Fillable Haines Borough Planning and Zoning (Haines Borough)

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Haines Borough Planning and Zoning (Haines Borough)

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  • 13 check-boxes
  • 267 other fields

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BROWSE HAINES BOROUGH (AK) FORMS

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Haines Borough Planning and Zoning
103 Third Ave. S., Haines, Alaska, 99827
Telephone:
(907) 766-6401 * Fax: (907) 766-2716
Site Development Application Permit #_____________
Date________________
I. Owner/Authorized Representative
Owner’s Contractor(If Any)
Name:
Name:
Haines Borough Business License #:
Mailing Address:
Alaska Business License #:
Contractor’s License #:
Contact Phone:
Mailing Address:
Contact Phone:
Fax:
Fax:
E-mail:
E-mail:
II. Property Information
Property Tax ID #:
Size of Property:
Legal Description: Lot (s) Block Subdivision
OR
Parcel/Tract Section Township Range_
Zoning: □Waterfront □Single Residential □Rural Residential □Significant Structures Area □Rural Mixed Use
□Multiple Residential □Heavy Industrial □Waterfront Industrial □Commercial
□Industrial Light Commercial □Recreational □Mud Bay Zoning District □Lutak Zoning District
III. Description of Work
Type of Project:
Check all that apply
o
Residential
o Commercial
o Industrial
o Church
o Other__________________________
Brief Project Description:
Estimate cost of work: _______________
Estimate date of Construction:_________________________________________
(must be within two years of date of submission)
Haines Borough Site Development Application
Excavation and Fill
Will more than 5,000 board feet or 100 cubic yards of material be displaced on
or removed from this property?
Example: One standard dump truck can hold about
10 cubic yards of gravel; one
standard logging truck holds 4,000-5,000 board feet.
Yes No
Estimate total
amount
and
type
of material
_______________________________________________________________________________
Will excavation be required? Yes No
Will excavated material be removed from the site?
Yes No
Will fill be brought onto the site?
Yes No
Drainage (HBC 18.60.010 J)
The applicant for a proposed use shall provide for the control of runoff during and after
construction. All roads and parking areas shall be designed to alleviate or avoid runoff into public streets or adjoining lots and to
protect rivers, lakes and streams from pollution. Developers may be required to provide for the conservation of natural features
such as drainage basins and watersheds, and provide for land stability.
Is drainage addressed on the site plan?
Yes No
If not, describe drainage plan (use separate sheet as necessary): __
___
Habitat and Anadromous Fish Streams (HBC 18.60.010 O & P) A reclamation or landscaping plan may be required
as a condition of approval of any use within 100 feet of a state-identified anadromous stream. The purpose of the reclamation or
landscaping plan includes the control of dust, soil erosion, water runoff and siltation which otherwise would be generated on the lot
and affect the surrounding area. Unless approved by variance, no development shall occur within 25 feet of the banks of
anadromous fish streams, designated as such by the Alaska Department of Fish and Game.
Are streams addressed on the site plan? Yes No
If not, describe stream(s) on property ____
_________
Off Site Impacts (HBC18.60.010 N)
Including excessive noise, fumes or odors, glare, smoke, light, vibration, dust, litter,
or interference in any radio or television receivers off the premises. Buffering may be required to alleviate impacts between
residential and nonresidential uses. The owner of the property upon which the buffering is constructed is responsible for the
maintenance of the buffering.
Describe possible off-site impacts
(use separate sheet as necessary): _
________________________________________________________________________________
Flood Plain (HBC 18.60.010 S)
All applications for land use or conditional use permits shall be reviewed for compliance
with the National Flood Insurance Program prior to approval. Per HBC 18.120.020, the “Flood hazard area” includes all the area
within the corporate limits subject to the 100-year flood as delineated on the flood hazard boundary map or the flood insurance
rate map for the borough published by the Federal Insurance Administration; flood hazard area includes the coastal high hazard
area where applicable.
Is the property located within a flood hazard area? Yes No
IV. CERTIFICATION
I hereby certify that I am the owner or authorized representative of the property described above and
that I file a site development form in conformance with all of the provisions in the Haines Borough Code. I
understand that all contract work on this project will be done by a contractor holding valid licenses
issued by the State of Alaska and the Haines Borough.
Signature (Representatives must provide written proof of authorization) Date
PROVISIONS: The applicant is advised that the submittal of this site development form will not relieve
responsibility of the owner or authorized representative to comply with the provisions of all laws and
ordinances, including federal, state and local jurisdictions, which regulate construction and performance of
construction, or with any private deed restrictions.
Office Use Only Below This Line
INCOMPLETE SITE DEVELOPMENT APPILCATIONS WILL NOT BE ACCEPTED
Application is Complete:
Notified Via:
Notified By:
Date:
Yes
No
If application is approved:
Approved By:
____________
Borough Manager/Designee
Permit ID #:
______
Permit Effective Date:
__________
If application is denied:
Denied
By: __________________
Borough Manager/Designee
Reason:
___________
Date:
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Haines Borough Planning and Zoning (Haines Borough)

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Completed 13 February 2021

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