BELLS FLATS BK 6 LT 3A - ZCP 10/28/2021k Kodiak Island Borough Print Form 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 PermitNo.
The following information is to be supplied by the Applicant:
Property Owner / Applicant:
Mailing Address: Po 6 c V,i-4< QK qqt ll�
Phone Number: Q07 S3 q 501 Z ' l
Other Contact email, etc.:
Legal Description:
Subdv: Be_\\S F-`C��S Block: Lot:
Street Address: ` 000-A(n Lialc2
Use & Size of Existing Structures:
Description of Proposed Action:
Ot OCCA.tj" Wilt bt iss"D Ltnti( M0614- home- I-
Site Plan to include: Lot boundaries and existing easements, existing
and vehicular parking areas.
Staff Compliance Review: Current Zoning: (fin k
Lot Area: Ll S, "ZSO Lot Width: I zo it
Front Yard: .Z-5i Rear Yard: �0of
Prk'g Plan Rvw? 4es # of Req'd Spaces: 3
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
eWV «Jr%C_- • C
proposed location
- sza-0<<y
new construction, access points,
PROP ID 2Z
Bld'g Height: v
Side Yard:
Subd Casl No. " Plat No. v v Bld'g Permit No.
Does the project involve Proof of EPA notification provided (if required)?
an EPA defined facility? ` } *Required for all demolitions, for renovations disturbing at least 160square
*Commercial buildings, installations (military bases), feet, 260 linearfeet, or 35 cubic feet of Regulated Asbestos Containing Material (RACM), 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
Approval: \J
Fire
Marshall: 1 13D
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. I agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments?
Date: ca — 1 l ^
List Other:
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.
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: V i9 ( Z ` CDD Staff:
Payment Verification Zoning Compliance Permit Fee Payable irf Cashier's Office Room # 104f 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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