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County of Ha ai'i Planning Department <br /> t 0arrulary 20,-V22) <br /> Zoning° Land Use, and SMA Violation Complaint Form <br /> IILlk�(VAC.Inn In Waimea) 11)I Paztilhi stregi.Salle�1 fie Io M 196720-4224 itSnttl 961 Xn9 Fax (9119)961-87421 F.maij plannim4ha%wiic 7tml,.gov <br /> Kona il'ahalu It)lia►�ij 74-3044 Antr K051k,1 tole IIm l41de E-2url FImn,Ka Jai-Kona.Iff`X)73ti (9119).1z3.4-170 Fax(808)327-3:563 <br /> Complainant Information: <br /> Com <br /> Mailin <br /> P hon <br /> E-ma <br /> Describe Alleged Zoning Violation (refer to Note t below): <br /> s r <br /> I na property address.what dislinguishing feature is seen from the street that identifies the property? <br /> i r <br /> Have you tried to resolve this probtem with ltie violalor before asking far our hetp7 Yeso <br /> WEI- <br /> 11 Yes. Please explain why it didn't work:�n��r i E q rat y a .Age <br /> - <br /> Have you fled this cornplarnt with another government agency? Yes FTNa If Yes.Date of Contact: �- <br /> Person Contacted: Results of Contact: <br /> Enter the following information for the alleged violator: <br /> Property Tax Map Key(TMK)# 79���- <br /> Property 5ireet Address- OK'A t�L : a <br /> Violator(s)Full Name fit known)- -�tr-�.a re-4 rl a C� f'r v%iG V v ►�-+'S <br /> Violator(s)Mailing Address(if <br /> Would you like to be blind copied on letters? Yes; NO <br /> 5igrtaltu Oate: zz . d <br /> Notes g permit is a But a ion andshould be eferred tot the <br /> a t of 9 c a trision 196 1-933 111 or Kajjua-Kana Bui Ll 3472 This ingkidek <br /> agg <br /> pie i Vi RQ I n ILK[ruses shacks sheds c see back page for inforwaVon on Zoning Code Vlofarlwts. <br /> 2) A. Per Planning pepartment Rules of Practice and procedures 9-2(a)(1):All Informationand records ac wired by the <br /> elantiona C1e arEm nt antler this aLL be confidential. However,it is pesstble that if court proceedings occur that this <br /> iniarmation coutd be subpoenaed and made known to all involved parties. <br /> b. 9-2(b)All comptaints shah be given to the zoning inspector- A s a by the Zoning <br /> mpeatvr arKVQF other Alannfrrg Department personnel assigned. <br /> Page 1 of 2 <br /> 1 <br />