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COR-17-109474
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2024-05-22 Leeward
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Item #2 Waikoloa Lutheran Church/Erick Jacobson (PL-USE-2023-000018)
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PL-USE-2023-000018
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6-8-002:056
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PL-USE-2024-000024
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6-8-002:031
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COR-17-109474
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Entry Properties
Last modified
3/8/2019 9:36:51 PM
Creation date
1/19/2017 12:07:05 PM
Metadata
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Template:
Plan Doc Template
Document Date
1/17/2017
Permit Number
COR-17-109474
Parcel Number
680020310000
Description
USE PERMIT ASSESSMENT APP FOR TELECOMMUNICATION FACILITY, RPT CLEARANCE AND SITE PLAN ATTACHED, WITH $500 F/F CHECK # 5026, VERIZON WIRELESS
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7817JAN! 12 pmt -) r3 <br /> NT <br /> Letter of Author atibtt 1"- <br /> APPLICATION <br /> "APPLICATION FOR ZONING,BUILDING AND LAND USE ENTITLEMENETS <br /> Site Name: 1113 Paniolo <br /> Property Address: 68-3670 Paniolo Avenue,Waikoloa,HI 96738 <br /> TMK Number: (3)6-8-002:031 <br /> I/We,the owner(s)of the above described property,authorize Verizon Wireless and their <br /> employees,representatives,agents and/or consultants,to act as an agent on my/our behalf <br /> for the sole purpose of consummating any building and/or land-use permit applications <br /> (s),or any other entitlements necessary for the purpose of constructing and operating a <br /> wireless telecommunications facility. I/We understand that any application may be <br /> denied,modified,or approved with conditions,and that such conditions or modifications <br /> must be complied with prior to issuance of any building permit(s). <br /> I/We further understand that signing of this authorization in no way creates an obligation <br /> of any kind. <br /> Property Ownersc ,- C, Date: k,l jq4q <br /> 1) L,6r t-• 6,e/a, jesA ij,Ja „a, <br /> Print Ndme <br />
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