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•• <br /> COUNTY U HAWAPT <br /> ? 101 Pauah! krcrn, Suite 7 <br /> Hilo,Hawai '95720 <br /> 1'•a Pkt:Hilo Qtf a{8081 961-8331 KonaC?ffict (8081 323-4720 DECLARATION# ACCEPTANCE DATE <br /> DECLARATION OF COMPLIANCE <br /> HRS SECTION 4648 RELATING TO AGRICULTURAL STIdtCTURES <br /> PRojECT/PPOPCRTYtty oRMATION a a <br /> rIft <br /> Y <br /> STATE LA OUSE DESIGNATION • 1 For confirmation ofStmc€imd U3 a risignntivn,contact the L)CpartMnt of Pjapning at(sea)961.818$., <br /> � r <br /> ADDRESS r`'3 . N <br /> TAXMAPKEY `[/�J{ PROPERIYe�RREA (r+ <br /> STRI10 RE INFf7RMAT1a q <br /> USE or.SfRIJCtiJRE ► �`����� <br /> EXEMPTION NO.(see hstott fallo%u ag sheen ra6-IJSTRUCTURAL SPAN(FDR EXEMPTIONS.7&12 ONLY) (ft}(scrtrsche less than ZSft.) <br /> DISTANCE:FROM WCAMT'STRUCTURE � [rt.)(raw.15 ft.) TOTAL FLOEIRAREA <br /> DIMENSIONS Qr STRUCTURE tersg[6 {h.)x VAdth <br /> AGGREGATE Ft 00 KAWOF Alt EX£MPTLDSTRUCT III itt$t-tAtALDUNDER F*45-$a [sq It) <br /> Prwrdemmimyrn8•a/2"xa1"sitaplanslrowingappro <br /> Pate fo at•ortofstmoute.proporrylines odicrs[rucsures,aerhat stood eratuccures,cfrrnenrionsa suntture.aadanyvr etperlu+encfafo=idun. <br /> Attach twx sheets.if aeecssasy. <br /> COMMENTS(fordcpaoment use rr+ry}t - <br /> o�'U fJ G <br /> [OBtaln approval xignatoras priorso subnn�al of tleclara�;innm Public Works; <br /> ENGINF„ERINGDNNONAPPROVAL Flood Zone X <br /> 6rt5ieieetingOi cion B.H. Qate12-30-2027 <br /> OWNERS <br /> - - <br /> OWNERS CERTIFICAMONMECf ARATIQN <br /> I declare tills Fro]ect to br exempt from appik abiz Tau'ding per mitAode regult emenIs under the gruwisiono of FIRS Section 46-88-1 have teadand fullp understand FIRS 46.88 and Certify <br /> that the project is in compliance. <br /> 1. i tmderstand that:this exemption ovl a PI lies Pacer to in building per nsit/todc rr~quiragar it[$.I shall obtain all alter required peanks and approvals and shall comply with ail <br /> app ficable:codes aro#latus associated withthis developmenr,which may include and star be hat ited to Special Management Arca,Fit cid Hatard.electrical,plumbing,ggeading. <br /> driveway,wort-in County/State right of tire,waitewater,and Depanrsiem of Health requirements. <br /> I. 1 u ndersmad that the isssrance of d declar tion number by etc Cuvaty should riot be taken to meas:that comislrance with HRS 4E.fie has peen conflrrnitA and that it is my sale <br /> responsibility to confirm compliarsec.The Stowe or County sial€no;be liable for any claims arising From ronstrur4on:of buildings,structures,at apptsaarrances thereto exempt <br /> From the building code and pe;-liting pr tss as described in HRS <br /> Propeny Owner: <br /> Phone No: Emit& ' <br /> Signature' [ <br /> Printed Name• <br /> l'DSTCDNSTRLI[T1QN A FINALr15 S D LATiDN FCsRf41 mtistbe su€ Itted trpon sompledan of cvtisAN45e,mr [he form will catistt this <br /> REgUIREMENTS: (DECLARATION 01 COMPLIANCE to he declared INVALID and shall VOID tire building permit and/or code exemption,Asirigie FinalAs•8trllc <br /> Notification Farm n rut be submitted in cempriaaca with boih of dse foilowingdeadlines: <br /> Z. Submir arm wklfsn#year of Declaration of Compliante acceptance date. <br /> 2. S€rbmit i arm within 30 days of completion,occupancy,or use vfatructure. <br /> 4atrvai`i County is an Equal opportunity Provider and EMP10yer Rev.3122 <br /> € <br />