ERSKINE ADD BK 5 LT 15 - ZCP 10/26/2021Kodiak Island Borough
Community Development Department
y 710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907) 486 - 9396
http://www.kodiakak.us
Print Form ISubmit by Email
Zoning Compliance Permit Permit No. C,,L, -azy
The following information is to be supplied by the Applicant:
Property Owner / Applicant:
Mailing Address:
Phone Number:
Other Contact email, etc.:
Legal Description:
Street Address:
Use & Size of Existing Structures:
Subdv: �`� Jk \ � � ��G;k� °� �iiJ� Block: � Lot: f �--
of Proposed Action: N
L
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: 1) A
Lot Area:
Front Yard:
Lot Width: Bld'g Height:
Rear Yard:
Prk'g Plan Rvw? # of Req'd Spaces:
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
Side Yard:
Subd Case No. Plat No. 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 160 square
*Commercial buildings, installations (military bases), feet 260 linear feet; or 35 cubic feet of Regulated Asbestos Containing Material (RACM), and
institutions (schools, hospitals) and residences withs for renovations that remove a load -supporting structural member.
more than four(4) dwelling units. No permit will be issued for such projects without proof of EPA notification
E ,
ti
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
Applicant Certification: I 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?
List Other:
Date: (� Zt Signature:
i
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: �b �� J� L� CDD Staff:
Payment Verification Zoning Compliance Petit Fee Payable in
Not Applicable ❑ $0.00
Less than 1.75 acres:
$30.00
1.76 to 5.00 acres:
'2�
$60.00
5.01 to 40.00 acres:
R
$90.00
40.01 acres or more:
F7
$120.00
Office Room 1k# V4 - Main floor of Borough Building
After -the -Fact 2X the published amount
El $0.00
$60.00
$120.00
$180.00
❑ $240.00
Transaction Receipt - Success
Kodiak Island Borough
Kodiak Island Borough Community Development
MID:200006988265
710 Mill Bay Road
Kodiak, AK 99615
907-486-9323
10/26/2021 01:43PM
Remittance ID:
Kodiak102621174055552Cur
Transaction ID:
280807298
TERRI BLONDIN
PO Box 159
KODIAK, Alaska 99615
United States
Visa - 5337
Approval Code: 044654
Sale
Amount: $30.00
Terri Blondin
19079421282
CZ2022-024
412 Erskine
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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