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BUILDING DIVISION - DPW <br /> . COUNTY OF HAWAVI <br /> 101 Paunhi Street, Suite 7 <br /> a:l l•�la Hilo,Hawaii 96720 <br /> Ph: Hilo Office (8081961-8331 Kona Office(808)323-4720 DECLARATION 6 ACCEPTANCE DATE <br /> �`'►i►" a(27022000 R ZI ZZ <br /> R;uarsO <br /> DECLARATION OF COMPLIANCE 1/ D <br /> HRS SECTION 46-RR RELATING ILIAGRICUs IURAE SIRUC IURES I� <br /> PROJECT/PROPERTY INFORMATION <br /> 1+1401f[1 NAW 0 `ow- <br /> SIAIE EANU%JS(DESIGNAFION of Suir Land Vote Designation,conma the DepArtntcnl of I+ianning as(WH)9h 1 8:88. <br /> Trs L <br /> ADDb, Y'U� �1 <br /> s } <br /> TAXMAPMV MOPERTY AREA <br /> 111)0M 0 I 6141PAcre51 <br /> STRUCTURE INFORMATION <br /> `1 /1 `''�1{w�'tpp•� 4 'T1� <br /> EtFX1Pnl]hNls(ue4nnuhsllnusuRshreu .l¢[ f,� S`RU'TURAtSPAN;r OA EXEMPTIONS7&1.10NEYl (h)'.n-unbelrssrhen25ft► <br /> I1tSIAtvrf lRltMNE ARF5171NSIi TURk 17� �vv') F[llrrvn •51[S l0l Atftt1nRAREA 1-1 lr# <br /> JAM[NM NN?s)1 STROr1HNf iragrh <br /> M1L11IGAEI(UIURANIA[lf All I\IASPTEDSTRI-CTIJRESCtAJM(1tt1NDIRt1RS46.RR isq h) <br /> prnnJrmrnrmumBt^.-sit utrplanshowmgappru iArinratusrsnfsu wrepreprnylrnes.athrrmrsfnwrs.usbacisrnrnher+uunurrs,drmm.mmulstiuU[nr.andauynthrtpnunrnrmormaunrs <br /> Artachrxua shrers_rf rxY r:sarr y4+�� - ��j�(�.s� � � + <br /> COMMENTS(for drpamm�u use smlyi <br /> (obtain approval t Fgrlararn prior to stolon tial of Dirclaristlnn W Public WwW <br /> kNGINk(RING D111S10N APPROVAL <br /> rnrrrrn;[s+vr Isar �. <br /> OWNERS CERTIFICATION/DECLARATION <br /> I detWelilts Forulrtt to be exempt from applicable pudding prrmrt/;ode requirements under the prawsrons of HRS Simian 46-118:have fired Aid fullF undr+ssanrl HRS 46.8111 and certify <br /> that the project n err eomplunce <br /> I i understand that this exemission ooh-Apphn m mtun bu+ldmg permiticodr reNUormrnts I shall obarn all other requited prnnrss and approvals and stiall comply wnh all <br /> applicable codts and laws associated with this development,which nay include and not he lmuted to Special Management AmA,l lood 11aeard,electrical.plumb-%grading. <br /> driveway,work n+CounlylState right of ways,fire.wasiewatrr.and Department of Health requtremems <br /> I understand[hal the isstranre of a declaration number by the County should 0101 be taken to mraas that compliance with HRS 46.RR has been confirmed.and that it is my sole <br /> rrsponsihrlity so confnm complurice [he State m County shale Ions be(rabic for any rlatms arising from construction of isrrildings st-ucsures,ar appurtenances thereto exempt <br /> from site building code and permnLng proress as descr bed err HRS 46.86 <br /> Isropefty Owner y <br /> Address: 11 <br /> Phone No ` Email: r' 1 <br /> Signature PrrrurdName ` T <br /> POST CONSTILlI1MON A FINAAS-BUt N I TION FORM must w itis upon camp Eon construct----Fat are to w mit a m w[ cause this <br /> filiQUTAE&4Emm. DECLAFLA71ON OF COMPLIANCE to be dedared INVALID Wood shall VOID the bsdlding permit and/or code exemption,A tingle Final As-eWh <br /> NoWkgtlon Form must be wbmined in compliance with both of the fallowing deadllrtn <br /> I Submit fonts within t year of Declaration of Cls"liance acceptance dao. <br /> 2. Submit Form within 30 days of completion,occupanry,or use of smrcturs. <br /> Hawa1'I County is an Equal Opportunity Provider and Employer Rev.3/22 <br /> EXHIBIT 4 <br />