KEA SUB LT 1 - ZCP 10/3/2012 Kodiak Island Borough Print Form Submit by Email
a Community Development Department
710 Mill Bay Rd.Rm 205
e Kodak AK 99615
Ph.(907)486-9362 Fax(907)486-9396
htti)://www.kodiakak.us
Zoning Compliance Permit Permit No. CZ2013-028
The following information is to be supplied by the Applicant:
Property Owner/Applicant: KEA
Mailing Address: PO Box 787,Kodiak,AK.99615
Phone Number: 907-486-7739
Other Contact email,etc.:
Legal Description: Subdv: Airpark First Addition Block: 4 Lot: 12
Street Address: 1614 Mill Bay Rd
Use&Size of Existing Structures: 8.848 sgft commercial 2 story
Description of Proposed Action: Demolition
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: Current zoning: Business KIBC 17.90 PROP_ID
Lot Area: Lot Width: Bld'g Height:
Front Yard: Rear Yard: Side Yard:
Prk'g Plan Rvw? #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? YES "Permit will notbe issued until receiatis submittedto K18" YES
Subd Case No. Plat No. Bld'g Permit No.
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
Applicant Certification: 1 hereby certify that 1 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? List Other: A+
Date: Oct 3,2012 Signature: Darron Scott for KEA
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 3,2012 CDD Staff: Martin Lydick
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Ro m#104-Main floor of Borough Building
After the-Fact 2X the published amount
Not Applicable r $0.00 1� F $0.00
Less than 1.75 acres: r $30.00 �f �,, F_ $60.00
1.76 to 5.00 acres: (— $60.00 PAI! $120.00
5.01 to 40.00 acres: r $90.00 �^f1 $180.00
40.01 acres or more: F $120.00 OcT 0.3- 7[. F_ $240.00
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U.S.EPA NOTIFICATION OF DEMOLITION AND RENOVATION
X DESCRIPTION OF PLANNED DEMOLITION OR RENOVATION WORK,AND METHOD(S)TO BE EMPLOYED,INCLUDING DEMOLITION OR
RENOVATION TECHNIQUES TO BE USED AND DESCRIPTION OF AFFECTED FACILITY COMPONENTS:
Removal of gypsum wallboard with ACM joint compound and texture.ACM flooring to be removed as weld. Intact removal of 311
materials, wet methods,negative pressure enclosure,prompt cleanup.proper packaging.
XI DESCRIPTION OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO COMPLY WITH THE REQUIREMENTS,INCLUDING
ASBESTOS REMOVAL AND WASTE HANDLING EMISSION CONTROL PROCEDURES:
Wet methods,critical barriers.negative pressure enclosure.and HEPA vacuuming
XIL WASTE TRANSPORTER YI: REMOVAL CONTRACTOR
Name:
Sato.i Group.ine.
Address:
1310 E 6F :L.ve, Suite 2
City: Slate: ZIP:
Anchorage AK 99513
Contact Person: Tel:
Alan (907)350-9919
WASTE TRANSPORTER 92: DEMOLRIONCONTRACTOR
Name:
Address:
City: state: Zip:
Contact Person: Tel:
XIII. WASTE DISPOSAL SITE ASBESTOS MATERIAL(RACM)
Name:Kodiak island Borough Landfill
Lorahon:
1203 faicnashi<a Bev Road
City: State: Zip:
Kodiak 199615
Contact Person: Tel:
Alan Torres 907-486-9345
XIII. WASTE DISPOSAL SITE: DEMOLITION MATERUAL
Name:
Location:
City: State: Zip.
contact Person: Tel:
XIV. EMERGENCY DEMOLITION(Complete item,XIV Only if this proj ect is an Emergency Demolition.)
1.Mach a copy of me Omer to this notice.
2. Name of Authority Issuing Order. Tale:
3. Authority of Omer(Citation of Code):
4. Datem Order(MMIODNY): Date Orderto Begin:
XV. EMERGENCY RENOVATIONS(Attach separate sheet with the following information If project is Emergency Renovation.)
1. Dateand Hourofthe Emergency:
2. Description of the Sudden,Unexpected Event:
3. Explanation of how the event caused unsafe conditions or equipment damage or an unreaaonable financial burden.
DESCRIPTION OF PROCEDURES TO BE FOLLOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS FOUND OR PREVIOUSLY NONFRIABLE
I' ASBESTOS MATERIAL BECOMES CRUMBLED,PULVERIZED,OR REDUCED TO POWDER:
Evacuate non-essential personnel,restrict access to area,clean with wet methods and HEPA vacuums
I CERTIFY THAT AN INDIVIDUAL TRAINED IN THE PROVISIONS OF THIS REGULATION(46 CFR PART 61,SUBPART M)WILL BE ONSITE DURING
XVIL 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.
4%vr2B. Alan Caldvrell,Project Manager
Signature of OwnedOperator Data Type or Print Name and Title
Signature of Owned0perator Data Type or Prim Name and Title
XVIII. I CERTIFY THAT PiE ABOVE INFORMATION IS CORRECT:
917/28[2 Alan Caldwell,Project Manager
Signature ofOwnerlOperator Date TypeorPrintNameandTHle-
Signatureof OwnedOperator Data Type or Print Name and Title
Return to:U.S.EPA Region 10 C3 .avt3 —096
1200 Sixth Avenue(OAQ•107)
Seattle,WA 98101
U.S. EPA NOTIFICATION OF DEMOLITION AND RENOVATION
Ope2tor Project# Postmark Date Received Notification#
vSJ �
I, TYPE OF NOTIFICATION(check one): ❑' Original ❑Revised ❑Canceled
II. FACILITY DESCRIPTION
Building Name:
Address:
161,i ikl ill Bay Road
City: State: County:
Kodak AK I�/A
Site Location:
161A Mill Saw Road
Building Size(square feet): #of Floors: Age in Years:
4500 SF 2 U
Present Use Prior Use:
AhandOnad Cornnnercial building
III. TYPE OF OPERATION(check one): ❑✓ Demo ❑Ordered Demo ❑Renovation ❑Emergency Renovation ❑Fire Training
IV. IS ASBESTOS PRESENT?(check one) Eyes ❑No
V. FACILITY INFORMATION
OWNER NAME:
:pdia,Electric Association
Address':
615 trlarne Way E2st
City: State: Zip:
t<0c8al; AK 99615
Contact: Tel:
Jarror. Scow 907-.486.7730
REMOVAL CONTRACTOR:
Satori Group,Inc.
Address:
1310 E 80th iwe, Suite 2
City: State: Zip:
r,nchorage AI: 99518
Contact Tel:
Alan Cal vlell (907)350-9919
OTHER OPERATOR(Demolition I General): PRIME CONTRACTOR
Address:
City: State: Zip:
Contact: Tel:
PROCEDURE,INCLUDING ANALYTICAL METHOD,EMPLOYED TO DETECT THE PRESENCE OF AND TO ESTIMATE THE QUANTITY OF RACM AND
VI- CATEGORY I AND CATEGORY II NON-FRIABLE ACM:
Laboratory Buik -,rlvsis using PLn4 methods
VII. APPROXIMATE AMOUNT OF ASBESTOS MATERIAL:
Nonfriable Asbestos Material Indicate Unit of Measurement Below
(SEE CONTINUATION SHEET) RACM to be Removed Not To Be Removed
Cat 1 Cat II Unit
Suracinq materials/Texfure 20300 SF
Vinyl Flooring 1200 SF
VIII- SCHEDULED DATES ASBESTOS REMOVAL MMIDD SYait: 9/26/12 Cote fete: 10/18/12
DAYS OF THE WEEK: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
HOURS OF OPERATION: 7 A&5 3u P8, 'AM',-5:30 Ph4 3u?r:.1 7 AM-5:30 I 7 Ai:i 5 30 I'M 7 A%4-5:30 PL!
IX. SCHEDULED DATES DEMO/RENOVATION MMIDD Stall: Cornplete:
DAYS OF THE WEEK: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
HOURS OF OPERATION: