ASLS 91-134 TR A KUPREANOF - ZCP 7/27/2026Print Form Submat byEmail
Kodiak lsland Borough
Community Development Department
710 Mill Bay Rd Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907)486 - 9396
htl o://w ww kodiakak us
Zoning Compliance Permit
Property Owner/ Applicant:
Mailing Addrass: f),/
Phone Number:
Other Contacl email etc.:
Legd Description:
The following information is lo be supplied by the Applicant
oa.riJ fYli ll c "hri Baile, r(PY 3) Ro"li^k llK qjbq)
t)-o 7 R.!
AS(5 *-29 @nd Block Lot
Street Address
Use & Size of Existing Strucitures
N*
D ripl ion of
iTil
posedAction
t)LYlt
sile Plan 1., includ.,: htl b.ruttl.trics nl
ond rchi.ulor porklng oreos,
tng i in hnihlirtl:t, trtotro\al hrcotion of n?b (onttrl.,rtiol. (rtc\\ ptrirtts,
Staff Complianco Review:non PROP rD t91L/dts.,,*
05'
Lo &5o tdHLOr tAq- 36 t
?5!Front Yard Re Yard L5'Yd
Prk'g Pl Rvw?*/#ofR 'd
Plat No Bld'g PermitNo
Permit No. bZg"z, -oe-7
Subdv LI
4
Slaff Comp liance Rw i ew Notes , r Specitic Pl t / Subdivi R quarem nl s
Subd Case No
Does the pro,ect involve
an EPAdefined facility?
.L\ n n t: rt i d I hu i l.l nry\. i ns to I la t io n \ i m i I i t dn bds e s ).
instifittion! (schoob.hospitaIs) anl .i&,k1 r 1r'ith
nok than Ioff (4 ) dn| I ling unil\
Driveway
Permit?
Septic Plan
Approval
Fire
Marshall
AlltiqalfgAdilicatie!: I hereby certify thatlwiltcomplywiththeprovisions of lhe Kodiak lslandBoroughCode and thatl
havethe authority tocedifythisastho propedy owner,or asa represenlativeofthe propeftyowner. lagreetohave identifiable
comer matkers in placefor verification of building setback (yad) requirements.
Attachments? Lrst Other
Date Print Name Dsn aoN ccrt\R-
Date: 3 Signatur e
This permil is onty lbr lhc pntposed pnlet,l us describcd b.t, the applirunt. If thcrc arc un-l' chungas lo thc
this oJJica intmcdiutcl-t' to dcrntinr: iJ Jfurthcr rcfien, und uppn^,ul ttl lhc revise d pnled is nctcssur-t'.
TH'S FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BU'LD'NG PERM'T IS REQUIRED.
huildinll lrarrrril i\tudl for th.! \nttt! <'.rrrrtrfi.lion Pcruil. * *
COD Staff Certif ication
ilo Proof of EPA notification provided (if required)?
.R.qutr|l fu lld,. dilion\ /i,-n ot. rn\ ltsnt, hoe nt hal't L O squdt.
li|t :60lt,n1r l;\'t oi 5 crhk lrt tn Rt culdt,:l .1\h \to\ < .,1k-i t,tP .\krlontl iR.1( 'rli utl
li t't tdatin! lhnt ft'nd ( u h.d \tqf,litgst,ttrtttt,' nk nbtt'
No oermit will beissued for such oroiects without Droof of EPA notification
Date CDD StaffLz-
eey$eD$fedligafiQtr Zonrng Complrance P rt Fee Payeb
s/, /t"
oom /t 104 - Main flcor ofBorough Buildrng
t he p ubli hed amount
Not App licable
Lessthan 'l 75 acres
1.76 to S.00 acres:
5.01 to 40.00 acres:
40.01 acresor more
$0 00
$30 00
s60.m
$90.00
s120.00
$0 00
$60 m
$120.00
$180 00
$240 00
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PAYMENT DATE
03t11t2022
COLLECTION STATION
CASHIER
RECEIVEO FROM
DAVID MILLER
DESCRIPTION
82-2022-029 ASLS 89 241 KUPREONOFF
Kodiak lsland Borough
710 Mill Bay Rd.
Kodiak, AK 99615
BATCH NO.
2022-O0000254
RECEIPT NO.
2022-OOOOO7Al
CASHIER
Brandi Wagner
$90.00
TRANSACTION AMOUNT
Zoning Compl
Printed by: Brandi Wagner
Zoning Compliance Permit
Payments:Type Detail
$90.00
Total Amount:
$90.00
0311112022 03:54:23 PM
Amount
Check 3140
Customer Copy
Page 1of 1
PAYMENT CODE RECEIPT DESCRIPTION