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COUNTY OF HAWAII BOARD OF APPEALS PETITION FOR VARIANCE FROM REQUIREMENTS OF COUNTY CODE (Except Zoning & Subdivision) (Type or legibly print the requested information) OWNER OF LAND OR BUILDING: OWNER' S SIGNATURE : DATE : ADDRESS : TELEPHONE : (Bus . ) (Home) PETITIONER' S INTEREST IN THE PROPERTY: IDENTIFY PROVISION OF CODE FOR WHICH VARIANCE BEING SOUGHT AND TYPE OF VARIANCE BEING REQUESTED: TAX MAP KEY: (land in question) AREA OF PROPERTY: STATE LAND USE DESIGNATION: COUNTY ZONING: STREET ADDRESS OF PROPERTY: OWNER' S/PETITIONER' S REPRESENTATIVE : REPRESENTATIVE ' S SIGNATURE : DATE : REPRESENTATIVE ' S ADDRESS : TITLE : TELEPHONE : (Bus . ) THIS PETITION MUST BE ACCOMPANIED BY A FILING FEE OF TWO HUNDRED DOLLARS ($200) PAYABLE TO THE COUNTY DIRECTOR OF FINANCE AND: 1. The Original and ten (10) copies of this completed petition with the following: a. A description of the property involved in the variance in sufficient detail for the public to precisely locate the property. b. A scale-drawn plot plan of the property showing all existing and proposed structures and improvements. C. A statement explaining: (i) The special or unusual circumstances or conditions applying to the land or building for which a variance is sought, which circumstances or conditions are peculiar to such land or building and do not apply generally to lands or buildings in the neighborhood or surrounding property. (ii) The circumstances or conditions that deprive the owner of the reasonable use of the land or building by the strict application of the particular provision of the Code. (iii) How the granting of a variance is necessary for the reasonable use of the land or building. (iv) The effects, if any, that the variance will have on other persons or property. BOA (P:\WP60\FORMS\BOA\VarianceBOA11-24-2003