TOLBERT PTN LT 4 - ZCP 8/31/2026Kodiak lsland Borough
Community Development Department
7l() Nlill Bal Road Rrxrm 202
Kocliak. .,\leska 99(r I 5
Phonc ((.)0?) ,ltl(r-93(r3 trax (9t)7) .186r.)396
bcurde(c kodirkak.us
Zoning Compliance Permit Permit No CZ Qoe-l -o )
The following information is to be supplied by the Applicant
Property Owner/Appticant: #evgvt f Slwry'.$aa^--
iaro $n r 6<'t o $-
c c)7--q 3q -c',al7
Other Contact Email, etc..:a,r.-5 vv-
LegalDescription: Subdv rrN uf ro&f LI - lta totcr
StreetAddress: I a \O Oq .!E IOIA
Use & Size of Existing Structures: iA<c- ,'< sJ^J* -k,,.. lVU
Description of Proposed Action: Qg5sr;.4. \{, tcL,--
.'rr€-\l
Applicart Certilication:. I hcrehv certilt thut I v'ill compl1u'ith the ptotisions ol the Kodiok lsland Borough Code
tn.l thdt I h.tve the duthorit.\' to g!!!!fu!!!!!!_g!J!L!!!go!4!!@ or ds u rept'ese tulit e of the property ovner. I
agree to hot e iclentifiable Lrtrner n(,]tkets itt ploce fitr vetifitulbn ol huildittg setha(k (.\'drd) rcquircDpnts.
Title: o \\2r''Print Name: 5\ e-ro,.= rJrc, r "::
[)atc Signaturc
Site Ploa to include lot hounduries ttnd existing edsenents dn(l huildings, proposed ktcution ol ne* tct stru(lion
ucLess poitt"^, und vehitulu lturking urea, As-Built rcquireLl x'ith all inproveDte ts che ges.
This permit is only Jbr lhe proposed project as described by lhe qplicant. U'lhere are anl
changes to the proposed project, including its intended use, prior to or during ils siting,
consttucliorr, operution, cotrtdcl lhis ofJice immediately to determine iJ fnrther review and
approvol of the revised project is necesssry'.
THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDINC
PERMIT IS REQUIRED.
Lf
Mailing Address:
Phone Number:
R
u.r Staff Compliance Revierv
Does the Projecl involvc EPA Proof ol EPA notification providcd (ifrcquircd)?
'Required for all demos, renovalions disturbing at leasl Uo sq _
feet, 260 lineafeet, or 35 cubic ft of Regulated Asbestos Containing
Material {RACM} and for renovation lhal remove load supporting struclure'
Dcfi ncd Facility'l'commerical Buildings,
lnstallations. inslitutions. and residences
Will. more lhan four (4) dwelftnq uniles'
Expiralion.- An Zoning Llompliurce Pertnit isnted is suhjet't lo lhe sune expiftrlion. suspensiort, !nd rero(ulkrn
provisk,ts a"^ u ltuilding per til issued lbr the sdme cot6lru.lion pennit-
Current Zoning !Z ^6\Prop. ID 156?
Lor Area: r 2E3 +(
Front Yard: Q{'
Parking Plan: lV p
Building H
Rear Yard:
As-Built:
eight 35
Side Yard: /O' (IT'lo'5
Parking Spaces: tt/ A irt I
.I
u \it.T o r'L.V r
StalT Certification
Date:S/:/aoar t"t*ut'""'""'\D-{ 8=.
Afier thc Fact 2X thc publishcd amount
Waived:
Less than 1.75 Acres
I .76 to 5.00 Acres:
5.01 to 40.00 Acres:
40.01 Acres or more:
s0.00
s30.00
$60.00
s90.00
trF
tr
tr
tr
$0.00
$60.00
$ l 20.00
$ l 80.00
$240.00
tr
tr
tr
tr
tr Cash
RECEIVED
,AUG 3 1 2026
s I 20.00
Kodiak lsland Borough
Finance Departmont
TI
Statf Notes:
Lot Width: 35
TI
Pavment Verification