Laserfiche WebLink
I. <br /> I EP T ENT OF PUBLIC 'S <br /> ADDITIONAL CO0 ,TACT INFOR0 ",0 0 I <br /> ILII,,on° <br /> AGENT NA E <br /> _ <br /> AILING ADDRESS .... <br /> PHONE NU BER <br /> E AIL <br /> AGENTNA E _�.rr.�,.����� .� e� .. � ........�.�. ....�. ................ _� <br /> AILING ADDRESS <br /> PHONENU BER._w................. �_ ........ ....�....._�..... ...�,,�...._____� <br /> E AIL <br /> I hereby certify that I am the owner of the property listed above and all information provided is accurate <br /> and complete.I understand that all contacts listed above will receive communication regarding my permit <br /> application and plans. <br /> CHECK THE BOX IF tir <br /> PROPERTY OWNER <br /> INFORMATION ABOVE <br /> MATCHES RPT'S DATA. <br /> If no,proof of ownership is <br /> Richard Standke/Deborah Standke required.Verify at: <br /> �.. PROPERTY (PRINT)OWNER imm ° <br /> �aa �I��: ��wu :�aa:�m xccffirn <br /> ..� .. <br /> 2-04-2024 <br /> PROPERTY OWNER(SIGNATURE) Date <br /> Document 1 - Pg 2 of 2 <br /> Hawai`i County is an equal opportunity provider and employer <br />