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Docusign Envelope ID: B22F2063-44AF-46A8-8642-7250DC191AA7 <br /> County of Hawaii Planning Department <br /> 4• �~ �Iidy� <br /> www.hiplanningdept.com - planningCd�co.hawaii.hi.us <br /> East Hawaii Office• 101 Pauahi Street, Suite 3 - Hilo,Hawaii 96720 <br /> e- Phone(808)961-8288 - Fax(808)961-8742 <br /> .x�.fir <br /> °F West Hawaii Office • 74-5044 Ane Keohokalole Hwy - Kailua-Kona,Hawaii 96740 <br /> Phone(808)323-4770 - Fax(808)327-3563 <br /> SPECIAL MANAGEMENT AREA USE PERMIT ASSESSMENT APPLICATION <br /> APPLICANT INFORMATION (Applicant is the person or entity actually responsible fbr the proposed use, activity or <br /> operation—typically the landowner or lessee.) <br /> APPLICANT'S NAME(S): Bumper Productions, LLC <br /> ADDRESS: 510 18th Ave. <br /> CITY: Honolulu STATE: HI ZIP CODE: 96816 <br /> EMAIL: amira.soliman@gmail.com <br /> PHONE NUMBER(S): bus. hm/cell: (614) 477-0330 <br /> SIGNATURE(S): 9 DATE. <br /> 02/20/2026 <br /> LANDOWNER INFORMATION ❑ SAME AS APPLICANT (may leave this section blank) <br /> LANDOWNER'S NAME(S): Brian Clark <br /> ADDRESS: 27-121 Mill Rd. <br /> CITY. Papa'ikou STATE: Hawaii ZIP CODE: 96781 <br /> EMAIL: bc0427@gmail.com <br /> PHONE NUMBER(S): bus: hm/cell: (310) 804-8651 <br /> SIGNATURE(S): ( DATE: 2/23/2026 <br /> 0 Landowner agrees to grant representatives of the County of Hawai`i the right to enter the property at <br /> reasonable business hours for the purpose of site inspection. <br /> AUTHORIZED AGENT/CONTACT PERSON <br /> CONTACT NAME(S): Amira Soliman <br /> ADDRESS: 510 18th Ave. <br /> CITY: Honolulu STATE: HI ZIP CODE: 96816 <br /> EMAIL: amira.soliman@gmail.com <br /> PHONE NUMBER(S): bus. hm/cell: (614) 477-0330 <br /> �d 02/20/2026 <br /> SIGNATURE(S): DATE: <br /> TAX MAP KEY(S): TMK 3-2-7-004:118 <br /> 1 <br />