HOSPITAL BK 1 LT 2A-1 - ZCP 8/15/2017Kodiak Island Borough Print Form Submit by Email
Community Development Department
Alms 710 Mill Bay Rd. Rm 205
ae Kodiak AK 99615
Ph l9071 dRF, - QZF� FaX (Qn71 dRF _ Q2QF,
-- -- - 23656
http://www.kodiakak.us
Zoning Compliance Permit Permit No. BZ2018-007
The following information is to be supplied by the Applicant:
Property Owner / Applicant: Kodiak Island Borough/Providence Medical Center
Mailing Address: 710 Mill Bay Rd
Phone Number:
Other Contact email, etc.:
Legal Description: Subdv: HOSPITAL Block: 1 Lot: 2A-1
Street Address: 1915 Rezanof Dr
Use & Size of Existing Structures:
Hospital and community health clinic
Description of Proposed Action:
Interior remodel of community health clinic
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: Public Use KIBC 17.130 PROP ID 23656
Lot Area: 11.82 Acres Lot Width: 60' Bldg Height: 50'
Front Yard: 25' Rear Yard: 25% Side Yard: 10%
Prk'g Plan Rvw? Not Applicable # of Req'd Spaces:
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
Subd Case No. Plat No. Bld'g Permit No. TBD Bldg Dept
Does the project involve YES
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 Bldg Dept
Proof of EPA notification provided (if required)? NO
*Required for all demolitions, for renovations disturbing at least 160 square
feet 260 linear feet or 3S 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 I
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: Aug 11, 2017
List Other:
Signature: Robert K. Tucker
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.
THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED.
"EXPIRATION: Any zoning 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: Aug 11, 2017 CDD Staff: Daniel McKenna -Foster
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:
❑
$30.00
❑ $60.00
1.76 to 5.00 acres:
❑
$60.00
❑ $120.00
5.01 to 40.00 acres:
$90.0- ❑ $180.00
40.01 acres or more:
❑
$120.00
❑ $240.00
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