2025-10-22 Appellants Exhibit 11-12_STVR Application, Act 17

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1. Completed STVR Registration Form. • 2. Landowner Authorization,if applicable. Any entity applying for an STVR Registration shall submit written authorization from the owner(s)to act on their behalf. 3. $500 Non-refundable filing and processing fee. Payments by check may be made payable to: Director of Finance. 4. Final Approvals from Building Division. Please provide documentation establishing that all permits from the County of Hawai'i Department of Public Works-Building Division for all necessary building,electrical,and plumbing permits were granted final approval.Please visit the Hawaii County Real Property Tax website (www.hawaiipropertytax.com)and"Search Records"to retrieve and print out a copy of the real property tax records for your property,showing all applicable building,electrical,and plumbing permits.Include a copy of this print-out with your application. Incomplete permits will require page 5 of the Registration form to be completed with the County of Hawaii Department of Public Works-Building Division. 5. Current tax licenses. Please submit copies of your current State of Hawaii General Excise Tax/Transient Accommodations Tax licenses for your STVR. 6. County of Hawaii Real Property Tax Clearance Certificate obtained from the Real Property Tax Division. 7. Site Plan. Drawn to scale,on 11"x 17"white copy paper,identifying: a) All property boundaries,dimensions, setbacks,and easements; b) Location of existing and proposed structures,driveway access,swimming pools,ancillary structures,eaves, and overhangs shall be clearly identified and labeled; c) Designated parking spaces for the STVR in compliance with Hawai'i County Code(HCC), Sections 25-4-50 through 25-4-54;and d) Reference points such as roadways,shoreline,etc;and e) Table indicating total square footages of each of the structures on the property. 8. Floor Plan. Drawn to scale,on 11 "x 17"white copy paper,identifying the location and use of all rooms in the STVR with dimensions of all spaces. 9. Notarized Affidavit of Compliance. All landowners must sign a copy of the attached Short-Term Vacation Rental Affidavit of Compliance. Submit notarized affidavit(s)with this application. 10. Pre-existing STVRs: Please provide proof of your prior use of the property as an STVR.Proof may include tax documents for the relevant time period or other reliable evidence. 11. List of affected property owners/lessees. A list of the names, mailing addresses,and tax map key numbers of all owners and lessees of record of all lots of which any portion is within three hundred(300)feet of any point along the perimeter boundary of the STVR property.Please visit the Hawaii County Real Property Tax website (www.hawaiipropertvtax.com)and use the"New Web Access Portal"to retrieve and print out the surrounding property owners list. 2 12. Copy of First Notification Letter to Affected Property Owners/Lessees. Please review the attached Notification Requirements for Nonconforming Use Certificate Applicants,and follow the instructions provided. • 13. Proof of service. Applicants shall provide proof of service or of good faith efforts to serve notice of the application to affected property owners and lessees of record.Proof may consist of certified mail receipts, affidavits,declarations,or the like. APPELLANT EXHIBIT- 11 , pg. 3 of 22