LEITE ADD BK 8 LT 6A - ZCP 6/27/2016Print Form Submit by Email
Kodiak Island Borough
r Community Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907) 486 - 9396 15442
http://www.kodiakak.us
Zoning Compliance Permit Permit No. CZ2016-068
The following information is to be supplied by the Applicant:
Property Owner / Applicant: Helm Johnson
Mailing Address: P.O. Box 261 Kodiak, AK 99615
Phone Number: (907) 539-5014
Other Contact email, etc.: helm@helmarts.com
Legal Description: Subdv: Leite Addition Block: 8 Lot: 6A
Street Address: 1522 Kouskov Street, Kodiak, AK 99615
Use & Size of Existing Structures: Single-family residence
Description of Proposed Action: Establish a two room B&B in existing single-family residence (permitted use per KIBC 17.080.020.N)
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: R2 KIBC 17.80 PROP_ID 15442
Lot Area: 11,755 sq. ft.
Front Yard: 25 '
Lot Width: 60'
Rear Yard: 10,
Bld'g Height: 35'
Side Yard: 5 '
Prk'g Plan Rvw? Yes # of Req'd Spaces: 4
Staff Compliance Review Notes:
Plat/ Subdivision Requirements? Existing SFR requires 3 off-street parking spaces (per KIBC 17.175.040 Table 1) and two room
B&B requires 1 additional off-street parking space (per KIBC 17.25.035). A total of 4 off-street parking spaces required. Site provides
more than 4 spaces. Applicant provided proof of KIB transit accommodations tax and City sales tax accounts.
Subd Case No. S98-019 Plat No. 98-20 Bldg Permit No. TBD by Building Dept.
Does the project involve N / A
an EPA defined facility?
*Commercial buildings, installations (military bases),
institutions (schools, hospitals) and residences with
more than four (4) dwelling units.
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
N/A
N/A
TBD by Building Dept.
Proof of EPA notification provided (if required)? N / A
*Required for all demolitions, for renovations disturbing at least 160 square
feet 260 linear feet, or 35 cubic feet of Regulated Asbestos Containing Material (RACM), and
for renovations that remove a load -supporting structural member.
No permit will be issued for such projects without proof of EPA notification
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. 1 agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments? Site Plan
Date: Jun 27, 2016
List Other: Proof of KIB Transient Accommodations and city sales tax accounts
Signature: Helm Johnson
This permit is only for the proposed project as described by the applicant. 7f 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.
THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED.
"EXPIRATION: Anyzoning compliance permit issued is subject to the same expiration, suspension, and revocation provisions as a
building permit issued for the same construction permit.**
CDD Staff Certification
Date: Jun 27, 2016 CDD Staff: Jack Maker
Payment Verification Zoning Compliance Permit Fee Payafile in Cashier's Office Room # 104- Main floor of Borough Building
I After -the -Fact 2X the published amount
Not Applicable
❑
$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:
❑
0 ❑ $240.00
$120.00 PAI
JUN 2 7 2016 CY, 06o'J
KODIAK ISLAND BOROUGH
FINANCE DEPARTMENT
PAYMENT DATE
06/27/2016
COLLECTION STATION
CASHIER
RECEIVED FROM
HELM JOHNSON
Kodiak Island Borough
710 Mill Bay Rd.
Kodiak, AK 99615
DESCRIPTION
CZ -2016-068 1522 KOUSKOV KODIAK AK 99615
BATCH NO.
2016-00000536
RECEIPT NO.
2016-00001216
CASHIER
Cashier
PAYMENT CODE RECEIPT DESCRIPTION TRANSACTION AMOUNT
—Zoning—Comp) - —
Payments:
Zoning Compliance Permit _ . - ---- _ _. _ _.___..._-._.__.___
Type Detail Amount
--------._.__..___ -- __ - $30.00
Check 1803 $30.00
Total Amount:
Customer Copy
$30.00
Printed hv- Cashier Pane 1 of 1 06127/2n16 10.22.03 AM
Application for Registration
(Transient Accommodation Tax 2016)
Ta Kodiak Island Borough
710 Mill Bay Road
Kodiak. AK 99615
A. Anplicant intormatton
Name of Firm
e
Physical Address ' = -
E F c"s Loy
Is Business Seasonal?
Mailing Address
If yes, list approximate dates
business operates each year.
Name of Owner
y h 17 S 0
ORmer'S Home AddressJ 5
iz V, 4t./S f-av
Type of Business �,/i
FA -r
Date Business Started j' -
6
Alaska Business License No.
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J
y @ JU4 27 2016
Business Phone
(_—) �II- Svlzl
Home Phone
C. Certification Statement
I 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 asse[ bly.
Print or Type Name of Applicant !T C /m v h M 50
Signature & Title of Applicant
D. To Be Completed It A Partnership or Corporation
Name
Title
Type of Organization
Individual Partnership [] Corporation E] Other (explain below)
Is Business Seasonal?
Yes No
If yes, list approximate dates
business operates each year.
From: To: No. of months:
Name
Title
C. Certification Statement
I 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 asse[ bly.
Print or Type Name of Applicant !T C /m v h M 50
Signature & Title of Applicant
D. To Be Completed It A Partnership or Corporation
Name
Title
Mailing Address
Home Address
Name
Title
Mailing Address
Home Address
Name
Title
Mailing Address
Home Address
E. To Be Completed By The Kodiak Island Borough
Accepted By Date
Denied Title
Phone
Phone
Phone
Arrillk-A I I "IN rtin I-En11r11 AIE Vr nr�%'10 1rx-,111JI,
F 'Rig ' SALES, SERVICES, AND RENTAL TAX
_ KODIAK CITY CODE 3.08 SALES TAX
LAS
MAIL TO: CITY OF KODIAK — SALES TAX OFFICE
710 MILL BAY ROAD, ROOM 211 0 NEW APPLICATION
P.O. BOX 1397
KODIAK, ALASKA 99615 UPDATED APPLICATION
PHONE: 907-486-8655
FAX: 907-486-8600
Date of Application: � — ��'
Account Number (Issued by City):
Name of Business:
e 1-
Physical Address of
Business in Kodiak:
# Street K city 6,/.',,1 K State zip
Mailing Address of
Business:
# Street (PO Bos)
City State Zi
Email: i! t j�, `� %�� �m -'r �, ;7-
Phone:
Cell: S 3 c/ " 5 G f L
Fax:
Name of Owner:
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Owner's Contact Number: 3 `% �'� G
Owner's Mailing Address:
# Street (PO Bos) S
) % = 11/ 01G'L' Cit �i� . �� State ���� Zi
Type of Business Activity:
/
Date Business Started
In Kodiak
)
/
Type Of Or anization:
0 Individual
= Company
Social Security Number
(Individual)
_ _
2-1 S 3
Employer Identification
Number (EIN
Alaska Business License
Number:
NAICS Code: _
Business Activity for the State of Alaska
Must Submit Code with or without Business License
Line of Business Code:
Drivers License Number &
State of Owner:
�/ �
/� /�
/1
Owner's Date of Birth:
/,
mm/dd/ % 2--
yM
TO BE COMPLETED IF A PARTNERSHIP OR CORPORATION (Use additional sheet if needed)
1. Name:
Title:
Mailing
Address:
Physical
Address:
Phone:
2. Name:
Title:
Mailing
Address:
Physical
Address:
Phone:
3. Name:
Title:
Mailing
Address:
Physical
Address:
Phone:
I AGREE TO ABIDE BY THE CITY OF KODIAK CODE FOR SALES TAX SECTION 3.08
OWNER'S
SIGNATURE:
/
DATE:
(P/7 01L
RE MADE ON OR BEFORE THE DUE DATE TO
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