RUSSIAN CRK LT 3A - ZCP 5/31/2023Kodiak Island Borough Community
+/. Development Department
710 Mill Bay Rd. Rm 205
n Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907)486 - 9396
Zoning Compliance Permit
Permit
The following information is to be supplied by the Applicant:
Property Owner/ Applicant: F,�Aan �'ske✓
Mailing Address: I a NN (fir c k3'- ✓�—
Phone Number. (9 (7) '&i j >>pS
Other Contact email, etc.: Pj_ F-'�Jf Fw le llo-y" I L•LOM
Legal Description: Subdv: .Russ µ,me 3j8r Block: Lot:
Street Address: 12121 6-�r k.
Use & Size of Existing Structures:
Descri on of Proposed Action:
-29v1(c i)Spe � e� c c�traM� In or�c� r ('OMMP/jCL
Site Plan to include lot boundaries and existing easements, existing buildings, proposed location ofnew construction, access points, and
vehicular parking areas, As Built required with all improvement changes.
Staff Compliance Review: CurentZoning: P) _ 1-1 -1 lo PROP -ID
Lot Area: -' o) Lot Width: I Building Height: �6
Front Yard: /I"5, Rear Yard: Side Yard: '� r
Parking plan? N(A p Of Req'd Spaces: I �" As Built:
Staff Compliance Review Notes and Specific Plat I Subdivision Requirements:
P ya.& Q Iaj: (ur on ,caLca.k nrt
Subd Case No. Plat No. Building Pernit No.
Does the project involve
an EPA defined facility?
vommercialbuildings, installations(militarybases),
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 UO square _ _ _ _ _
feet,2601inearfeet, or35cubtcfeetofRegulated Asbestos Containing Matenal (RACM), and for
renovations that remove a load-suppordngstructure/memberer.
No nermit will be issued for such oroiects without proof of EPA
notification
AnolicantCertification: lherebycertifythat 1willcomplywiththe provisions oftheKodiak lslandBoroughCodeandthat I
have the authorityto certifythisas the propertyowner, orasarepresentativeofthepropertyowner.I agreetohaveidentifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments?
List Other:
Date: S ILLI� Print Name:
Date: I UwI v 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: Anyzoningcompliancepermitissuedissubjecttothesameexpiration, suspension, andrevocationprovisionsasa
buildingpermit issued for the sameconstruction permit **
COD Staff Certification
Date: � CDDStaff: J
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's OfficeRoom It 104-Main floorof Borough Building
After -the -Fact 2X the published amount
Not App li cable
❑
$0.00
0.00
Less than 1.75 acres:
�$30.00
A
V$60.00
1.76 to S.00 acres:
❑
$60.00
❑
$120.00
5.01 to 40.00 acres:
❑
$90.00
El
$180.00
40.01 acresor more:
Ei $120.00
❑
$240.00
9 r 7
naYP rP.VIP.WP(Y ,'l `Z- Zco
YES
NO
N/A
1.
The permit is filled out by applicant and signed by owner, an
✓
appropriate representative or a letter signed/dated from owner
giving permission to signee. Leased properties can submit a
copy of the lease in lieu of owner's signature.
2.
As -Built is required for any parcel with structures on it,
WlAv
vacant land can be done on plat (for exterior work only).
W
The proposed structure/project must be shown on the
to -
document with dimensions, along with all required
parking. Must show the distance of proposed project in
relevance to the property lines.
3.
Building (site) plans, the outside, will need to be included
/
V
in the packet along with side elevation of proposed
structure. All plans must show dimensions.
4.
Applicant was detailed in the "Description of Proposed
V
Action" area.
5.
Check to make sure all information filled out by applicant
is accurate. While reviewing, double check the
information on the permit matches the information in the
site plan.
6.
Pull and go through property file, make sure everything is
in compliance with the property or no notes have
previously been taken.
PRELIMINARY PLAT CHECKLIST.dot Page 1 of 5 Revised 2/28/05
7.
For lots that someone wants to live in an RV while
N
building Residence, make sure they have proof of both
Well and Septic being hooked up.
8.
Update Zoning Compliance Log with permit and write in
permit number on original copy.
9.
Collect payment from applicant. Once payment has been
processed, email a copy to applicant or any listed emails
on application. If requested send paper copy via mailing
address as shown on permit.
10.
Print off copy and deliver to the Building Department.
Email Copy to finance.
11
Print o r to the epartmen .
12.
Scan into laser Fiche.
13.
Give original copy to the Assessing Department, they will
give it back after data input. Once Assessing has given
the permit back, file in correct property folder.
14.
Clear Laserfiche after every permit or at the end of the
week.
PRELIMINARY PLAT CHECKLIST.dot Page 2 of 5 Revised 2/28/05
( .D
Existing
Mobile Home
12181 Gara Drive
Approx.
140cubic
yards 20ft
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