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USE PERMIT APPLICATION <br /> COUNTY OF HAWAI`I <br /> PLANNING COMMISSION <br /> (Type or legibly print the requested information) <br /> APPLICANT(S): CW C4 3Aa6SOv t,tJ/k r��j�rC �'C1n .r�1/� C�,1 0 <br /> (�,✓/'C� <br /> APPLICANT'S SIGNATURE: DATE: /5 Z <br /> ADDRESS: 63 - S28 UNA -PPERE -ST, WA'l KOLPA . <br /> I-+Aw A i i <br /> LIST APPLICANT'S INTEREST (if not owner): <br /> PHONE: (Bus.) (Res.) (Email) <br /> REQUEST: <br /> TAX MAP KEY(S): `�J F-002 05(o ZONING: S �� <br /> SIZE OF PROPERTY/AREA OF REQUESTED USE: / 05 ACE!AS <br /> LANDOWNER(S): _.— :i A C0950N <br /> FEE SIMPLE LANDOWNER(S) WRITTEN AUTHORIZATION <br /> (may be provided by letter with the below statement included): <br /> DATE: <br /> a1�tt�cQ,,►? ia�l TO �4CT OIJ C �inn F C t7(R DATE: 9 <br /> AGENT: PACLi iL pri►�{ + � ,_�1C <br /> AGENT ADDRESS: . PO (5014 W" iI191 y-AMUO-A— <br /> PHONE: (Bus.) f?Crp'25e,,-,L3{7(Res.) (Email) C.�tft�{i�tf► ii '�'�`y"tu'lr�,y'h• <br /> ^r er <br /> L?TL L�'t?'JViGi�tC.c�c na;_cL��a�- <br /> Please indicate to whom original correspondence and copies should be sent. 1 <br /> ORIGINAL: kNA1"%.,nA LsrjiG-fL4,J COUP-6'ii- COPIES: fAc,i,(JL: Atn1.4 VLS144 <br />