USS 3101 LT 19C - ZCP 8/19/2020Kodiak Island Borough Print For Submit by Email
Community Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907) 486 - 9396
http://www.kodiakak.us
Zoning Compliance Permit
Permit No.
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The following information is to be supplied by the Applicant:
Property Owner/Applicant:
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Mailing Address:
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Phone Number:
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Other Contact email, etc.:
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Legal Description:
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Block: j
Lot: G
Street Address:
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AV- 91/64-
Use & Size of Existing Structures:
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Description of Proposed Action:
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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:
Lot Area: , H a
Current Zoning: () n
Lot Width
Front Yard: Q I Rear Yard
05
10 "
Prk'g PlaIn Rvw? El # of Req'd Spaces:
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
J
PROP —ID
Bld'g Height: CJ
Side Yard: r
Subd Case No. Plat No. Bld'g Permit No.
Does the project involve ❑_
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:
Proof of EPA notification provided (if required)? ❑_
*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: 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. I agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments? S �� 64
Dat�
List Other:
Signature: 1
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: 10i0 CDD Staff:
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:
$90.00
$180.00
40.01 acres or more:
❑
$120.00
$240.00
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Transaction Receipt - Success
Kodiak Island Borough
Kodiak Island Borough Community Development
MID:200006988265
710 Mill Bay Road
Kodiak, AK 99615
907-486-9323
08/ 10/2020 11:36AM
Remittance ID
Kodiak08 102015 3454699 Wel
Transaction ID:
250072466
JOHN P SIKES
3504 Tona Ln
KODIAK, Alaska 99615
United States
Visa - 3521
Approval Code: 00034D
Sale
Amount: $30.00
John Sikes
907-727-8752
BZ2021-005
3504 Tona Ln.
Service Fee: $1.00
Service Fee Type: Dual Transaction
Total Amount: $31.00
Cardmember acknowledges
receipt of goods and/or
services in the amount of
the total shown hereon and
agrees to perform the
obligations set forth by the
cardmember's agreement with
the issuer.
Signature
click here to continue.
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