ERSKINE ADD BK 9 LT 84 89 - 92 115 - 118 - ZCP 4/4/2022Print Form Submit byEmaii
Kodiak Island Borough
Community Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907) 486 - 9396
hit n://w ww kodiakak_us
Zoning Compliance Permit Permit No. Cza,aa - 633
The following information is to be supplied by the Applicant:
Property Owner/Applicant: Bic Ray•e
Mailing Address: 212 Lower Mill Bay Rd, Kodiak, AK 99615
Phone Number: 907-279-2401
Other Contact email, etc.: lesseglamann@bigrays.com
Legal Description: tt� -Ilg
Subdv: �� �;� p Block: 7 Lot: gy89 _q2
Street Address: 212 Lower Mill Bay Rd, Kodiak, AK 99615
Use & Size of Existing Structures:
Desorption of Proposed Action
Site Plan to include lot boundaries and existing easements, existing buildings, proposed location of new construction, access points, and
vehicularparking areas.
Staff Compliance Review: Current zoning: ,�S PROP_ID
�^I
Lot Area: �k— Lot Width: Building Height: \� OU
Front Yard: `;ix- Rear Yard: ,1 \ , Side Yard:
Parking plan? 6V L # Of Req'd Spaces: &
StaffComplianceReview Notes and Specific Plat / Subdivision RequirementsS:+'r 1 ` 1
G�nnLl,..... n.rl... ., n..`.. roll ..c�n.��. A..,., .n w�.r l._.
Subd Case No. Plat No. Building PermitNo.
-Testing being completed to determine if EPA notification is needed.
Does the project involve Proof of EPA notification provided (if required)?
an EPA defined facility? •Requiredfor all demolitions, for renovations disturbing at least UO square J _
-commercial buildings, installations(mildwybases), feet, 260Itnearfeer,ar35cubicfeetofRegulatedAsbestosCon taming Marenat(RdCM),adfor
institutions (schools hospitals) and residences renovations that remove a load -supporting structure/ member er.
with more thanfour (4)dwelling units. No permit will bessued for such nro4ects without proof of EPA
notification
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
AnnlicantCertification: Iherebycertifythat Iwillcomplywiththe provisions oftheKodiaklslandBoroughCodeandthat I
havetheauthoritytocertifythisasthepropertyowner, orasarepresentativeofthepropeityowner. I agreetohaveidentiftable
comermarkers in place for verification of building setback (yard) requirements.
Attachments?
Date: 2-7-2022
Date: 2-7-2022
List Other: Titled, -Kodiak Asbuilts-
Jesse Glamann
Print Name:
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 itssiting, construction, 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. Anyzoningcompliancepermitissuedissubjecitothesamee piraLion,suspension, andrevocationprovisionsasa
building permit issued for the sameconstruction permit. **
COD Staff Certification
Date: I1 , I =_ CDDStaff: /
Payment Verification Zoning Complian erm itF P yable in Cashiers ffice Room It 104- Main floor of Borough Building
After -the -Fact 2X the published amount
Not App livable -
$0.00
$0.00
Less than 1.75 acres:
$30.00
$60.00
1.76 to S.00 acres:
❑ $60.00
$120.00
5.01 to 40.00 acres:
❑ $90.00
$180.00
40.01 acresor more:
❑ $120.00
❑
$240.00
U.S. EPA NOTIFICATION OF DEMOLITION AND RENOVATION
Page I of 2
Operator Project #
Postmark
Date Received
Notification #
I. Type of Notification (check one): LJ Original LJ Revised Canceled
If. Facility Description
Building Name: Big Ray's
Address: 212 Lower Mill Bay Rd
City: Kodiak State: AK Zip Code: 99615 County:
Site Location:
Building Size (square feet): # of Floors: 1 Age in Years:
Present Use: Retail Prior Use:
ID, Type of Operation (check one):DemoLJ Ordered Demo Ll Renovation LxJ Emergency Renovation Fire Training
IV. Is Asbestos Present? (check one): LJ Yea No Samples have been pulled for testing. Current y wor
V. Facility Information
Owner Name: Big Ray's
Address: 212 Lower Mill Bay Rd
City: Kodiak State: arc Zip Code: 99615
Contact Jesse Glamann Telephone: 907 279-2401 Fax:
Removal Contractor Name:
Address:
City: State: Zip Code:
Contact: Telephone: (_ J Fax:
Other Operator(demolition/general: cadence General Contractors
Address: 700 Bast 46th Avenue
City: Anchorage State: AK Zip Code: 99703
Contact: Kendall Wilson Telephone: 907 433-9299 Fax:
VI. Procedure, including analytical methods, employed to detect the presence of and to estimate the quantity of RACM and
Category 1 and Category 11 non -friable ACM:
Vll. Approximate Amount of Asbestos Materials:
RACM to be Removed
Non -friable Asbestos Material
to be Removed
Non -friable Asbestos Material
NOT to be Removed
Category I
Category II
Category I
Category 11
Pipes (linear feet)
Surface Area (square feet)
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: 3/15/22 Complete: 4/l/22
DC Dates for Asbestos Removal (MM/DD.h'Y) Start: TBD Complete:
Days of the Week:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Hours of Operation:
U.S. EPA NOTIFICATION OF DEMOLITION AND RENOVATION
Page 2 of 2
X. Description of planned Demolition or Renovation work to be performed and method(s) to be employed, including derno"t
an
or renovation techniques to be used and description of affected facility romponents:
We are providing structural repairs to the existing slab on deck and interior crarlspace.
Xi. Description of work practices and engineering controls to be used to comply with the requirements, including asbestos
removal and waste handling emission control procedures:
we have seat off for testing of the material that will used to be disturbed post the fouada
ion
repair.
XD. Waste Transporter #1
)
Name:
Address:
City: State: Zip Code:
Contact: Telephone: ( )
Waste Transporter #2
Name:
Address:
City: State. Zip Code:
Contact: Telephone: ( )
XHI. Waste Disposal
Namc:
Address:
City: - State: Zip Code:
Contact Telephone: ( )
XI V. Emergency Demolition (complete Item XIV only if this project is an Emergency Demo.)
1. Attach a copy of the Order to this notioe.
2. Name of Authority Issuing Order: Title:
3. Authority of Order (Citation of Code):
4. Date of Order (MM/DD/YY): Date Ordered to Begin
XV. Emergency Renovation (Atmcb separate sheet with the following information if project is Emergency Renovation.)
1. Date and Hour of the Emergency:
2. Description of the Sudden, Unexpected Event:
3, Explanation of how the event caused unsafe conditions or equipment damage or an unreasonable financial burden.
XV7. Description of procedures to be followed in the event that unexpected RACM is found or non -friable ACM becomes
crumbled, pulverized, or reduced to powder.
XVH. 1 certify that n in us[ if fisted in the provisions of NESHAP (40 CFR PART 61, SUBPART M) will be on -site during
De litin or a ovation, and evidence that the required training has been accomplished by this person will be
e
avail le un arms[ business hours. (�
zj Z zv2Z �]p r�. � OSi
Signature of Owner/Operator ate Type or Print NsAie and Title
XVDI. I acknowledge the existence of laws prohibiting the submission of false or misleading statements, and I certify that facts
contained in this notification are true, accurate, and complete.
Signature of Owner/Operator Date Type or Print Name and Title
March 2, 2022
To Whom It May Concern:
Jesse Glamann is hereby authorized to act on behalf of AIA Kodiak Properties, LLC regarding all issue
involving government agencies, construction projects and purchasing materials required for the
maintenance of all properties and land held by the company.
Monty Rostad
k Properties, LLC
507 Second Avenue
Fairbanks, Alaska 99701
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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
03/03/2022 11:23AM
Remittance ID:
Kodiak030322151848254Cur
Transaction ID:
286618403
JESSE GLAMANN
507 second ave
KODIAK, Alaska 99615
United States
Visa - 2007
Approval Code: 04996G
Sale
Amount: $30.00
Jesse Glamann
9072792401
CZ2022-033
212 lower mill bay rd
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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