NEW KODIAK BK 17 LT 3 - ZCP 2/27/2013Kodiak Island Borough
Community Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9362 Fax (907) 486 - 9396
http://www.kodiakak.us
Zoning Compliance Permit
Print Form
Submit by Email
15567
Permit No. CZ2013 -066
Property Owner / Applicant:
Mailing Address:
Phone Number:
Other Contact email, etc.:
Legal Description:
Street Address:
Use & Size of Existing Structures:
The following information is to be supplied by the Applicant:
State of Alaska ADOT /PF
1500 Anton Larsen Road, Kodiak Alaska 99615
907 - 487 -2611 office 907 - 539 -2655 cell
Doug B. Bunting doug.bunting @alaska.gov
Subdv: New Kodiak Subdivision
211 Mission Road
Block: 17
Lot: 3
Office Building - Old ADF &G Building
Description of Proposed Action: Interior alterations (doors, walls, etc) - No change of use noted.
Site Plan to include: Lot boundaries and existing easements, existing buildings, proposed location of new construction, access
points, and vehicular parking areas.
Staff Compliance Review:
Lot Area: 25,302 Sq. Ft.
Current Zoning: Business KIBC 17.90
Front Yard: Not Applicable
Prk'g Plan Rvw? Not Applicable
Plat / Subdivision
Requirements?
Does the project involve
an EPA defined facility?
NA
PROP_ID 15567
Lot Width: Not Applicable Bld'g Height: 50'
Rear Yard: Not Applicable
# of Req'd Spaces:
Side Yard: Not Applicable
YES
If YES, do you have an EPA Return Receipt of Notification?
"Permit will not be issued until receipt is submitted to KlB"
YES
Subd Case No. NA Plat No. NA Bld'g Permit No. Pending
Driveway NA
Permit?
Septic Plan NA
Approval:
Fire Unknown
Marshall:
Applicant Certification: 1 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 for verification of building setback (yard) requirements.
Attachments? Other List Other: Existing and Revised First Floor Plans
Date: Feb 27, 2013 Signature: ADOT /PF by: Doug B. Bunting
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, or operation, contact
this office immediately to determine if further review and approval of the revised project is necessary.
**EXPIRATION. Azoning compliance permit will become null and void if the building or use authorized by such permit is not
commenced within 180 days from the date of issuance, or if the building construction or use is abandoned at any time, after the
work is commenced, for a period of 780 days. Before such work can be recommenced, a new permit must first be obtained. (Sec.
106.4.4 Expiration. 7997 UBC) per KIBC 17.15.060 A. **
CDD Staff Certification
Date: Feb 27, 2013 CDD Staff: Duane Dvorak
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Room # 104 - Main floor of Borough Building
After - the -Fact 2X the published amount
Not Applicable $0.00 $0.00
Less than 1.75 acres: FX $ 30.00 F $ 60.00
1.76 to 5.00 acres: F $60.00 DA F $ 120.00
5.01 to 40.00 acres: F $90.00 l &'Q F $180.00
40.01 acres or more: F $ 120.00 FEB 27 2013 F $ 240.00
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NOTIFICATION OF DEMOLITION AND RENOVATION
Operator Project#
Postmark
Date Received
Notification#
I. T e of Notification 0 =0r1 inai R= Revised C= Canceled O 5j
II. FACILITY INFORMATION (Idonfify owner removal contractor, and other operator
OWNERNAME: e o Ia T+
Address: G I , Z11 s'
CI ty: ke)d;qk
iState: 19 lets ka
Zip 1 T q4 Is
Contact- „ ^I'e I/rT
Tel: D 3
REMOVAL CONTRACTOR:
Address:
City;
State:
Zip:
Contact:
Tel:
OTHER OPERATOR:
Address:
City:
State:
Z113:
Contact:
Tel:
III. TYPE OF OPERATION D=Damo O= Ordered Demo R= Renovation E -Emer. Renovation
IV. IS ASBESTOS PRESENT? es /No
V. FACILITY DESCRIPTION Include building name number and floor or room number
Bid . Name: e ; v.
Address: Z11
CH Y;
State: a
Coun
Site Location:
Building Size: /d 406 SF
# of Floors:
Ago in Years: 3q
Present Use:
Prior Use: u'
VI. PROCEDURE, INCLUDING ANALYTICAL METHOD, IF APPROPRIATE, USED TO DETECT THE PRESENCE OF ASBESTOS MATERIAL:
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VII. APPROXIMATE AMOUNT OF ASBESTOS
INCLUDING:
1. Regulated ACM to be Removed
2. Category I ACM Not Removed
9. Category II ACM Not Removed
RACM
To Be
Removed
Nonfriable
Asbestos
Material Not
To Be Removed -
Indicate Unit of
Measurement Below
Category I
Category II
UNIT
Pines
LnFt:
Ln M:
Surface Area
C Ft:
I So M:
Vol RACM Off Facility Component
CuFL• I
CUM:
VIII. SCHEDULED DATES ASBESTOS REMOVAL MMIDDIYY Start: JAIA, S' Zo 1 3 Complete: 1 I
IX. SCHEDULED DATES DEMO /RENOVATION MM /DD/YY Start: M!j S -T Com late: a r 22 Zn I.3
0 -2�r3
- 2- / 2- q ( ?, -140
X. DESCRIPTION OF PLANNED DEMOLITIO N OR RENOVATION WORK, AND METHOD(S) TO BE USED:
Ek..a.K V L.'. do / W +4A rsites'os con l'S ,v1.N o;A+e_dm dvhj N1vq ,
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XI. DESCRIPTION OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO PREVENT EMISSIONS OF A SBESTOS AT THE
DEMOLITION OR RENOVATION SITE: A64 .t Con'('v/4¢ & r +c ofescr;pi;ah e'F Wo,k Uj
4nd
ft ;
XII. WASTE TRANSPORTER #7
Name:
Address:
CI :
State:
Zip:
Contact Person:
Tel: '
WASTE TRANSPORTER #2
Name:
Address:
City:
State:
ZI
Contact Person:
Tel:
XIII. WASTE DISPOSAL SITE
Name:
Address:
City:
State: ZI ;
Tel:
XIV. IF DEMOLITION ORDERED BY A GOVERNMENT AGENCY PLEASE IDENTIFY THE AGENCY BELOW:
Name: Title:
Autharl
Date of Order MMIDDIYY :
Date Ordered to Begin MMIDDIYY ;
XV. FOR EMERGENCY RENOVATIONS:
Date and Hour of Emergency MMIDD
Description of the sudden unexpected event:
Explanation of how the event caused unsafe conditions or would cause equipment damage or an unreasonable financlal burden:
XVI. DESCRIPTION OF PROCEDURES TO BE FOLLOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS FOUND OR PREVIOUSLY
NONFRIABLE ASTESTOS MATERIAL BECOMES CRUMBLED, PULVERIZED, OR REDUCED TO POWDER:
XVIL I CERTIFY THAT AN INDIVIDUAL TRAINED IN THE PROVISIONS OF THIS REGULATION (40 CFR PART 61, SUBPART M) WILL BE ON-
SITE DURING THE DEMOLITION OR RENOVATION, AND EVIDENCE THAT THE REQUIRED TRAINING HAS BEEN ACCOMPLISHED BY THIS
PERSON WILL BE AVAILABLE FOR INSPECTION DURING NORMAL BUSINESS HOURS.
Zd/3
(Signature or Own0noperator) (Date)
XVIII. I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT:
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ne
(Signature or Owr /Operator) (Date)
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• Complete Items 1, 2, and 3. Also complete - - ?�sl9narure
Item 4 If Restricted Delivery Is desired. ❑ Agent
• Print your name and address on the reverse X 0 Addre see
so that we can return the card to you. S. Receive , (Printed Name) C. Da of D very
• Attach this card to the back of the mallpiece, e G,
or on the front if space permits.
D. Is delivery. address different fm
1. Article Addressed to: I s
If YES, enter delivery addresb E O
Ashe -c s5 Ale5OR d6- 6rdrno. -�k
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4. Restricted Delivery? (Ezhs Fee) ❑ Yes
2. Article
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PS Form 3811 February 2004 Domestic Return Recelpt 702595 -92 -M 4540
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Return Receipt Fee
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Total Postage &Fees $,
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