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r .:: :}%, r BUILDI G DIVISION - DPW .`: \. COUNTY 1 HAWAII •' "1 t': 101 Pauahl `trcet, Suite 7 'tia:m r, I411o, Hawai '96720 '.\'.t. ,,e ',' Ph: Hilo OW a(808) 961-8331 Kona Office(808) 323-4720 DECLARATION# ACCEPTANCE DATE IllEiraMMIIW DECLARATION OF COMPLIANCE HRS SECTION 4648 RELATING TO AGRICULTURAL STRUCTURES PROIECT/PROPERTY INFORMATION PROJECT NAR. 14/4 cootgrie STATELANOUSCOE ION J . ,` d -'pot confirmation of State LandUse Designation,contact the Department of Planning at(808)961.8288:. ADDUEss r I(.(.vf�G/{•t1','�r L.r t 73-41r03 ; •,`, P, ,- - IZ.ot • Ci+ice- kovut. -t 61(0-1 ~TAX MAP if EY PROPERIYARLA _ -�- eel --01 ] (acres) . STRUCTURE INFORMATION �1 USE OF.STRUCTURE /y 11` _ y. y/6 /`j'`� fl 1 Ca.)/� EXEMPTION NO.(see hs on foiiow.ng sheds E z STRUCTURAL SPAN(MMR EXEMPTIONS:7 p 12 ONE JI. ,....g2 i (it)(mystbekssrl,an2Sic) DISTANCE FROMNCARESrSTRUCCURE 77(h.)limn.1Sh) TOiALItOORAREA e,0 (sq.ft,) • OIMCNSIONSOFSTRUCiURE Length .O CO x Wehlt ( Q. (ft) AGGREGATE FEOORAR(A OF ML(X(MPTEOS1UCYURE5(LA1MtD UNDER HR546-B! dilj f (sq hi Provide mmimumB.1/2 i1`s7ceplanshowie appouhutotgcaienofaurxture.propnrylmet. ikeet�iunwer.setbackstoorherruunIures.,d,.remlonsofwunurr.andan,otherperrhentfnformation. Attach extra theets.if necessary. � 00 e. 3 T�� ?J�r�.e. COMMENTS(for dcpanmesr use an9); r `f 1467.-64". (Obtain approval signatures prior to submmnc l el Dedar$ion ro Public Works) ENGINEERING OIVISIONPAPPROVAL Flood Zone X blowfly!'Division B.H. IOate 12-30-2022 OWNERS CERTIFICATION/DECLARATION I declare this project to be exempt horn applicable bu;ding perrniifcode requirements under rhe provisions of HRS Section 46.08.t have read and fully understand HRS 4688 and certify that the project Is in compliance. 1. I understand that this exemption only applies to certain building permit/code requirements I shall obtain all other required penults and approvals and shall comply with all applicable codes and laws associated with this development.whichmay include and not he limited to Special Management Area.Flood Hazard,electrical plumbing.grading, driveway,work in County/State sight of ways.fire.wastewater,and Department of Health requirements. 2. I understand that the issuance of a declar.tion number by the County should not be taken to mean that compliance with HRS 46•HHha:been confirmed,and that iris my sale responsibility to confirm con eliance.TheiStace or County shall not he Gable for any claims arising from construction of buildings.savouries,or appurtenances thereto exempt from the building code endpastiling process as described in HIS 46.88. Property Owner: /4/C Address: 7 3-490e Mz i -- j&,4 7cc Phone No: Email: Signature: Printed Name: I POST CONSTRUCTION A FINAL AS-BUILT OTIFICAT;ON FORM must be 5itivnitxtc upon completion oiconstruction.Failure to submit the form wali cause this REQUIREMENTS: DECLARATION O COMPLIANCE to he declared INVALID and shall VOID the building permit and/or code exemption.A tingle Final At.Bullr Notification Form int be submitted in compliance with both of the following deadrmes: T. Submit within 1 year of Declaration of Compliance acceptance date. 2. Submit rim within 30 days of completion,occupancy,or use of structure. Haw ail County is an Equal Opportunity Provider and Employer 3/22 ,. . ROA DOCUMENT 1 PAGE 004