HOSPITAL BK 1 LT 2A-1 - ZCP 2/24/2012Kodiak Island Borough
j Community Development Department
710 Mill Bay Rd. Rm 205
-A4 Kodiak AK 99615
oaa, 332
Ph. (907) 486 - 9362 Fax(907)486 -9396
httr)://www.kodiakak.us
Zoning Compliance Permit
Print Form Submit by Email
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Permit No. CZ2012 -058
The following information is to be supplied by the Applicant:
Property Owner/ Applicant: KIB /PKIMC
Mailing Address: 1915 E. Rezanof Dr., Kodiak, AK 99615
Phone Number: 486 -3281
Other Contact email, etc.:
Legal Description: Hospital Subd Bk 1 It 2A
Street Address: 1915 E. Reza nof Dr.
Use & Size of Existing Structures: Medical Facility
Description of Proposed Action: Interior alterations( undisclosedsgftg - noexterioradditions)
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:
ZONING: Public Use
Lot Area: 11..65 acres
Front Yard:
Prk'g Plan Rvw? No
Plat / Subdivision
Requirements?
Lot Width:
Rear Yard:
# of Req'd Spaces:
PACS_No. 16180
Bldg Height:
Side Yard:
Does the project involve If YES, do you have an EPA Return Receipt of Notification?
an EPA defined facility? N/A "Permit will not be issued until receipt is submitted to KI8" N/A
Coastal Policy Consistent? Attachment?
Subd Case No. Plat No. Rld'g Permit No.
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
Applicant Certification: 1 hereby certify that I 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?
Date: Feb 24, 2012
List Other:
Signature: Stan Thompson for PKIMC `' 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.
** EXPIRATION: Azoning compliance permit will become null and void if the building or use authorized by such permit is not
commenced within 180 days from the date of issuance, or if the building construction or use is abandoned at any time, after the
work is commenced, for a period of 180 days. Before such work can be recommenced, a new permit must first be obtained. (Sec.
106.4.4 Expiration. 1997 UBC) per KIBC 17.03.060. **
CDD Staff Certification
Date: Feb 24, 2012 CDD Staff: Martin LydickK
Payment Verification
Zoning Compliance Permit Fee
Payable in Cashier's Office
Room # 104
Fee Schedule
5.01 to 40 acres $90.00