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County of Hawaii Planning Department <br /> www.cohplanningdept.com • planning@co.hawaii.hi.us <br /> • -"s'c- East Hawaii Office• 101 Pauahi Street,Suite 3 •Hilo,Hawai`i 96720 <br /> Phone(808)961-8288 • Fax(808)961-8742 <br /> •O ........'`. <br /> West Hawaii Office•74-5044 Ane Keohokalole Hwy•Kailua-Kona,Hawai`i 96740 <br /> Phone(808)323-4770 • Fax(808)327-3563 <br /> APPLICATION FOR PLAN APPROVAL <br /> LEGAL Waikoloa Baptist Church <br /> LANDOWNER(S): <br /> LANDOWNER'S SIGNATURE(S): DATE: 16 JAN 17 <br /> PRINTED NAME OF SIGNER(S): Duane Richey TITLE: Pastor <br /> (iffor a Corp.,LLC,Trust or Partnership) <br /> MAILING ADDRESS: P. O. Box 384330 <br /> CITY: Waikoloa STATE: IiI ZIP CODE: 96738-4330 <br /> PHONE NO.: (808)895-6811 EMAIL: duane@wbchawaii.org <br /> Any entity acting on behalf of the recorded landowner must also provide written/signed authorization. <br /> FHG Architects AIA, LL Written/signed letter of <br /> APPLICANT(please print): authorization attached: ® YES <br /> APPLICANT'S SIGNATURE: c.- <br /> APPLICANT'S INTEREST,IF NOT OWNER: itect`Sz Owners' Representative <br /> PRINTED NAME OF SIGNER: Piitz Harris-Glade,AIA LEED AP TITLE: Architect <br /> (if for a Corp.L.L.C.,Trust or Partnership) <br /> MAILING ADDRESS: P. O. Box 4476 <br /> CITY: Kailua Kona STATE: RI ZIP CODE: 96745 <br /> PHONE NO.: (808) 896-9003 EMAIL: fhgarchitects@mac.com <br /> PROPOSED USE: Community Center <br /> STREET ADDRESS OF PROPERTY: 68-3670 Paniolo Ave <br /> CITY: Waikoloa STATE: HI ZIP CODE: 96738 <br /> TAX MAP KEY: (3)6-8-002:031 LAND AREA: 12381 ac. ZONING: RS-10 <br /> STATE LAND USE DISTRICT: Urban SPECIAL MANAGEMENT AREA: 0 YES ® NO <br /> • For Agricultural Tourism: please see attached Section 25-2-75 that lists the required information to be <br /> submitted with your Plan Approval Application. <br /> • For Telecommunication Antennas:please see attached Section 25-4-12 for required information to be <br /> submitted with your Plan Approval Application. <br /> This application must be accompanied by additional items as specified on the second page. <br />