Kostrzewe, Theresa

V
. WGENERAL
CAMA / DREDGE & FILL No 70999
PERMIT Previous permit# A B C D
-New -Modification --Complete Reissue -_Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 7H y f f
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
emulgs attached.
r
Applicant Name � �`� � �� tf'' Project Location: County
7 --
Address c f �'I p . € Street Address/ State Road/ Lot #(s)
City : , ,.. StateN ZIP
Phone # ( )'" E-Mail Subdivision
Authorized Agent r ( r. J�}r!' S City t" f' / t` �`' ZIP
Affected ElCW ElEW El PTA ',OfS ElPTS Phone # ( ) t River Basin
AEC s ; El El
J HHF ❑ IH ElUBA El N/A Ad . Wtr. Bod f € '
ElPWS: I Y nat /man /unkn)
Closest Maj. Wtr. Body
ORW: yes 'no) PNA yes / no -
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length i
avg distance offshore
max distance offshore +✓
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length ? °.
SAV: not sure yes no'
Moratorium: n/a yes �n
Photos: yes no
Waiver Attached: yes nplt
(Scale L )
A building permit may be required by: (. ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) 1
Notes/ Special Conditions
Agent or Applicant Printed Name
r,
Si ature* Please read compliance statement on back of permit
plication Fee(s) Check i t
I' ' I •t►t ,
PermitOffiOr'rinted Name
Signature
Issui A Date Exoir ion Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888ARCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Theresa Kostrzewa
Mailing Address: 137 Palmetto Drive
Cedar Point NC 28584
Phone Number:
Email Address: tkost/[e-mail]
I certify that I have authorized ( Wrfll
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: replace seawall
at my property located at
137 Palmetto Drive
in Carteret County.
/ furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
SignAurd
Theresa Kostrzewa
Print or Type Name
Title
Date
This certification is valid through 12/ 31f 2018

Harber Contracting Inc.
P.O. Box 4562 Emerald Isle, NC 28594
252-342-9987
Mr. Sigman
Enclosed you will find an Adjacent Riparian Property Owner Notification/Waiver Form.
We plan on replacing the seawall. It would be greatly appreciated if you could fill out
the form and send it back. Please feel free to give me a call if you have any questions.
Thanks,
Cliff Harris
252-342-9987
[e-mail]

Theresa Kostrzewa
ioommPin lrorzrn

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Theresa Kostrzwa
(Name of Property Owner)
I
property located at 137 Palmetto Drive
(Address, Lot, Block, Road, etc.)
on White Oak , in Cedar Point , N.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
ItiQn.
1 have no abjection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must till In description below or attach a site drawing)
L019LL KE P-14' C E' �
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
,(/ LJJ I do not wish to waive the 15' setback requirement.
(Property Owner Information)
SiMgffsa Kostrzewa
Print or Type Name
Mailing Address
City/state/zip
Telephone Number/email address
Date
'Valid for one calendar year after signature"
(Adjacent Property wrier Information)
Signature
Dale Sigman
Print or Type Name
8836 Seacraft Ct
Martin! A d s
Spn�igf�e�d�/a. 22153
Gity/state/Zip
03 64Y Q 60&mxll L. CC*
Tele ho a Nu ber/ emai! ddress
U/ Mo/8
Dale*
(Revised Aug. 2014)

aDdACINr RIPAp�gN RROPERrir oINERUMMUff
ti
hereby certify that .1.OW6. Property adjacent to i 1� 5 i � D S—I v_Z�11/k- I
property located at 1-37 FA► y .(Nape 0f Pt'°PO'h/ Owner) . .S
..
on (AddCess, to Block;
N.0 :�.�..
l (City/Town.And/or:Countyj
The applicant has describe to me,. as shown below, `the.de rnent ro
�•., .
. •' Iocatlon. � .. mop. p RoSed at the :above.
_.. _ f have no obj00tion to -this proposal.
• I have. ob ecficn . .. . , - :. :<�-
j 5. �iis proposl..-
DE3CFiiP?'i4N-i�INQ1f R QF 41�ffl�la 4F PROpOSgo, DEVELOPMENT.
dual propo in develo
of 9 R:+.. !tru st fll�'In de�scri/i#lon below or attachoslte drii :. .
:�.
:'---------------
• . .. �Q � � . 'vex:
I understarid.th4t: a pier,.. q* nmiin-`j 1 in` s;.IJ `tbr, boathouse; ,lift, or groin must be set
back, a rpirtit�yrn dlsta�itce ol:f5';frorh-'O :a o f .rt ariari access unless waived try me. (If you -
wish to mtwth6ioiadt; yqu iptst 1iita(the, appririate' bl!alik below..);
'1 db.wish.ta waive.the 15'9ef4aac requarement.l
do'not wish fo,wve the 15' Setback requirement.
(Mperiy bwnerinfortfitloh): ::'Aedj" :t 1 ormatlon) ,
PAW -or N e Print yr Type Name
Z t,t:12LN- l lit_. h-p
MalNngAOderas
T Ncim"e7epl�tne 1lfiiinber J
Date Date i
(Revised fJial`20f2) .1

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