I'vpc or legibly print the requested information) <br /> AITLWANT(S): <br /> APPLICANT'! ')[(-;NA'I'URI--': DATE: <br /> ADDRESS. <br /> Alf at <br /> - <br /> LIST :APPLICANT'S not owner): <br /> PHONF: (Hus.) <br /> REQUEST'. <br /> VAX%I A P K E N 3AJ-_0 ZONING: <br /> SIZE OFPROlIERTY /ARF.A OF REQUESTED IISI-::-- <br /> LANDO%VN E R(S): <br /> FEE SIMPLE LANDOWNER(S) WRITTFN AUTI 10RIZATIONP/�,1� Seer f 1- 4 ea, <br /> 1-1 6.=Q DATE: OL <br /> DATE: <br /> Note: The above written matioriz.mion of the fandowner(s)gives petimssion f6i the:ipplicant1petitioncr to file the application/ <br /> petition and acknowledges that the landowner(s)and lhcir successor,;ore bound by the Special Pemiit and its conditions. <br /> AGENT: I <br /> AGENT ADDRESS: <br /> PHONE: (Bus.) (Iles.) <br /> Please indicate to whom original correspondence and copies should be sent. <br /> ORIGINAL.: <br /> Planning Dept. <br /> Exhibit <br />