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APPLICATION FOR OHANA DWELLING UNIT PERMIT <br /> COUNTY OF HAWAII <br /> PLANNING DEPARTMENT <br /> APPLICANT: <br /> APPLICANT'S SIGNATURE: DATE: <br /> ADDRESS: <br /> TELEPHONE (Bus): (Res): <br /> TITLEHOLDER(S): <br /> APPLICANT'S INTEREST, if not titleholder(s): <br /> TAX MAP KEY: LAND AREA: <br /> STATE LAND USE DISTRICT: ZONING: <br /> THIS APPLICATION SHALL SHALL BE FILED WITH THE PLANNING DIRECTOR AND SHALL INCLUDE: <br /> (a) A non-refundable filing fee of twenty-five dollars, <br /> �) Original and five copies of <br /> (1) Application form; <br /> (2) Plotplan, drawn to scale, showing: <br /> O Allproperty boundaries, <br /> (i) Proposed ohana dwelling unit, including yard (setback) requirements from property <br /> lines, <br /> (ii) Existing and proposed structures, including detached garages and watercatchment <br /> system; <br /> (iv) Two addition alparking spaces for the proposed ohana dwelling unit; <br /> (v) Existing and proposed driveway, and <br /> (v) Location ofprivate sewage disposalsystem. <br /> (3) Elevations of the ohana dwelling unit, drawn to scale. <br /> (c) A notarized affidavit s tating that the applicant is a titleholder of the affected property. <br /> (d) A notarized affidavit stating thatprovisions ofany restriction, covenant orotherland use restriction <br /> applicable to the lot by way ofa deed orlease orotherprovision do notprohibit the construction of <br /> placement ofan ohana dwelling unit ora second dwelling unit. <br /> (e) A copy of the notice of the application sent to allparties listed in the application who did not execu, <br /> the application as a titleholder; to owners ofproperties within three hundred feetofthe perimeter <br /> boundary of the lot; to and any known association ofsuch property owners, informing them that an <br /> application foran ohana dwelling unitpermithas been filed. Proof of service or of goodfaith effor <br /> to serve notice ofthe appplication shallalso be submitted. Such proofmay consist o certified mail <br /> receipts, affidavits, ofthe like. The list of names, addresses, and tax map key oft hose individuai <br /> notified shall also be submitted. <br /> A cerlfication of clearance (from the Director of Finance that the real property taxes and all other <br /> fees relating to the subject arcel(s) have been paid and that there are no outstanding delinquencies, <br /> shall accompany this Application. <br /> THE OHANA DWELLING UNIT SHALL MEET ALL APPLICABLE REQUIREMENTS OF THE <br /> HAWAII COUNTY CODE <br /> PD:05/98(F:\wp60Aorms\pd\OHDApp98.frm) <br />