HOSPITAL BK 1 LT 2A-1 - ZCP 6/20/2023 (3)Kodiak Island Borough Community D L > D
Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph, (907) 486 - 9363 Fax (907) 486 - 9396
Zoning Compliance Permit
Permit No. ✓7,��}3_p,-�
The following information is to be supplied by the Applicant:
Property Owner/ Applicant: Kodiak Island Borough/Providence Medical Center
Mailing Address: 710 Mill Bay Road
Phone Number. 907 486-9304
Other Contact email, etc.:
Legal Description: Subdv: Hospital BK 1 LT 2A-1
Street Address: 1915 Rezanof Drive East
Use & Size of Existing Structures:
& Community Health Clinic
Block: 1 Lot 2A-1
Description of Proposed Action:
Relocate an existing mobile MRI trailer & electrical disconnect for temporary use. The new
location will be adjacent to the main entry of the hospital.
Site Plan to include lot boundaries and existing easements, existing buildings, proposed location of new construction, access points, and
vehicular parking areas, As Built required with all improvement changes.
Staff Compliance Review: Current Zoning: Public Use KIBC 17.130 PROP_ID 23656
Lot Area* 11.82 Acres Lot width: 60' Building Height: 50'
Front Yard: 255' Rear Yard: 25%/25 ft Side Yard: 10% /25 ft
Parking plan? a Of Req'd Spaces: As Built:
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
Subd Case No. Plat No. 2012-20 Building Permit No. TBD Bldg Dept
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Does the project involve
Yes
Proof of EPA notification provided (if required)?
an EPA defined facility?
-Requiredfor alldemolitions, for renovations disturbing at least UO square _NO
•commeraalbuildings, installations Joiduarybases),
feet,260(inearfeet, or35cubicfeetofRegulated Asbestos Containing Marerial(RACM), andfor
institutions (schools, hospitals) and residences
renovations that remove aload-supportingstructure/member er
with more than four (4)dwelling units
Driveway NIA
Permit?
Septic Plan NSA
Approval
Fire Marshall: TBD Bldg Dept
AnnlicantCertification: I hereby certify that I willcomplywith the provisions of the Kodiak lslandBoroughCode and that I
have the authority tocertifythisasthe propenyowner, orasa representativeof the property owner. I agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments? Site Plan List Other: Design Document Drawing Set
Date: LAe \ Le 1 202-t> Print Name: DAVID CONRAD
Date: Z� 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, 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. Anyzoningcompliancepermitissuedissubject to thesameexpiration,suspension, andrevocadon provisions asa
building permit issued for the sameconstruction permit. **
Date:
CDD Staff:
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Room lt104- Main floorof Borough Building
After -the -Fact 2X the published amount
Not App li cable $0,00 ❑ $0.00
Lessthan 1.75acres:
Fi
$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:
Ei
$120.00
$240.00
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