SC_15-20_ Majewski

Issued by WiRO SC15-20
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environment,
and Natural Resources and the Coastal Resources Commission for development
in an area of environment concern pursuant to Section 113A-118 of the
General Statutes,"Coastal Area Management"
Issued to Francis and Martha Maiewski authorizing development in the Ocean Hazard (AEC) at 504 S. Shore Drive, in
Surf City, Pender County as requested in the permittee's application, received by DCM on September 23, 2015. This
permit, issued on October 5, 2015, is subject to compliance with the application and drawing dated and received by
DCM on September 23, 2015 (where consistent with the permit), all applicable regulations and special conditions and
notes set forth below. Any violation of these terms may subject the permittee to a fine, imprisonment or civil action, or
may cause the permit to be null and void.
This permit authorizes: Construction of a dwelling, driveway, decking and beach access walkways.
(1) All proposed development and associated construction must be done in accordance with the permitted survey drawing
dated received by DCM on September 23, 2015.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at(910)
766-7221 for a final inspection at completion of work.
(Additional Permit Conditions on Page 2)
'This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for
compliance. Any maintenance work or project modification not covered under
this permit,require further written permit approval.All work must cease when this Jason Dail
permit expires on: MA LOCAL PERMIT OFFICIAL
December 31,2018 127 Cardinal Drive Extension
W' in. f� -3845
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to r-m
another party without the written approval of the Division of Coastal Y)106161'
Management. o G)m

Name: Francis and Martha Majewski
Minor Permit#SC15-20
Date: October 5, 2015
Page 2 of 3
(5) The permittee is REQUIRED to contact the Local Permit Officer(910) 796-7221, shortly before he/she plans
to begin construction to arrange a setback measurement that will be effective for sixty (60) days barring a
major shoreline change. Construction must begin within sixty (60) days of the determination or the
measurement is void and must be redone.
(6) Any structure(s) constructed within the Ocean Hazard area shall comply with the NC Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage
Prevention Ordinance as required by the National Flood Insurance Program. If any provisions of the building code
or a flood damage prevention ordinance are inconsistent with any of the following AEC standards, the more
restrictive provision shall control.
(7) With exception of the proposed structural access walkways and deck(s), all other structure(s) must be set hack a
minimum of 60 feet from the First Line of Stable Natural Vegetation (FLSNV), as determined by the DCM, the LPO,
or other assigned agent of the DCM.
(8) Any deck(s) located within 60 feet from the FLSNV shall not exceed a combined footprint of 500 sq. ft. and shall be
structurally independent of the residential or primary structure. The deck(s) may be cosmetically attached, but shall
remain free standing as a single unit.
(9) All buildings must be elevated on pilings with a diameter of at least 8 inches in diameter if round, or 8 inches to a
side if square; and the first floor level of the sills and joists must meet the 100-year flood level elevation.
(10) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(11) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetatatively stabilized (planted and
mulched)within 14 days of construction completion.
(12) Any structure authorized by this permit shall be relocated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. The structure(s) shall be relocated or dismantled within two years of the time
when it becomes imminently threatened, and in any case upon its collapse or subsidence. However, if natural
shoreline recovery or beach renourishment takes place within two years of the time the structure becomes
imminently threatened, so that the structure is no longer imminently threatened, then it need not be relocated or
dismantled at that time. This condition shall not affect the permit holder's right to seek authorization of temporary
protective measures allowed under CRC rules.
(13) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
c;;;74 /67.e.—
SIGNATURE: \ otib PERMITTEE:
DATE: /&lilc
RECEIVED
DCM WILM'NGTON, NC

/' CI' Cr'V2-0OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
Locality Vy Permit NumV minor development permit,including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Energy Conservation,FIA
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
(For official use only) others.Check with your Local Permit Officer for more information.
GIMBAL INFORMATION STATEMENT OF OWNERSHIP:
i,the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
LAND OWNER person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
Name Francis A.Majewski and wife,Martha D.Majewski listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
Address 101 Kelso Court
Flan owner or record title,Title is vested in Fee Simple ,see Deed Book 4579
City Cary State Zip 27511 Phone (910)455 oe77 page 329 in the Pander County Registry of Deeds.
Email [e-mail]
ran owner by virtue of inheritance.Applicant is an heir to the estate of ,
AUTHORIZED AGENT probate was in County.
Name Charles F.Riggs&Associates,Inc. [—if other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
Address P.O.Box 1570 NOTIFICATION OF ADJACENT PROPERTY OWNERS:
City Jacksonville State NC Zip 28541 Phone [phone] 1 furthermore certify that the following persons are owners of properties adjoining this property.I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
Email [e-mail]
(Name) (Address)
(I) Ms.Mary F.Thomas Edens et al.,619 Laurel Valley Way,Salisbury,NC 28144
LOCATION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
adjacent waterbody.)504 South Shore Drive,Town of Surf City(Portion of Lot 2 and All of Lot 3,Block 6,Surf City#1) ,At1<L'.()('uAA)(2) Mr.Michael H.Martin et al.,209 Edinburgh Drive,Cary,NC 27511
(3)
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) Proposed Two-Story (4)
Dwellings Partially Enclosed Below with Uncovered and Covered Decks and Pervious Drive
SiZE OF LOT/PARCEL: 15,300 square feet 0.351 acres ACKNOWLEDGEMENTS:
I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
PROPOSED USE:Residential 0 (Single-family 0 Multi-family Q) Commercial/Industrial 0 Other 0 may be susceptible to erosion and/or flooding.I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
COMPLETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer((you are not sure which AEC applies tion and floodproofing techniques.
to your property):
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:4,976 square feet(includes i furthermore certify that I 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 infonnation
air conditioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but related to this permit application.
excluding non-load-bearing attic space)
(2) COASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This the O�� day o�i,/—rA 20��
UPON SURFACES: square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks, (..34/64,,
concrete or masonrypatios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) ��
Landowner or person authorized to act a . edt for rpose of filing a CAMA permit application
STATE STORMWATER MANAGEMENT PERMIT:is the project located in an area subject to a State Stonnwater
Management Permit issued by the NC Division of Water Quality? This application includes:general inft this form),a site drawing as described on the back of this application,the
YES= NCli ✓ I ownership statement,the Ocean Hama •'i otice where necessary,a check for S100.00 made pamnble to the locality and
any information as may be provided o , .'by the applicant.The details of the application as described by these sources are
If yes,list the total built upon area/impervious surface allowed for your lot or parcel: square feet. incorporated without reference in any permit which may be issued Deviation from these details will constitute a violation of
0 n any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
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North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
October 5, 2015
Francis A. & Martha D. Majewski
101 Kelso Court
Cary, NC 27511
Dear Mr. & Mrs. Majewski:
Attached is CAMA Minor Development Permit# SC 15-20 for work to be done at 504 South Shore Drive, in
Surf City, Pender County.
In order to validate this permit, please sign both copies of the permit as indicated for our records. Please
retain the gold copy for your files and front and back pages of the white copy then return to us within 20
days of receipt, in the enclosed, self-addressed envelope. A copy of this permit has been sent to your
agent.
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Sincerely,
Shaun K. i pson
Permit Sup ort Technician
Enclosures
Cc: WiRO files
127 Cardinal Drive Ext.,Wilmington, NC 28405
Phone: [phone]\FAX: [phone] www.nccoastalmanaoement.net
An Equal Opportunity\Affirmative Action Employer

' csuyIsit) ,r / c17
cAmA PE
PROJECTApplicantAPPLIED FOR
proposes construct ct a single-
family dwellingat 504 South" Shore Drive,
a - _ - - " -
= - -Pender County.
COMMENTS ACCEPTED THROUGH october4r,2at5__
APPLICANT: FOR MORE DETAILS CONTACT
THE LOCAL PERMIT OFFICER BELOW:
Francis A. MaJewski NC Div. of Coastal Management
1 u1 Kelso Court 127 Cardinal Dr Ext
Cary, NC 27511 �ALi1mi C 28405
ason ail, Field Representative
910-796-7221
Agent: Charles F. Riggs & Associates 910-455-0877

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
September 15, 2015
Date
Name of Property Owner Applying for Permit:
Francis A. Majewski and wife, Martha D. Majewski
Mailing Address:
101 Kelso Court
Cary, NC 27511
1 certify that I have authorized(agent) Charles F. Riggs & Assoc. to act on my
behalf,for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) proposed dwelling, as shown on map
at(my property located at) 504 South Shore Drive, Town of Surf City
This certification is valid thru (date) September 15, 2016
/;J eptem er 15, 2015
•
Property Owner Signature f Date
',ECJJVED
DCM WILMINGTON,

OCEAN HAZARD AEC NOTICE
Project is in an. Ocean Erodible Area High Hazard Flood Area . inlet Hazard Area
Francis A.Majewski and wife.Martha D. Majewski
Property Owner 504 South Shore Drive.Town of Surf City
Property Address -
Date i_ot Was Platted:
August 1948
I his notice is intended to make you. the applicant. aware of the SPECIAL NOTE: Ihis hazard notice is required for
special risks and conditions associated with devekmpment in this development in areas subject to sudden and massive storms and
area.which is subject to natural hazards such as storms.erosion erosion Permits issued for development in this area expire on
and currents 1 he rules of the ( oastai Resources (.ommission Ihcember 7,I of the third year tollowing the year in which the
require that you receive atm Al:l' Hazard \yoke and permit was issued. Shorflti before work begins on the project
acknowledge that notice us writing before a permit for sue.the Local Permit Officer must be contacted to determine the
development can he issued. vegetation lino and setback distance at your site. If the property
has seen little change since the time of permit issuance.and the
the (ommisstnu s rules on hutidmg suuaasards. oceanfront proposed development can still meet the setback requirement.
setbacks and dune alterations are designed to minimize.hut not the f.P() will inform you that v.0 may begin work. Substantial
eliminate. property loss from hazards By granting permits. the progress on the project must t e made within 61) days of this
Coastal Resources Commission does not guarantee the safety of setback determination.or the,etback must he re-measured.Also.
the development and assumes no liability for future damage to the occurrence of a major shoreline change as the result of a
the Jestkip:rent Pemtits issued in the Ocean liazard Area of storm within the 60-day period will necessitate re-measurement
1-n%ironmental t oni.ern include the condition that structures be of the setback. It is important that you check with the LP()
relocated or dismantled if they become imminently threatened before the permit expires for official approval to continue the
by changes in shoreline configuration. Tnx structureisi must he work after the permit has expired. (>'encrally, if foundation
relocated or dismantled within two 121 year, of becoming pilings have been placed and substantial progress is continuing.
imminently threatened. and in any case upon its collapse or permit renewal can he authorized It is unlawful to continue
subsidence. work after permit expiration,
the hest available intwtnattoo.as accepted by the toasts! for more tit/arwwtun.contact:
Resources t onunisston. indicates that the annual long-term
average(ice")erosion rate for the area where your property is 'IAI4) ti r`"
located is fret per year
Local Permit Officer
the rate was established by careful analysis of aerial /co ` .- 14---photographs of the astline taken over the past 50 yam. /Z' U ''yea /
c/also indicate that the shoreline could move as much as Address
ZYs -'.7 tees landward in a manor storm. ` L /lC 2... " //
iti
food water-in a major storm are predicted to he.trsiui
iect deep in this area. Localrty
Preferred oceanfront protection treasures are ticach nourishment 1,arm - 7q 6' 7 Z Z
and relocation of threatened structures. Hard erosion control
structures such as bulkheads.seawalls.revetments.groins,jellies Phone Numb"
and breakwaters are prohibited. temporary sand bags may he
authorized under certain conditions
the applicant must acknowledge this intornatton and
requirement v signin i this notice in the space he iw. ►ii ithout
the ;;ignnature. appli will u he • pi.te
1 �,
- .40/fiz2V .._ 9-- in- ,/-S -
raperty Owner Srgn ore Date
Revised May 2010
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U.S.DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCYMANAGEMENTAG AGENCY ELEVATION CERTIFICATE OMB No. 1660-0008 I
National Hood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31,2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name FRANCIS A MAJEWKSI&WIFE,MARTHA D MAJEWSKI Policy Number.
A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number:
504 SOUTH SHORE DRIVE
City SURF CITY State NC ZIP Code 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
PORTION OF LOT 2 AND ALL OF LOT 3,BLOCK 6,SUBDIVISION NO.1 OF SURF CITY
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude: Lat.34d25'21"N Long. 77d32'59"W Horizontal Datum: 0 NAD 1927 Z NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 2328 sq ft a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
B1.NFIP Community Name&Community Number I B2.County Name B3.State
TOWN OF SURF CITY 370186 I PENDER NORTH CAROLINA
B4. Map/Panel Number B5.Suffix B6. FIRM Index Date B7. FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
3720423400 J 02/16/07 Effective/Revised Date Zone(s) AO, use base flood depth)
02/16/07 VE 14.0
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 Z NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes Z No
Designation Date: ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ® Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters.
Benchmark Utilized: NC CORS Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. 0 NGVD 1929 ® NAVD 1988 ❑Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 15.0 0 feet ❑meters
b)Top of the next higher floor 25.0 Z feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) 23.0 ®feet ❑meters
d)Attached garage(top of slab) N.A ❑feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building 15.2 ®feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 10.4 ®feet ❑meters
g) Highest adjacent(finished)grade next to building(HAG) 15.0 ®feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N.A ❑feet ❑meters
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ,,,itirtesiii
information./certify that the information on this Certificate represents my best efforts to interpret the data available. ``��NA CA/:?0",„
I understand that any false statement may be p qit qb py fine or imprisonment under 18 U.S. Code, Section 1001. %% ,
.`� 4><' P o•Essio• cf;-.
® Check here if comments are provide(1.o @kk(q y; ,, Were latitude and longitude in Section A provided by a °•• P F p,
0 Check here if attachments. .` Q` •• �•v.Z, fjCensed land surveyor? ® Yes 0 No . Q '�••' •
O • eessfof.•,p s - SEAL
Certifier's Name JAMES A. LEWIS,PiS''QQ `e.'.7 : License Number L-4562
f • L- 6Gc '
Title PROJECT MANAGER _ C LtlVameHAiLES F. RIGGS&ASSOCIATES, INC.
Address 502 W BRIDGE STREel •. c'City JACKSORfj;NLLLE a State NC ZIP Code 28540 REC E9 %..O SUR`I� `Co
. . t i7 . y:�c._ -�tn:/-.� T ,.« o�� DCM WILM N +T, > c� .-✓0./t`4

.LL II I/V I• VLI%I If IV/•I I., 'Jabc L
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit.Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
504 SOUTH SHORE DRIVE
City SURF CITY State NC ZIP Code 28445 Company NAIC Number:
SECTION D—SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agent/company,and(3)building owner.
Comments DWELLING IS PROPOSED TWO STORY DUPLEX ON PILINGS, ENCLOSED BELOW.PROPOSED BOTTOM OF BAND=23.0'
oottifis,ri
�Q��ass R�'��''
Signature 441WAy Al .f .;;Ye./.*V--- _ •• SEAL q• to Z
'
SECTION E-BUILDING ELEVATION INFOIgMATIQN k6i5kci11071*REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE), complete Items E1-4. �tre kektlfiatee,is d to support a LOMA or LOMR-F request,complete Sections A,B,
and C.For Items El—E4,use natural grade, if available.Ctre;# p8 tit y>�ed. In Puerto Rico only,enter meters.
El. Provide elevation information for the following and check#tF p boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is . ❑feet 0 meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑ below the HAG.
E3. Attached garage(top of slab)is . ❑feet ❑meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is . ❑feet ❑meters ❑above or❑below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B, and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments.
SECTION G—COMMUNITY INFORMATION (OPTIONAL)
the local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G
)f this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8—G10. In Puerto Rico only,enter meters.
31. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
32. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
33. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
37. This permit has been issued for: ❑ New Construction ❑Substantial Improvement
38. Elevation of as-built lowest floor(including basement)of the building: • ❑feet ❑meters Datum
39. BFE or(in Zone AO)depth of flooding at the building site: . ❑feet 0 meters Datum
310.Community's design flood elevation: . ❑feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
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❑Certified Mall Restricted Deliver), $ ,1I ).Box 1570
Adult Signature ReQurted Ss r . 1213 Culbreth Drive
0Adutt Signature Rest rcted Dew,
/Z3/Z015 North Carolina 28541 Wilmington,North Carolina 28405
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vent
. .-S a men of Environment and Natural Resources
127 Cardinal Drive
Wilmington,North Carolina 28405
Re: Francis A. Majewski and wife,Martha D. Majewski Minor CAMA Application
Dear Mr. Dail:
On behalf of Francis A.Majewski and wife, Martha D. Majewski, Charles F. Riggs&Associates, Inc.
submits for your review the enclosed Minor CAMA Application for the property at 504 South Shore
Drive,Town of Surf City,Topsail Township,Pender County,North Carolina.
Respectfully,
. C7),-,
7149/—) \i- f- ______
ames L. Riggs
•
RECEIVED
DCM WILMINGTON, NC

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Francis A. Majewski and wife, Martha D. Majewski
Address of Property: 504 South Shore Drive, Surf City, Pender County
(Lot or Street#, Street or Road, City&County)
Agent's Name#: Charles F. Riggs & Assoc. Mailing Address: P. O. Box 1570
Agent's phone#: [phone] Jacksonville, NC 28541
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmanagement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pie , ck, mooring pilings, breakwater, boathous • , or groin must be set
back a minimum distance of 1 my area of riparian ac nless waived by me. (If you
wish to waive the setback, you must ini ' e a ate blank below.)
I do wish to wa. e 15' setback requirem
do not wish to waive the 15' setback requirement.
(Prope wn I rmation) (Adjacent Property Owner Information)
Signature Signature
Charles F. Ri , agent for application
Print or Type Name Print or Type Name
P. O. Box 1570
Mailing Address Mailing Address
Jacksonville, NC 28541
City/State/Zip City/State/Zip
[phone]
Telephone Number Telephone Number
RECEIVED
Q 2/� DCM WILMINGTON, NC
Date Date
ai1;11, b 9 3 7(119

CHARLES F. RIGGS & ASSOCIATES, INC.
Land Surveyors
Charles F. Riggs.P.L.S. L-2981 Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suite 217
Jacksonville.North Carolina 28540 P.O. Box 1570 1213 Culbreth Drive
[phone] Jacksonville.North Carolina 28541 Wilmington,North Carolina 28405
charlesriggs%riggslandnc.com [phone] [phone]
[e-mail]
September 23, 2015
Ms. Mary F. Thomas Edens et al.
619 Laurel Valley Way
Salisbury, NC 28144
Re: Francis A. Majewski and wife, Martha D. Majewski Minor CAMA Application
Dear Ms. Edens:
On behalf of Francis A. Majewski and wife, Martha D. Majewski, Charles F. Riggs&Associates, Inc.
is submitting to the Division of Coastal Management, North Carolina Department of Environment and
Natural Resources the enclosed Minor CAMA application for the property located at 504 South Shore
Drive, Town of Surf City, Topsail Township, Pender County. We are required to notify the adjoiners of
this CAMA application. Please review the package and sign the form provided,placing a check beside
whether you have objections or no objections to this. If you have no objections,please return the form to
us in the self-addressed stamped envelope provided. If you have objections, please send the form along
with your comments to Mr. Jason Dail, Division of Coastal Management, N.C. Department of
Environment and Natural Resources, 127 Cardinal Drive, Wilmington,NC 28405 within 10 days of
receipt of this notice.
Respectful ly,
c:;?_
James L. Riggs
RECEIVED
DCM WILMINGTON, NC

CHARLES F. RIGGS & ASSOCIATES, INC.
Land Surveyors
Charles F. Riggs.P.L.S. L-298I Corporate License(C-730) James A.Lewis,P.L.S.L-4562
502 New Bridge Street 502 New Bridge Street Landfall Executive Suite 217
Jacksonville.North Carolina 28540 P.O. Box 1570 1213 Culbreth Drive'
[phone] Jacksonville.North Carolina 28541 Wilmington,North Carolina 28405
charlesriggs'u;riggslandnc.com [phone] [phone]
[e-mail]
September 23, 2015
Mr. Michael H. Martin et al.
209 Edinburgh Drive
Cary,NC 27511
Re: Francis A. Majewski and wife, Martha D. Majewski Minor CAMA Application
Dear Mr. Martin:
On behalf of Francis A. Majewski and wife, Martha D. Majewski ,Charles F. Riggs& Associates, Inc.
is submitting to the Division of Coastal Management, North Carolina Department of Environment and
Natural Resources the enclosed Minor CAMA application for the property located at 504 South Shore
Drive, Town of Surf City, Topsail Township, Pender County. We are required to notify the adjoiners of
this CAMA application. Please review the package and sign the form provided, placing a check beside
whether you have objections or no objections to this. If you have no objections, please return the form to
us in the self-addressed stamped envelope provided. If you have objections, please send the form along
with your comments to Mr. Jason Dail, Division of Coastal Management,N.C. Department of
Environment and Natural Resources, 127 Cardinal Drive, Wilmington, NC 28405 within 10 days of
receipt of this notice.
Respectfully,
T
ames L. Riggs
RECEIVED
DCM WILMINGTON, I

1111111111111111111 111 1R11Igt 579eriser,P0329 if 3ao8 f
Pender ounty,
Register of Deeds
Sharon Lear Uilloughby
NC REVENUE SOR218P 040.00Pender( 83909) NC
NORTH CAROLINA GENERAL WARRANTY DEED
The attorney preparing this instrument has made no record search or title examination as to the property
herein described,unless the same is shown by his written and signed certificate.
Excise Tax:$1,040.00
Parcel Identifier No.4234-77-3953-0000Verified by County on the day of ,20
By:
Mail/Box to: Pollock&Pollock,Attorneys at Law,PO Drawer 999,Burgaw,NC 28425 t�
This instrument was prepared by: Pollock&Pollock,Attorneys at Law
Brief description for the Index:
THIS DEED made this 12th day of May,2015,by and between
GRANTOR GRANTEE
Gregory L.Ismay Francis A.Majewski
and wife, and wife,
Maria D.Ismay Martha D.Majewski
101 Kelso Court
Cary,NC 27511
Enter in appropriate block for each party: name,address,and,if appropriate,character of entity,e.g.corporation or partnership.
This property is or is not the primary residence of the Grantor.
The designation Grantor and Grantee as used herein shall include said parties,their heirs,successors,and assigns,and shall include
singular,plural,masculine,feminine or neuter as required by context.
WITNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt of which is hereby acknowledged,has
and by these presents does grant,bargain,sell and convey unto the Grantee in fee simple,all that certain lot or parcel of land situated
in the City of,Topsail Township,Pender County,North Carolina and more particularly described as follows:
Being all that tractor parcel located in Topsail Township,Town of Surf City,Pender County,North Carolina and being
more fully described on Exhibit A attached hereto.
The property hereinabove described was acquired by Grantor by instrument recorded in Book ,page
NC Bar Association Form No.3©1976,Revised©1977,2002
Printed by Agreement with the NC Bar Association—1981-Chicago Title Insurance Company
RECEIVED
DCM WILMINGTON, NC

II IIIIIIIiIIIIIIIIIIIIIIIII IIIIIIIIII Shiro PLER1t!loughb�G of
Ponder County, NC Register of Deeds page 2 of 3
A map showing the above described property is recorded in Map Book,Page.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee
in fee simple.
And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same in
fee simple,that title is marketable and free and clear of all encumbrances,and that Grantor will warrant and defend the title against
the lawful claims of all persons whomsoever,other than the following exceptions:
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as 1 day and year first above written.
(SEAL)
(Entity Name) Gregory Lay
By: A
— (SEAL)
Title:
aria D.Ismay
By:
Title: (SEAL)
By:
Title: (SEAL)
z
z o
M AI--S°.'�'ArIP State of North Carolina—County of W Glk-e
o
o ,, I, :1 S ,Notary Public of the County and State aforesaid,certify that Gregory L.Ismay and
3 ` Maria D.Ismapersonallyappeared before me this dayand acknowledged the due execution of the foregoing
� Y PP
< ^P a instrument for the purposes therein expressed.Witness my hand and Notarial stamp or seal this - day of
0 0' 0 0 May,2015.
c x M Commission Expires:
co —lp- 1� NotaryPubli' VV
'm o
NC Bar Association Form No.3©1976,Revised CO 1977,2002
Printed by Agreement with the NC Bar Association—1981-Chicago Title Insurance Company
DCM RECEIVED
NG ON,

11111111111111111111111110 I 1645onderounty, of Deeds page 3 of 3
Exhibit A
BEGINNING at a stake in the Eastern Edge of Shore Drive 66 feet South from the Southwestern
Intersectional Corner of Shore Drive and Durham Avenue and running thence South 29 degrees
30 minutes East 195 feet more or less to the high water mark of the Atlantic Ocean in a Southerly
Direction 70 feet;thence North 29 degrees 30 minutes West 196 feet more or less to a stake in the
Eastern edge of Shore Drive;thence with Shore Drive North 58 degrees 10 minutes East 70 feet
with the Eastern Edge of Shore Drive to the point of beginning, and being the same property
conveyed to W.F.Harper by A.C.Hatch(widower)by Deed dated May 1, 1972,and recorded in
Pender County Registry in Book 450 at Page 145 and being a portion of Block#6 as shown by
subdivision of Surf City,North Carolina,on Topsail Island, according to Plat prepared by J.R.
Burt,surveyor,and recorded in Pender County Registry in Plat Book 3,at Page 45.
•
RECEIVED
DCM WILMINGTON, NI

SITE DRAWING/APPLICATION CHECKLIST yy
make sure your site drawing includes the following information required for a CAMA minor development permit.
ocal Permit Officer will help you,if requested.
iICAL DIMENSIONS OE LOAD! APPLICATION FOR
Label roads
Label highways right-of-ways o CAMA MINOR z
/Label any local setall k lines DEVELOPMENT
,Label any and all structures and driveways currently existing on property
Label adjacent waterbody
i1CAL CHARACTERISTICS )C PERMIT
Draw and label normal high water line(contact LPO for assistance) In 1974,the North Carolina General Assembly passed the Coastal Area Management Act
/Draw location of on-site wastewater system
(CAMA)and set the stage for guiding development in fragile and productive areas that
If you will be working in the ocean hazard area: border the state's sounds and oceanfront.Along with requiring special care by those who
_/Draw and label dune ridges(include spot elevations) build and develop,the General Assembly directed the Coastal Resources Commission
/Draw and label toe of dunes (CRC)to implement clear regulations that minimize the burden on the applicant.
/Identify and locate first line of stable vegetation(contact LPO for assistance)
"Draw and label erosion setback line(contact LPO for assistance) This application for a minor development permit under CAMA is part of the
Draw and label topographical features(optional) Commission's effort to meet the spirit and intent of the General Assembly.It has been
designed to be straightforward and require no more time or effort than necessary from
If you will be working in a coastal shoreline area: the applicant.Please go over this folder with the Local Permit Officer(LPO)for the
e-Show the roof overhang as a dotted line around the structure locality in which you plan to build to be certain that you understand what information he p
Draw and label landward limit of AEC or she needs before you apply.
Draw and label all wetland lines(contact LPO for assistance)
Draw and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be issued within 25 days once a '-I
3LOPMENT PLANS complete application is in hand.Often less time is needed if the project is simple.The
process generally takes about 18 days.You can speed the approval process by making
l Draw and label all proposed structures certain that your application is complete and signed,that your drawing meets the
/Draw and label areas that will be disturbed and/or landscaped specifications given inside and that your application fee is attached.
/Note size of piling and depth to be placed in ground
/brave and label all areas to be paved or graveled Other permits are sometimes required for development in the coastal area.While these
how all areas to be disturbed are not CAMA-related,we urge you to check with the Local Permit Officer to determine
Show landscaping which of these you may need.A list is included on page two of this folder.
E TO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
you: and your willingness to build in a way that protects the resources of our beautiful and
• completed all blanks and/or indicated if not applicable? productive coast.
• notified and listed adjacent property owners?
• included your site drawing?
Coastal Resources Commission
• signed and dated the application?
Division of Coastal Management
• enclosed the$100.00 fee?
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner) trlo
FOR STAFF USE •G n 3
r
lotice Posted Final Inspection Fee Received
c.n
b7 rn
ispections X C
tn
z rn
" -3
❑O z
;of Acton:Issued Exempted Denied Appeal Deadline(20 days from permit action) DCM Form EB1952-2010/Revised April 2010 Z
r—fr
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z
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DENR CAMA Daily Check Log for WIRO
Date
Date Deposi Check Check Receipt
Received ted Check From(Name) Name of Permit Holder Vendor Number amount Permit Number/Comments Refund/Reall,
9/17/2015 9/18/15 John Clawson same _ Citizens Bank 3506 $300.00_LGP 64748D see also ck.3501 @$100 'HS rct.0289D
9/17/2015 9/18/15 Francis and Ann Prior same PNC Bank 720 $200.00iGP 66105D _ RM rct.0363D
9/17/2015 9/18/15 H5 Construction LLC Thomas Fitzgerald BB&T _ 1306 • $200.00 GP 64793D TM rct.0430D
9/17/2015 9/18/15 H5 Construction LLC Bill Sewell BB&T 1307 $200.00 GP 64794D TM rct.0429D
9/18/2015 9/23/15 F and S Marine Contractors Inc Brook Taube PNC Bank 4818 $250.00 major fee,29 Sandy Pt.,Figure 8,NHD RM rct.0364D
9/21/2015 9/23/15 Jeffery and Cindy Young same First Bank 2015 $644.00 NOV 15-11 D $250/$250/$144 PH rct.1012D
9/21/2015 9/23/15 American Marine Construction First Citizens Bank 86008 $200.00 GP 65024D
9/21/2015 9/23/15 Mark L.Dalen Stapleton BB&T 2467 $200.00 GP for 3 Fairmont,OIB
9/21/2015 9/23/15 Jennings and Julie Outlaw same Wells Fargo 6935 $200.00 GP for 505 Trade Winds Dr.NTB
9/21/2015'9/23/15 Northern Riverfront Marina and Hotel same PNC Bank _ 3927 $100.00;mod fee,MP 44-07 PH rct 1013D
9/21/2015 9/23/15 Northern Riverfront Marina and Hotel same PNC Bank 3926 $100.00 transfer fee,MP 44-07 PH rct.1014D
9/23/2015 Town of North Topsail Beach same/Stuart Turille First Citizens Bank 40018 $400.00 GP 66106D JD rct.0306D
9/23/2015 Coastal Dredging ;Craig Youndt&Joan Kelly BB&T 4214 $400.00,GP 66107D _ JD rct 0307D
9/23/2015 Charles Riggs&Assoc. Keith and Cheryl Steinhoff First Citizens Bank 14186 $100.00 minor fee,1515 Ocean Blvd,TB,PN 'PH rct.1015D
9/23/2015 Charles Riggs&Assoc. Francis and Martha Majewski First Citizens Bank 14187 $100.00 minor fee,504 S.Shore DR.SC,PN PH rct.1016D
I-- —
I
1