USS 3466 LT 10A-1 - ZCP 6/7/2021Kodiak Island Borough Print FormIF—
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. Bzaba l - 5�s
The following information is to be supplied by the Applicant:
Property Owner / Applicant: -A-C ; Q- ) L rl_, 'A 1-, ), 111, -A—
Mailing Address:
Phone Number:
Other Contact email, etc.:
Legal Description:
Subdv: ��� 3 Block: Lot: jj
Street Address: 6a2l 2enn,—
Use & Size of Existing Structures: C
Description of Proposed Action: O c
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: PROP -ID a (�
o a
Lot Area: 1 O LA Lot Width: 14PO I Bld'g Height: 35 r
Front Yard: t Rear Yard: Side Yard: r O,
Prk'g Plan Rvw?e 5 # of Req'd Spaces: V
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
l� `*
Subd Case MY X/ 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 linearfeet, 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 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? !J 14,epkCList Other:
Date: 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: 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: H 119 Id A
CDD Staff:
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Odom # 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
14'-3 1/211 �23-
LIVING AREA
45150 FT
' 1 I vl— I
Transaction Receipt - Success
Kodiak Island Borough
Kodiak Island Borough Community Development
MID:200006988265
710 Mill Bay Road
Kodiak, AK 99615
907-486-9323
04/ 19/2021 02:16PM
Remittance ID:
Kodiak041921181452158Wel
Transaction ID:
266835534
PATRICK M. CALLAHAN
PO Box 8941
KODIAK, Alaska 99615
United States
MasterCard - 8149
Approval Code: 278147
Sale
Amount: $30.00
Patrick Callahan
907-942-5750
BZ2021-55
650 VonScheele Way
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
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