HomeMy WebLinkAboutRequest to Maintain County Roadside AreaREQUEST TO MAINTAIN COUNTY ROADSIDE AREA
County of Hawai‘i
DEPARTMENT OF PUBLIC WORKS – HIGHWAY MAINTENANCE
Office Hours: Weekdays, 6:30 AM to 3:00 PM
DPW Form- (1)9/3/13
It is requested that the County of Hawai‘i not utilize any herbicide in the area shown on the attached map/
sketch.
REQUESTOR:PHONE NO.:
MAILING ADDRESS:EMAIL:
LOCATION OF AREA(S) – REQUIRED SIGNATURES ON ATTACHED LOCATION MAPS:
Name of County Road/Street
TAX MAP KEY:
Name of County Road/Street
TAX MAP KEY:
Name of County Road/Street
TAX MAP KEY:
TAX MAP KEY:
Name of County Road/Street
DURATION(Dates):From:to (Not to exceed 1 year)
IN CONSIDERATION OF GRANTING THIS REQUEST THE REQUESTOR UNDERSTANDS AND
AGREES TO:
(I) We agree to maintain, which includes the cutting and trimming of grass and shrubbery within this
area to permit the County of Hawai‘i to skip the use of herbicide in this area. To identify this area for the
Highway Maintenance personnel, (I) (We) will place a sign on the left and right boundaries of this area. The
sign will be 6 ( six) inches high and 18 (eighteen) inches long, with white background and red lettering 4
(four) inches high and ½ ( half) thick, with the words, ‘NO SPRAYING.”
The sign shall be visible and easily seen by the County workers to prevent spraying. (I) (We) will
notify the County of Hawai‘i by email or phone: 961-8349 of any problems or special conditions
regarding maintenance that may arise
By:
Requestor’s Signature(s)Date
By:
Requestor’s Signature(s)Date
Its:
APPROVED:
Highways Division Chief, Department of Public
Works:
DATE:
County of Hawai‘i is an Equal Opportunity Provider and Employer
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