USS 3218 TR E-3 MILL BAY RD - ZCP 4/27/2018Kodiak Island Borough Print Form Submit by Email
Community Development Department
710 Mill Bay Rd. Rm 205
d ' Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907) 486 - 9396
http://www.kodiakak.us
Zoning Compliance Permit Permit No. �Z
The following information is to be supplied by the Applicant:
Property Owner/ Applicant: 011 h Ca 17
Mailing Address: 0
Phone Number: Cid 7 _ Ve-i _ 6 j 93 /
Other Contact email, etc.:
Legal Description: Subdv: 7- Block: �_ Lot:
Tr, c G �, S , 51u "„ / —3 .��8
Street Address: 3 T
Use & Size of Existing Structures: / VZz�
T
Description of Proposed Action: /POye ��% X �� Tia : /e r Aa Si 7F AS SXOwti
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:
Lot Area:S Lot Width: 1 .CT
Front Yard: Rear Yard:
Prk'g Plan Rvw? �S # of Req'd Spaces
PROP—ID
Bld'g Height:
I
D Side Yard: )S—
Staff Compliance Review Notes:
Plat/ Subdivision Requirements?
Subd Case No. Plat No. — a� Bld'g Permit No.
Does the project involve
�/
Proof of EPA notification provided (if required)?
an EPA defined facility.
�Y �
Required for all demolitions, for renovations disturbing at least 160square
*Commercial buildings, installations
(military bases),
feet, 260 linear feet or 35 cubic feet of Regulated Asbestos Containing Material ACM), and
institutions (schools, hospitals)
and residences with
for renovations that remove a load -supporting structural member.
more than four (a) dwelling units.
No permit will be issued for such projects without proof of EPA notification
Driveway
Permit?
Septic Plan
r
Approval:
/
Fire
Marshall:
IV/X
Applicant Certification: I hereby certify that I 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?
Date: 41741,2
?
List Other:
Signature: I
This permit is only for the proposed project as describe y the applicantllf there are any changes to the
proposed project, including its intended use, prior to r during its siting,` construction, or operation, contact
this office immediately to determine if further revie 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:
z)m CDD Staff:
Payment Verification Zoning Compliance
Not Applicable
Less than 1.75 acres:
1.76 to 5.00 acres:
5.01 to 40.00 acres:
40.01 acres or more:
Payable in Cashier's Office Room # 104 - Main floor of Borough Building
After -the -Fact 2X the published amount
❑ $0.00 ❑ $0.00
0
30.00 ❑ $60.00
zr$$60.00
❑ $120.00
❑ $90.00 ❑ $180.00
❑ $120.00 ❑ $240.00
PAYMENT DATE
04/27/2018
COLLECTION STATION
CASHIER
RECEIVED FROM
DUNCAN FIELDS'
RENTALS
DESCRIPTION
3523 E REZANOF DR
Zoning Compl
Kodiak Island Borough
710 Mill Bay Rd.
Kodiak, AK 99615
RECEIPT DESCRIPTION
Zoning Compliance Permit
CZ 2018 043
Payments: Type Detail Amount
Check 5173 $60.00
Customer Copy
Total Amount:
BATCH NO.
2018-00000581
RECEIPT NO.
2018-00001117
CASHIER
Teresa Medina
$60.00
$60.00
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