NORTHLAND RANCH SUB LT 6 - ZCP 4/29/2025Kodiak Island Borough
Community Development Department
710 Mill Bay Road Room 202
Kodiak, Alaska 99615
Phone (907) 486-9363 Fax (907) 486-9396
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Zoning Compliance Permit Permit No. - �S
The following information is to be supplied by the Applicant
Property
Mailing Address
Phone Number:
Other Contact Email, etc..: 'CQa cLW ibll3M) Lirnat It C6yKl
Legal Description: Subdv: Aior"" ?4n6k Block:
Street Address:
Use & Size of Existing Structures:
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Description of Proposed Action:
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Lot: !0
Applicant Certification: I hereby certify that I will comply with the provisions of the Kodiak Island Borough Code
and that 1 have the authority to certify this as the property owner. or as a representative of the property owner. I
agree to have identifiable corner markers in place far verification of building setback (yard) requirements.
Title: Print Name: T v% 0. LJ l 1`t3
Date: 3 J a Signature:
Site Plan to include lot boundaries and existing easements aWd
, proposed location of new construction,
access points, and vehicular parking area, As -Built required with all improvements changes.
This permit is only for the proposed project as described by the applicant. If there are any
changes to the proposed project, including its intended use, prior to or during its siting,
construction, operation, contact this office immediately to determine iffurther review and
approval of the revised project is necessary.
THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING
PERMIT IS REQUIRED.
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Staff Compliance Review
Does the Project involve EP Proof of EPA [cation provided (if required)?
Defined Facility? 'Comm 1 Buildings, 'Required for emos, renovations disturbing at least UO sq _
Installations, institutions, d residences feet, afeet, or 35 cubic k of Regulated Asbestos Containing
With more than fo 4) dwelling unites' Maten CM) and for renovation that remove load supporting slmcture'
Expiration: Any Zoning Compliance Permit issued is subject to the same expiration, suspension, and revocation
provisions as a building permit issued for the same construction permit.
Current Zoning:
Lot Area:
Front Yard: '222
Parking Plan: Q y
Staff Notes:
Lot Width:
Side Yard: S t
Parking Spaces:
Prop. ID: ' (old,
Building Height:
I
Rear Yard:
As -Built:
Staff Certification
Date: I �./ CDD Staff Signature: 6�5
Payment Verification
After the Fact 2X the published amount
Waived:
$0.00 ❑
$0.00
❑
Less than 1.75 Acres:
$30.00 ❑
$60.00
❑
1.76 to 5.00 Acres:
$60.00 ❑
$120.00
❑
5.01 to 40.00 Acres:
$90.00
$180.00
❑
40.01 Acres or more:
$120.00 ❑
$240.00
❑
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Kodiak Island Borough
KODIAK ISLAND BOROUGH 710 Mill Bay Road
Kodiak, AK 99615
APPLICATION FOR REGISTRATION Attention:
Finance Department
(907)486-9324
Applicant Information
Name of Firm: Viiki-A
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Owners Home Address: 4Z CQ N +Ykerflip
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Physical Address: 32-1 Yf&6A<Va
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Type of Business: 0
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Mailing Address:4�NA �h �
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Date Business started: 3�(/
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Name of Owner: � I . V Tam a Wit'
Alaska Business License No.
Business Phone:
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Home Phone:
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Email address: F�I�I
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Organization Information
Type of Organization
❑ Individual
ElPartnership
IXf Corporation
❑ Other (explain below)
Is Business Seasonal?
❑ Yes No
If yes, list the approximate dates business operates each year.
From:
To:
Number of months:
To Be Completed If a Partnership or Corporation
Name
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Name
Name
Title
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Title
Title
Mailing
Address
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Mailing
Address
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Mailing
Address
Home
Address
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Home
Address
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Home
Address
Phone
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Phone
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Phone
Email
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Email
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Certification Statement
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1 certify that the information on this application is true and correct. Any misstatements or omissions will result in
civil action as directed by the borough assembly.
Print or Type Name of Applicant
Tam Wi 111 S
Date!
//aS
Signature & Title of Applica
�
Dates //V&S
To Be Completed by The Kodia Bland Borough
Accepted
❑
By:
Date
Denied
❑
Title:
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Transaction Receipt - Success
Kodiak Island Borough
Kodiak Island Borough Community Development
MID:200006988265
710 Mill Bay Road
Kodiak, AK 99615
907-486-9323
04/04/2025 03:07PM
Remittance ID:
Kodiak040425190548949Cur
Transaction ID:
333837149
TANYA M. WILLIS
426 N. Amerigo Lane
PAYSON, Utah 84651
United States
MasterCard - 8080
Approval Code: 61659Z
Sale
Amount: $90.00
Tanya WIllis
801-361-9480
BZ2025-035
32157 Pasagshak Road
Service Fee: $2.25
Service Fee Type: Dual Transaction
Total Amount: $92.25
Cardmember acknowledges
receipt of goods and/or
services in the amount of
the total shown hereon and
agrees to perform the
obligations set forth by the
cardmember's agreement with
the issuer.
Signature
click here to continue.