USS 3098 LT 26B MILL BAY RD - ZCP 11/21/2012 Kodiak Island Borough Print Form ! Submit by Email
--� \ Community Development Department
710 Mill Bay Rd.Rm 205
a Kodiak AK 99615
Ph.(907)486-9362 Fax(907)486-9396
htti)://www.kodiakak.us
Zoning Compliance Permit Permit No.c zl1 s 'f
The following information is to be supplied by the Applicant:
Property Owner/Applicant:
Mailing Address: PO go '97,S3
Phone Number: 902- S3?-5905
Other Contact email,etc: le ra/e e S8 F 9ci s
Legal Description: Subdv: Block: Lot:
ySS 3o�g a(o�
Street Address: a31 La vy�i\\ !261
Use&Size of Existing Structures ��� �8a/� `jQ rjj E 4'eS P.vr f� O Qlovr
Description of Proposed Action: hLP/2T ReS/ctle ce— 7o D05 do i4 e CO'V
(:54;z/:?,/,5 A arl- el:ne;r y74,r:�u su6-Z� `f —le� 17.90, 05 r G"
Site Plan to include: Lot boundaries and existing easements,existing buildings,proposed location of new construction,access
points,and vehicularparking areas.
Staff Compliance Review: Current zoning: 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? /7;'c "Permit will not be issued until receipt is submitted to KIB"
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 l
have the authority to certify this as the property owner,or as a representative of the property owner. 1 agree to have identifiable
corner markers in place for verification of building setback(yard)requirements.
Attachments? List Other:
Date: _! Z Signature:
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)perKIBC 17.15.060A.**
CDD Staff Certification
t
Date: r 14 CDD Staff: I
Payment Verification Zoning Cp AW)it Fee Payable in Cashier's Office Room# 104-Main floor of Borough Building
\\�yOV���ll.�,12U12
After-the-Fact 2X the published amount
Not Applicable�a�2n�R�Q11?t}�1Pn+
r $0.00 r $0.00
Less than 1.75 acres: P</ $30.00 r $60.00
1.76 to 5.00 acres: r $60.00 r $120.00
5.01 to 40.00 acres: r $90.00 r $180.00
40.01 acres or more: r $120.00 r $240.00
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