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r. <br /> COUNTY 4 11AWA3`i <br /> ." ; '• 141 Vauahi `treet. Suite 7 <br /> Hilo, Hawai''96720 <br /> Ph-, Hilo 0€fi a(808)961-8331 Kona Office(808) 323-4720 DECLARATION 9 ACCEPTANCE DATE <br /> �pl sly <br /> DECLAl3ATION OF COMPLlAl7 <br /> 14AS SECTION 46.88 RELATING TO AGRICULTURAL 5TPUCTURES <br /> AIZtO{IiE�/PIipPERT'Y ItrTFTJRfVSArrC7FJ <br /> PROJECT <br /> STATE LANDUSE DES Tf0N }r�- For confirmation orstaie Land use vc ignatimt,comaci the Depatlinentof Planning at(SOTS)%1-82K. <br /> ADDRESS T <br /> TAX MAP K EY PROPER IYARER <br /> 01 {acral} <br /> STRUCTURE E INFORMATION <br /> usEnr:sTlzucruRE �1 <br /> EXEMPTIONND.{sec hstonfaifosv ng sheers �—EM(a1tJ7 STRUCTURAL SPAN(FDR EXEMPTIONL-7&12 ONLY) (Ft)tmuszbe last than 2S Q <br /> DES TANCEMOM NE.AgFSrSTRUCWRf � tlr.)[mrn.S5ft3 TOTALFLOORARFA �0.01ui-rt,) <br /> DIMENSIONSOF51MXTURE Lnogth '50 (Er)s Width j� (o <br /> AGGREGATE FLOOD,-%M OF ALL EXCINPTED STRUCT AES i:tA M%O tTNDER HX.446-89 Ir.] <br /> Provrda minimum 8 iJ2"aT T'site plan slsow a ateigcac•o�n o structure•propenyhnc++tFdtfheerr Vructwrs,se{hxks tovifierstrutnues,&MeA%*ns o urUCitt And inyother prsrtinentfnFohn"an. <br /> Attach extra:Mets,if necessary, s <br /> COMMENTS{far depanrnaur use ast v+. <br /> (Obr,Wn approval signatures Pdorto svbtatnai al Deda+an to Public Works) <br /> E <br /> NEERING DIUISION'APPROVAL Flood Zone X <br /> EnginecrirtgNip;s>oa B H Qac 2- <br /> OWNEPS CERTIFICATION/DECLARATION <br /> I declare this prefect M be t—Prfrorts applicable bn'&g pegma/cnde regeirements under rhe prouWans of WE$Section 46-88.1 have read and Fahy understand HRS 4688 and certify <br /> that the project is In comfsllance. <br /> 1. 1 tutderstand that this exemption only aPF lees to certain building petutitkode requirements.I shad obtain all alter required pemtim and approvals and shall comply with all <br /> appikahtc codas and€aws assozWed wl(K Ibis development,whkl�may include and not he limited to Special Management Arca,Fleod Hazard,electrical,plumbing,grading, <br /> driveway,walk in County/State right of iA ays.{ice,—ifewater,and Departmen3 of 14eakh regttirements. <br /> 2. 1 understand that the issuameof a dresar tion stomion by the County should noc be taken to mean that compliance with HRS ifs•B8 has been cooffrmcd,and that;r is my sale <br /> m5ponsihiliry to confirm com !iance,The State or County shall not he liable for any claims arising From ronstruciion of buildings,suucntres.at appurranances thereto exempt <br /> frarn the budding code And peg nitting pr ass as described In HR5 46-88, <br /> PrtrpertyOwner: � ' <br /> Address: <br /> Phone Nm Email: <br /> Signature; Printed[Jame: <br /> PQ53 C[]NSffttlCTtQN A FINAL AS BLflLT Yt]TIFICATfffN Fl3RAA must be submitted lrgaa campietinrt of cvnstruttion.Failure to submit the form well C1tlS@ This <br /> 1tFQUlREMErIis; DECLARATION 01COMPUANCE to he dedared INVALID and shag VOID the building permit and/or code exemption,A single Final&-Budr <br /> No4fesation Form_niiJuss he suhmived in camp€ianee with bath of tits followingdeadllnes: <br /> t. Submit form withM Y year of Declaration of Compliance acceprars<e date. <br /> 2. 5ubrml term within 30r days of twmpiction,a,eupancy,or use af5intaure. <br /> Havi ai`i County is an Equal Opportunity Provider and Employer Rev-3/22 I <br /> l� <br />