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County of Hawai‘i
DEPARTMENT OF PUBLIC WORKS – ENGINEERING DIVISION
SPECIAL ACTIVITY PERMIT
(FOR TEMPORARY COMMERCIAL ACTIVITY WITHIN COUNTY STREETS)
PHONE NO.: PERMITTEE NAME:
MAILING ADDRESS: EMAIL:
PROPOSED COMMERCIAL ACTIVITY WITHIN COUNTY STREET (INCLUDE PRODUCTS/SERVICES OFFERED, SIGNAGE, ETC):
INTENDED LOCATION OF COMMERCIAL ACTIVITY – ATTACH LOCATION MAP (SEE HAWAII COUNTY CODE SECTION 22-3.3.2 FOR ALLOWABLE AREAS):
Name of County Road/Street
DURATION(Dates): From:to (Not to exceed 1 year)
(Times): From:(am/ pm) to (am/pm)
REQUIRED ATTACHMENTS: (Hawaii County Code Section 22-3.3)
1.Location map showing the activity.
2.Provide a certificate of insurance and proof of a public liability insurance policy naming as an additional insured, the
county, its officers, representatives, employees, and agents covering any claim or liability for damages, injuries or deathresulting from any of the uses permitted hereunder. The minimum amount of coverage under such policy shall be
$1,000,000 per occurrence. The policy and coverage shall be kept in force until the special activity permit is terminated.
3.Proof of valid business license or permit required for conducting commercial activities in the State of Hawaii.
4.Waste Management plan.
IN CONSIDERATION OF GRANTING THIS PERMIT, THE PERMITTEE UNDERSTANDS AND AGREES TO:
Hold harmless, indemnify and defend the County of Hawai’i; its officers, employees and agents thereof from all claims, demands, suits, actions, or proceedings of every name, character, and description which may be brought against the County of Hawai‘i for or on account of any injuries or damages to any person or property received or sustained by any person by or in consequence of any act or acts of the holder of this permit for actions done under this permit. [Hawai‘i County Code section 22-3.3(5)]; and
Comply with all conditions as printed on the back of this permit. [Hawai‘i County Code section 22-3.9].
By signing below, the Permittee certifies that the Permittee has legal authority to sign in the capacity stated, and the Permittee understands and agrees that the terms and conditions of this permit are a legally binding contract.
By: Permittee’s Signature Date
Its:
APPROVED:
Director, Department of Public Works Date
AGENCY USE ONLY
PERMIT NO: FEE: $50
County of Hawai‘i is an Equal Opportunity Provider and Employer
Adjacent Tax Map Key(s)
Please submit form via e-mail to dpweng@hawaiicounty.gov
SPECIAL ACTIVITY PERMIT CONDITIONS OF APPROVAL(Hawai‘i County Code section 22-3.9)
In addition to any other conditions imposed by Chapter 22 of the Hawai‘i County Code, all permits issued pursuant to this article shall be subject to the following conditions:
1.All permitted items shall be removed from the county street during all periods outside of the permitted timesand days as specified in the publication dispenser, sidewalk use, or special activity permit.
2.Permittees shall comply with all laws, ordinances and regulations of the federal, state and countygovernments relating to the installation, operation and maintenance of their permitted items or uses.
3.Permittees shall be wholly responsible for the repair and maintenance of all permitted items, including anyassociated utility improvements.
4.Only the use described on the permit shall be deemed to be authorized by the Director of theDepartment of Public Works (“director”). Any additional uses shall require additional authorization from thedirector.
5.Should the permitted use, activity or improvement interfere with or obstruct any county facility or otherauthorized improvements, the permittee shall, at their own expense;
(A)Terminate the use and remove the activity or improvement; or(B)Move the use to a location acceptable to the director.
6.Should the permitted use, activity or improvement impede or obstruct any emergency repairs to a countyfacility or public utility, the permittee authorizes the county to use of all necessary action to immediately
relocate permitted activity use or improvement and shall make no claim for any damages that may result fromthe relocation action.
7.Any construction work associated with the permits of this article shall also be subject to the constructionrequirements of this chapter.
8.Upon termination of all permits, the permittee shall be responsible for the restoration of the county streetused or occupied by the permittee to a condition equal to or better than its original condition.
9.Permittee shall comply with all conditions noted on the permit as may be reasonably necessary for public safety.
County of Hawai‘i is an Equal Opportunity Provider and Employer
1.No commercial activities are allowed within marked parking stalls or on sidewalks, unless specifically approved
by the Director.
2.No standing or serving is allowed on the roadway side of any vehicle conducting commercial activity, unless
specifically approved by the Director.
3.Special activity permits are intended for itinerant use. No permittee shall remain in one location beyond theperiod designated by official signs or as allowed by the director.
4.Permittee shall comply with all conditions of Hawaii County Code Chapter 24 - Vehicles and Traffic, Article 8 -Parking, Standing, and Stopping, as amended.
Additional Conditions for Special Activity Permit: