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L <br /> DECLARATION# <br /> BUILDING DIVISION - DPW <br /> COUNTY OF HAWAII g,(202Z- 000 IL� <br /> '• •.•. 101 Pauahi Street, Suite 7 <br /> ,' oRilR�rx Hilo, Hawaii 96720 <br /> Ph: Hilo Office (808) 961-8331 Kona Office (808) 323-4720 <br /> FINAL AS-BUILT NOTIFICATION <br /> HRS SECTION 46-88 RELATING TO AGRICULTURAL STRUCTURES <br /> ***THIS FORM MUST BE SUBMITTED UPON COMPLETION OF CONSTRUCTION. <br /> ***FAILURE TO SUBMIT THE FORM WILL CAUSE THE HRS 46-88 DECLARATION OF COMPLIANCE TO BE DECLARED INVALID AND SHALL VOID THE BUILDING PERMIT AND/OR <br /> BUILDING CODE EXEMPTION. ASINGLE AS-BUILT NOTIFICATION FORM MUST BE SUBMITTED IN COMPLIANCE WITH BOTH OF THE FOLLOWING DEADLINES: <br /> 1. SUBMIT FORM WITHIN 1 YEAR OF DECLARATION OF COMPLIANCE ACCEPTANCE DATE. <br /> 2. SUBMIT FORM WITHIN 30 DAYS OF COMPLETION,OCCUPANCY,OR USE OF STRUCTURE. <br /> PROJECT/PROPERTY INFORMATION <br /> PROJECT NAME S 1cj -� � C+ �(� � _l <br /> ,151 <br /> ADDRESS 3 p3 Hol w I's ��1� <br /> TAX MAP KEY <br /> AS-BUILT CONDITIONS OFSTRUCTURE <br /> USE OF STRUCTURE 6 rned <br /> DISTANCE FROM NEAREST STR TURE (fr,}(mJin.15 f(t.)) VI TOTAL FLOOR AREA (sq.ft.) <br /> DIMENSIONS OF STRUCTURE I Lengih a i✓ (ft.)x Width CR (ft.) <br /> AGGREGATE FLOOR AREA OF ALL EXEMPTED STRUCTURES CLAIMED UNDER HRS 46-88 D (sq.ft.) <br /> OWNERS CERTIFICATION/DECLARATION <br /> • 1 certify that the as-built conditions of the structure are in full compliance with the requirements and provisions of HRS Section 46-88. <br /> CHECK THE APPLICABLE BOX BELOW: <br /> F�1 The as-built location of the structure is as shown in the original site plan. <br /> The as-built location of the structure has changed from what is shown in the original site plan. if this box is checked,you must do the following: <br /> • Provide minimum 8-1/2"x11"site plan showing the as-built location of structure,property lines,other structures,setbacks to other structures,dimensions of <br /> structure,and any other pertinent information.Attach extra sheets,if necessary. <br /> Property Owner: <br /> Address: <br /> Phone Na U -- �jml I- Email: <br /> Signature: N Ws,� <br /> Pri Pied Name: <br /> The project is not required to comply with county,state,and federaf floodplain management development standards,ordinances,codes,statutes,rules,and regulations pursuant to the <br /> National Flood Insurance Program requirements. <br /> Hawairi County is an Equal Opportunity Provider and Employer Rev.3/22 <br />