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Gitutfu <br />DEPARTMENT OF PUBLIC WORKS <br />ADDITIONAL CONTACT INFORMATION (LIMIT2) <br />NAME <br />Trent R. Thompson <br />MAILING ADDRESS <br />68-3670 Pedalo Avenue, (P.O. Box 383567), Waikoloa, HI 96738 <br />PHONE NUMBER <br />808-315-6406 <br />EMAIL <br />trent@wbchawaii.org <br />NAME <br />MAILING ADDRESS <br />PHONE NUMBER <br />EMAIL <br />Pursuant to Hawaii County Code, Section 5-4-1(a)(7), and by my signature below, I certify the following: (1) I am <br />the owner of the property described above or the owner's authorized agent and I consent to the submittal of <br />this permit application; (2) the information in this application is accurate and complete; and (3) I understand that <br />all contacts listed above will receive communication regarding the permit application and plans. <br />PRINT NAME <br />SIGNATUR <br />CHECK THE BOX IF v <br />PROPERTY OWNER <br />INFORMATION ABOVE <br />MATCHES RPT'S DATA. <br />If no, proof of ownership is <br />required. Verify at: <br />www.hawaiipropertytax.com/ <br />sea rch.html <br />Hawaii County is an equal opportunity provider and employer <br />DATE <br />