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4OJN(V of <br /> ♦� ;4 <br /> '1TE Of•NT'� <br /> County of Hawaii <br /> BOARD OF APPEALS <br /> Aupuni Center • 101 Pauahi, Suite 3 • Hilo,Hawaii 96720 <br /> (808)961-8288 • Fax(808)961-8742 , <br /> GENERAL PETITION FOR APPEAL OF <br /> DECISIONS BY PLANNING DIRECTOR OR PUBLIC WORKS DIRECTOR <br /> (Type or legibly print the requested information. See instructions attached.) <br /> TYPE OF PETITION (check one): <br /> Appeal Decision of the Planning Director Appeal Decision of Director of Public Works <br /> SUBJECT PROPERTY(land in question): <br /> Tax Map Key(TMK): Area of Property: <br /> State Land Use <br /> Designation: County Zoning: <br /> Street Address: <br /> APPELLANT INFORMATION: <br /> Name(s): <br /> Signature(s): Date: <br /> Mailing Address: <br /> Telephone: Email: <br /> Interest in Subject <br /> Property: <br /> LANDOWNER INFORMATION: <br /> Name(s): <br /> Signature(s)": Date: <br /> Mailing Address: <br /> Telephone: Email: <br /> APPELLANT REPRESENTATIVE INFORMATION (leave blank if not applicable): <br /> Names)/Title(s): <br /> Signature(s): Date: <br /> Mailing Address: <br /> Telephone: Email: <br /> 1 Not required if the Landowner is not the Appellant. <br /> \\COH01\planning\public\BOA\Forms and Labels\Application Forms\APPEAL 2021-07-PL or PW Dir.docx Revised April 2021 <br />