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USS 3218 COMM TR 1 OF TR S-5A-1 - ZCP 2/28/2013Kodiak 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 1 16353 Submit by Email Permit No. CZ- n 3 - 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: Safeway Inc. 1121 124th NE Bellevue WA 98005 425 - 201 -6420 Shei Kai Subdv: USS 3218 TR S -5A -1 TR1 2685 Mill Bay Road Block: Lot: Grocery Store Description of Proposed Action: Remodel of existing pharmacy to add a second consultation room. 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: Current Zoning: Business KIBC 17.90 PROP_ID 16353 Front Yard: Not Applicable Lot Width: Bld'g Height: 50' Rear Yard: Not Applicable Side Yard: Not Applicable Prk'g Plan Rvw? Not Applicable # of Req'd Spaces: Plat / Subdivision Requirements? Does the project involve If YES, do you have an EPA Return Receipt of Notification? an EPA defined facility? N / A "Permit will not be issued until receipt is submitted to KIB" Subd Case No. Plat No. Driveway �� Permit? Septic Plan Approval: _ i (- Fire Marshall: Bld'g Permit No. 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, oras 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: Floor Plan X n Date: Oct 18, 2012 Signature: Ed Warner S —*W max �av� �w�ogU2v �t[� 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 180 days. Before such work can be recommenced, a new permit must first be obtained. (Sec. 106.4.4 Expiration. 1997 UBC) per KIBC 17.15.060 A. ** CDD Staff Certification Date: Oct 18, 2012 COD Staff: Martin Lydick 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 F $0.00 4ASwv�F $0.00 Less than 1.75 acres: r $30.00 r $60.00 1.76 to 5.00 acres: r $60.00 r � 1 iD r $120.00 5.01 to 40.00 acres: (X $90.00 I� V r $1 80.00 40.01 acres or more: (— $120.00 FEB 21;2013r $240.00 +nan f:p i1eniftent PAYMENT DATE 02/28/2013 COLLECTION STATION CASHIER RECEIVED FROM SAFEWAY, INC. DESCRIPTION 2685 MILL BAY RD Kodiak Island Borough 710 Mill Bay Rd. Kodiak, AK 99615 BATCH NO. 2013- 00000432 RECEIPT NO. 2013 - 00001061 CASHIER Teresa Medina Printed by: Teresa Medina Page 1 of 1 0212812013 03:15:59 PM ---------- - K6o-Ax / / ALASKA USA / BANK 375 SQ. FT. 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