SC_18-05_ Koloski (2)

RECEIVF.D
Issued by WiRO FEB 0 8 2018 SC18-05
Surf City Permit Number
CAMA DCM- M H D CITY
MINOR DEVELOPMENT
RECEIVED
PERMIT Coastal Management
JAN21 2019 ENVIRONMENTAL QUALITY
DCM WILMINGTICANG
.rized by the State of North Carolina, Department of Environmental Quality
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 John and Robin Koloski authorizing development in the Estuarine Shoreline (AEC) at 130 Atkinson Road,
in Surf City, Pender County as requested in the permittee's application, dated December 15, 2017, and received by
DCM on December 22, 2017. This permit, issued on February 2, 2018, is subject to compliance with the application
and drawing dated and received by DCM on January 18, 2018 (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: Installation of a swimming pool with associated decking and utilities.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on January 18, 2018.
(2) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(3) 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 Jason Dail
compliance. Any maintenance work or project modification not covered under CAMA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December31,2021 Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land A 1`! -[(-1
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal PERMITTEE
Management.
(Signature required if conditions above apply to permit)

RECEIVED
Name: John and Robin Koloski FEB 0 8 2018
Minor Permit#SC18-05
Date: February 2, 2018 DCM- MHD CITY
Page 2 of 2
(4) 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 vegetated and stabilized (planted and
mulched)within 14 days of construction completion.
(5) Any proposed for grading within the 30' buffer from the Normal High Water level must be contoured to prevent
additional stormwater runoff to the adjacent marsh and/or canal. This area shall be immediately vegetated and
stabilized, and must remain in a vegetated state.
(6) All development shall be located at least 30' landward of the normal high water line.
(7) This permit does not authorize the excavation or filling of any wetlands, even temporarily.
(8) All structures 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.
(9) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
NOTE: 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.
SIGNATURE:'`. e4-' DATE: `4 ;V57/8
PERMITTEE

Issued by WiRO SC18.05
Surf City Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT coastal Murtuycmcnt
-4'1IRONM[Nl AL t))1AL TY
as authorized by the State of North Carolina, Department of Environmental Quality
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 John and Robin Koloski authorizing development in the Estuarine Shoreline (AEC) at 130 Atkinson Road,
in Surf City, Pender County as requested in the permittee's application, dated December 15, 2017, and received by
DCM on December 22, 2017. This permit, issued on February 2, 2018, is subject to compliance with the application
and drawing dated and received by DCM on January 18, 2018 (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: Installation of a swimming pool with associated decking and utilities.
(1) All proposed development and associated construction must be done in accordance with the permitted site drawing dated
received by DCM on January 18,2018.
(2) Any change or changes in the plans for development, construction,andkriend use activities will require re-evaluation and
modification of this permit.
(3) 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 Jason Dail
compliance. Any maintenance work or project modification not covered under LAMA LOCAL PERMIT OFFICIAL
this permit,require further written permit approval.All work must cease when this
permit expires on: 127 Cardinal Drive Extension
December 31,2021 Wilming on, NC 28405-3; 5
In issuing this permit it is agreed that this proiect is consistent with the local Land "RAW
Use Plan and all applicable ordinances. This permit may riot be transferred to
another party without the written approval of the Division of Coastal PER. `' EE
Management.
(Signature required if con.Lion abo - a! y to permit)
RECEIVED

Name: John and Robin Koloski
Minor Permit#SC18-05
Date: February 2, 2018
Page 2 of 2
(4) 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 vegetated and stabilized (planted and
mulched)within 14 days of construction completion.
(5) Any proposed for grading within the 30' buffer from the Normal High Water level must be contoured to prevent
additional stormwater runoff to the adjacent marsh and/or canal. This area shall be immediately vegetated and
stabilized,and must remain in a vegetated state.
(6) All development shall be located at least 30' landward of the normal high water line.
(7) This permit does not authorize the excavation or filling of any wetlands,even temporarily.
(8) All structures 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.
(9) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
NOTE: 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.
SIGNATURE: DATE:
PERMITTEE
RECEIVED
AUG 0 2 2018

i icf,I , i or
k
` OTHER PERMITS MAY BE REQUIRED:The activity you are planning may require permits other than the CAMA
LocalityPermit [/ O V 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 Shoreli ORW S line 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.
GENERAL 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 John Koloski and wife, Robin Koloski 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 130 Atkinson Road
Fee Simple 4643
✓�an owner or record title Title is vested insee Deed Book
City Surf City State NC zip 28445 phone [phone] page 2276 in the Pender County Registry of Deeds.
Email [e-mail]
Flan 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. rif 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:
CityJacksonville State NC zip 28541 phone [phone] I 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)
L � (1) Mr.and Mrs.John Lee Brogan,Jr., 1920 Blue Slate Court, Raleigh, NC 27603
LOCATION OF PROJECT:(Address,street name or directions to site.If not oceanfront,what is the name of the
adjacent waterbody.)Atkinson Road,Surf City,Pender County(4234-14-7644-0000&4234-14-7618-0000) (2) Mr.and Mrs.Ted R.Compton,121 Driftwood Lane,Surf City,NC 28445
(3) Mr.and Mrs.Jason E.Stone,8125 Blue Needle Lane,Apex,NC 27539
DESCRIPTION OF PROJECT:(List all proposed construction and land disturbance.) Proposed Pool with (4)
Decking,Fencing and Pool House
SIZE OF LOT/PARCEL: 1 3,51 1 square feet 0.310 acres(New Lot 32) 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 ID Multi-family❑) Commercial/Industrial❑ Other ❑ 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 if you are not sure which AEC applies tion and floodproofing techniques.
to your property):
I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
(1) OCEAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet(includes the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
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 SHOR4LINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT This the /� day of�'t41�F20/7
UPON SURFACES:'J/ square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks, '`� /
/'-'
concrete or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.)
Landowner or person authorized to. t as,. ._en for,. ,•s f 'ing a CAMA permit application
STA STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stornwater
Man ent Permit issued by the NC Division of Water Quality? This application includes:general in• ' 'n(this orm),a site drawing as described on the back of this application,the
©YES _ NCI ✓ I ownership statement,the Ocean lb..,ni'7/ Noti• where necessary,a check for SI00.00 made patnble to the locality,and
any information as may be provide• •ra by the•ppllcant.The details of the application as described by these sources are
C-)If ye ye total built upon area/impervious surface allowed for your lot or parcel: square feet. incorporated without reference in a permit ich may be issued.Deviation from these details will constitute a violation of
K C) any permit.Any person developing in• C without permit is subject to civil,criminal and administrative action.
I� Z<
CM -4m
11 z a
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ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Coastal Management
ENVIRONMENTAL QUALITY BRAXTON DAVIS
Uirec!or
February 2, 2018
John & Robin Koloski
130 Atkinson Road
Surf City, NC 28445
Dear Mr. & Mrs. Koloski:
Attached is CAMA Minor Development Permit SC 18-05 for work to be done at 130 Atkinson Road, in
Surf City, Pender County. An electronic copy has been sent to the SC Inspections Department and to
your agent.
To validate this permit, please sign both copies as indicated for our records. Retain the orange copy for
your files, and return the white copy to us within 20 days of receipt in the enclosed, self-addressed
envelope
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.Simpson
Permit Support Technician
Enclosures
Cc: WiRO files
SC Inspections Dept.
Charles Riggs-Agent
State of North Carolina I Environmental Quality I Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

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I' "'•r' '� (mow ,-*l: `^' rf ,x a rah$s g �,,,k,' :F;s "',.'-w e14�bv.

N.C. DIVISION OF- COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Lutt•ttt 5, 2017
DMe
Naive f( f'r,.lert) t iy►rrc, t1p4h ic+t for pcs+mit:
John Kolas i and wife, Robin Kotoski
4tritans tjjrti:
130 Atkinson Road
Surf City, NC 28445
Charles F. Riggs & Assoc. t aot on my
! crrtzfr that I halt authorized iztes l) _ .
l tts:tlf, far the ftrtrlaarc o l og fur sntt ubtainitti 1 hll ( ' 1 Pi•rrnitb tic(t %ar) go
a pool with decking and poolhouse, as shown on map
rnom!, or construct toctiti it)
Atkinson Road, Surf City, Ponder County
at cm?. pr€perir lnc-atcd
and I grant permission to the Division of Coastal Management to access
the property to mark/flag the First Line of Stable Natural Vegetation, etc.
December 5, 2018
certification w% ,shd taro (dale)
fe2/4/4"flalto"-.4. December 5, 2317
Propert2. nrr Signature Dale
RECEIVED
nf"nh MINGTON.NC_.

U.S. Postal Service
CERTIFIED MAIL° RECEIPT
A Domestic Mail Only
3 For delivery information,visit our website at www.usps.com .
APEX r NC 27539
0
r- Certified Mail Fee —�
$ 03
Extra Services&Fees(check box,add fee ��ppA date)
❑Return Receipt(hardcopy) $ I l,l_I I
jEl Return Receipt(electronic) $ $it 00 Postmark
['Certified Mall Restricted Delivery $ $1 0.00 Here
7 ❑Adutt Signature Required $ $0. 10
❑Adult Signature Restricted Delivery$
3 Postage $1.di
$
✓ Total Postage and Fees 12/19/2017
a $7.71
11 Sent To T ,
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I A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
I A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
I A record of delivery(including the recipient's retail associate.
signature)that Is retained by the Postal Service" -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent
mportant Reminders: -Adult signature service,which requires the
I You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,which
I Certified Mail service is notavailable for requires the signee to be at least 21 years of agi
International mail. and provides delivery to the addressee specified
I Insurance coverage Is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
I For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailplece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt'attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
,�P,....,aannAnnl,in,oa.bKe,SCM,[,,,sue

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 Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
December 19, 2017
Mr. and Mrs. Jason E. Stone
8125 Blue Needle Lane
Apex,NC 27539
Re: John Koloski and wife, Robin Koloski Submittal for Minor CAMA Permit
Dear Mr. and Mrs. Stone:
On behalf of John Koloski and wife, Robin Koloski, Charles F. Riggs & Associates, Inc. is submitting
to the Division of Coastal Management,North Carolina Department of Environmental Quality the
enclosed application for a CAMA permit for the property located on Atkinson Road, Surf City, Pender
County,North Carolina. John Koloski and wife, Robin Koloski are planning to construct a pool with
decking, fencing and a pool house. We are required to notify the adjoiners of this submittal. Please
review the package and sign, address and date the form provided and place a check and your
initials 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 Environmental Quality, 127 Cardinal Drive, Wilmington, NC 28405 within 10 days of
receipt of this notice.
Respectfully,
es L. Riggs
RECEIVED
DCM WILMINGTON,NC

I. . •os a ervice
CERTIFIED MAIL® RECEIPT
U Domestic Mail Only
7 For delivery information,visit our website at www.usps.com".
7 HO1 Y RIDGE, ANC 3445 `":�
0
r Certified Mail Fee y+� -,5
T t�•Lr-1 0600
II Extra Services&Fees(check box,add fee a� rite) tl`�'
❑Return Receipt(hardcopy) $ '1
❑Return Receipt(electronic) $ 4U-u0 Postmark
❑Certified Mail Restricted Delivery $ SCE[ICI Here
D ❑Adult Signature Required $ $0.00
I
❑Adult Signature Restricted Delivery$
Postage $1.61
12/19/2017
r Total Postage and Fr,•71
3
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II
Sent To ,�y�r, IM --rid_
7 Sheet snd A,,E'N L:o�1�c 1-I- ID rt a [cL JJf i r1Wo� ....
_____.
;ry,State, � �I TL1 ,1V e'2$gf�

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I A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
I A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
I Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
I A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service'" -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
mportant Reminders: -Adult signature service,which requires the
You may purchase Certified Mall service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service•, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,which
Certified Mail service is notavailable for requires the signee to be at least 21 years of age
international mail. and provides delivery to the addressee specified
I Insurance coverage is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
I For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save thls receipt for your records.
:c Fnrm Ran0_and!Xm c PQM 7san-na-nvionn-1

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 Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
December 19, 2017
Mr. and Mrs. Ted R. Compton
121 Driftwood Lane
Surf City,NC 28445
Re: John Koloski and wife, Robin Koloski Submittal for Minor CAMA Permit
Dear Mr. and Mrs. Compton:
On behalf of John Koloski and wife, Robin Koloski, Charles F. Riggs & Associates, Inc. is submitting
to the Division of Coastal Management,North Carolina Department of Environmental Quality the
enclosed application for a CAMA permit for the property located on Atkinson Road, Surf City, Pender
County,North Carolina. John Koloski and wife, Robin Koloski are planning to construct a pool with
decking, fencing and a pool house. We are required to notify the adjoiners of this submittal. Please
review the package and sign, address and date the form provided and place a check and your
initials 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 Environmental Quality, 127 Cardinal Drive, Wilmington,NC 28405 within 10 days of
receipt of this notice.
Respectfully,
es L. Riggs
RECEIVED
DCM WILMINGTON, NC

. . •os a ervice b_jt
CERTIFIED MAIL° RECEIPT
• Domestic Mail Only
• • Ii y • lip.tiii• t . r l AAA • m
RRA LAG It'
f Certified Mail Fee c 06
•. ,�..i,.r `IV
rl $ $2.75
Extra Services&Fees(check box,add fee a fyg fir€t7 te)
❑Return Receipt(hardcopy) $ ,�y(}•I_11_l
3 [I Return Receipt(electronic) $ Postmark
3 [I Certified Mail Restricted Delivery $ $Q•1 I1 I Here
El Adult Signature Required $ 1.0.141
❑Adult Signature Restricted Delivery$
rPostage $1.61
$ 12;19i 2017
nTotal Postage and Fr.71
Sent To I
mrr, d— Mr,. T K Zr
Street and Apt.No.,or? r (o.6 rN
! �iGlcf'�
City,State,ZIP+461al t c,1 \Aic / 63

.eruneu radii servtve proviues me rouowrng uenenis:
A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service' -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
important Reminders: -Adult signature service,which requires the
I You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,which
Certified Mail service is notavailable for requires the signee to be at least 21 years of agi
international mail. and provides delivery to the addressee specified
Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent
with Certified Mall service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,It should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
I For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.

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 Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville.North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
December 19, 2017
Mr. and Mrs. John Lee Brogan, Jr.
1920 Blue Slate Court
Raleigh,NC 27603
Re: John Koloski and wife, Robin Koloski Submittal for Minor CAMA Permit
Dear Mr. and Mrs. Brogan:
On behalf of John Koloski and wife, Robin Koloski, Charles F. Riggs & Associates, Inc. is submitting
to the Division of Coastal Management, North Carolina Department of Environmental Quality the
enclosed application for a CAMA permit for the property located on Atkinson Road, Surf City, Pender
County,North Carolina. John Koloski and wife, Robin Koloski are planning to construct a pool with
decking, fencing and a pool house. We are required to notify the adjoiners of this submittal. Please
review the package and sign, address and date the form provided and place a check and your
initials 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 Environmental Quality, 127 Cardinal Drive, Wilmington, NC 28405 within 10 days of
receipt of this notice.
Respectfully,
--7
ames L. Riggs
RECEIVED

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: John Koloski and wife, Robin Koloski
Address of Property: Atkinson Road, 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 pi , ck, mooring pilings, breakwater, boath , ift, or groin must be set
back a minimum distance of my area of riparian s unless waived by me. (If you
wish to waive the setback, you must ini a riate blank below.)
I do wish to wa. e 15' setback requirem .
o not wish to waive the 15' setback requirement.
(Prope j wner I for • • :on) (Adjacent Property Owner Information)
Signature Signature
Charles F. Rigs . • - for application
Print or Type Nam:VW 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
/2 /5//7
Date Date

U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner.
SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
JOHN KOLOSKI AND WIFE,ROBIN KOLOSKI
A2. Building Street Address(including Apt., Unit,Suite, and/or Bldg.No.)or P.O.Route and Company NAIC Number:
Box No.
130 WALTER R.ATKINSON ROAD
City State ZIP Code
SURF CITY North Carolina 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
LOT 32,THE PENINSULA AT TOPSAIL
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) ACCESSORY
A5. Latitude/Longitude: Lat.34d24'48"N Long.77d34'06"W Horizontal Datum: ❑ NAD 1927 ❑x 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 5
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0.00 sq in
d) Engineered flood openings? ❑Yes CI No
A9. For a building with an attached garage:
a) Square footage of attached garage 0.00 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A9.b 0.00 sq in
d) Engineered flood openings? ❑Yes j No
SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2.County Name B3. State
TOWN OF SURF CITY 370186 PENDER North Carolina
B4.Map/Panel B5. Suffix B6. FIRM Index B7.FIRM Panel B8. Flood 89. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO,use Base Flood Depth)
Revised Date
3720423400 J 02-16-2007 02-16-2007 AE 8.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 x❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPAqajailtcp No
Designation Date: ❑ CBRS ❑ OPA DCM WILMINGTON,NC
nED2r2 1111i.,

OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date:November 30,2018
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:
130 WALTER R.ATKINSON ROAD
City State ZIP Code Company NAIC Number
SURF CITY North Carolina 28445
SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑x Construction Drawings` ❑Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations—Zones A1—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.
❑ NGVD 1929 x❑ 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) 5.50 ❑x feet ❑ meters
b) Top of the next higher floor N/A ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑ feet ❑meters
d) Attached garage(top of slab) N/A ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building feet
(Describe type of equipment and location in Comments) 8.10 ❑ ❑ meters
f) Lowest adjacent(finished)grade next to building (LAG) 4.20 x❑ feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 4.30 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including
structural support ❑ 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 information.
I certify that the information on this Certificate represents my best efforts to interpret the data available. l understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? Ll Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
JAMES A. LEWIS L-4562 \\\``\�N�1CARp,,%
Title Q` '• •• S3 ''•.� �:
PROJECT MANAGER O ' OtE /47.
Company Name _ :4 seAL 9r %
CHARLES F. RIGGS&ASSOCIATES, INC. _ L 2
Address � •��
O�':
502 NEW BRIDGE STREET Air tid 3 .•
City State ZIP Code /ir�FS A. �, \�N`
JACKSONVILLE North Carolina 28540 /,1/I s I t`.��
/Z//9//7
Signature Date Telephone Ext.
? 9 /L//f//7 [phone] 41
� rr7T/
Copy all ges of this Elevation Certificate and all attachments for(1)co munity official,(2)insurance agent/company,and(3)building owner.
Comments(including type of equipment and location, per C2(e), if applicable)
ACCESSORY BUILDING IS PROPOSED POOL HOUSE ON PILINGS, OPEN BELOW.
POOL EQUIPMENT/MACHINERY TO BE INSTALLED AT AN ELEVATION OF 8.1'OR HIGHER.
RECEIVED
DCM WILMINGTON,NC
;-' 2 2 2017

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 Suites
Jacksonville,North Carolina 28540 P.O.Box 1570 1213 Culbreth Drive
[phone] Jacksonville,North Carolina 28541 Wilmington,North Carolina 28405
[e-mail] [phone] [phone]
[e-mail]
December 19, 2017
To: Mr. Jason Dail
Division of Coastal Management
North Carolina Department of Environmental Quality
127 Cardinal Drive
Wilmington,North Carolina 28405
Re: John Koloski and wife, Robin Koloski Submittal for Minor CAMA Permit
Dear Mr. Dail:
On behalf of John Koloski and wife, Robin Koloski, Charles F. Riggs &Associates, Inc. submits for
your review the enclosed application for a Minor CAMA permit for the property on Atkinson Road, Surf
City, Pender County, North Carolina.
Resp ctfully,
yn//n
NBC//
ames L. Riggs
RECEIVED

Dail, Jason
From: Dail, Jason
Sent: Thursday, December 28, 2017 11:10 AM
To: Charles Riggs ([e-mail]);James Riggs
([e-mail])
Subject: CAMA Minor permit application - John and Robin Koloski - Additional Information
requested
RE: INCOMPLETE APPLICATION —John and Robin Koloski -ADDITIONAL INFORMATION REQUIRED
APPLICATION NUMBER—N/A
PROJECT ADDRESS— 130 Atkinson Road,Surf City, NC
Dear Mr. Riggs:
The Division of Coastal Management's Wilmington Regional office received a CAMA Minor Permit application from you
on December 22, 2017, requesting approval for development activities at 130 Atkinson Road,Surf City, NC. In reviewing
your application,we have discovered that additional information is needed to complete the review process.Accordingly,
I am requesting that you submit the following additional information to this office:
1) The site plan submitted for this project, signed and sealed by you on 12/19/2017 and received by DCM on.
12/22/17, illustrates a "proposed concrete pool deck"within the 30' coastal shoreline buffer. Please be
advised that"concrete decking" is not a development activity that is permissible within the 30' Coastal
Shoreline buffer. Based on Current Rules established by the Coastal Resources Commission,the following
development activities are allowed within the 30' Coastal Shoreline buffer:
15A NCAC 07H .0209(d)(10) Within the Coastal Shorelines category (estuarine and public trust shoreline AECs), new
development shall be located a distance of 30 feet landward of the normal water level or normal high water level,with
the exception of the following:
(A) Water-dependent uses as described in Rule 07H .0208(a)(1)of this Section;
(B) Pile-supported signs(in accordance with local regulations);
(C) Post-or pile-supported fences;
(D) Elevated, slatted, wooden boardwalks exclusively for pedestrian use and six feet in width or less. The
boardwalk may be greater than six feet in width if it is to serve a public use or need;
(E) Crab Shedders, if uncovered with elevated trays and no associated impervious surfaces except those
necessary to protect the pump;
(F) Decks/Observation Decks limited to slatted, wooden, elevated and unroofed decks that shall not singularly
or collectively exceed 200 square feet;
(G) Grading, excavation and landscaping with no wetland fill except when required by a permitted shoreline
stabilization project. Projects shall not increase stormwater runoff to adjacent estuarine and public trust
waters;
(H) Development over existing impervious surfaces, provided that the existing impervious surface is not
increased and the applicant designs the project to comply with the intent of the rules to the maximum extent
feasible;
(I) Where application of the buffer requirement would preclude placement of a residential structure with a
footprint of 1,200 square feet or less on lots, parcels and tracts platted prior to June 1, 1999, development
may be permitted within the buffer as required in Subparagraph(d)(10)of this Rule,providing the following
criteria are met:
(i) Development shall minimize the impacts to the buffer and reduce runoff by limiting land
disturbance to only so much as is necessary to construct and provide access to the residence and to
allow installation or connection of utilities such as water and sewer;and
(ii) The residential structure development shall be located a distance landward of the normal high water
or normal water level equal to 20 percent of the greatest depth of the lot. Existing structures that

encroach into the applicable buffer area may be replaced or repaired consistent with the criteria set
out in Rules .0201 and.0211 in Subchapter 07J of this Chapter;and
(J) Where application of the buffer requirement set out in 15A NCAC 07H .0209(d)(10) would preclude
placement of a residential structure on an undeveloped lot platted prior to June 1, 1999 that are 5,000 square
feet or less that does not require an on-site septic system, or on an undeveloped lot that is 7,500 square feet
or less that requires an on-site septic system, development may be permitted within the buffer if all the
following criteria are met:
(i) The lot on which the proposed residential structure is to be located, is located between:
(I) Two existing waterfront residential structures, both of which are within 100 feet of the
center of the lot and at least one of which encroaches into the buffer;or
(II) An existing waterfront residential structure that encroaches into the buffer and a road,
canal, or other open body of water, both of which are within 100 feet of the center of the
lot;
(ii) Development of the lot shall minimize the impacts to the buffer and reduce runoff by limiting land
disturbance to only so much as is necessary to construct and provide access to the residence and to
allow installation or connection of utilities;
(iii) Placement of the residential structure and pervious decking may be aligned no further into the buffer
than the existing residential structures and existing pervious decking on adjoining lots;
(iv) The first one and one-half inches of rainfall from all impervious surfaces on the lot shall be collected
and contained on-site in accordance with the design standards for stormwater management for
coastal counties as specified in 15A NCAC 02H .1005. The stormwater management system shall
be designed by an individual who meets applicable State occupational licensing requirements for
the type of system proposed and approved during the permit application process. If the residential
structure encroaches into the buffer, then no other impervious surfaces will be allowed within the
buffer; and
(v) The lots must not be adjacent to waters designated as approved or conditionally approved shellfish
waters by the Shellfish Sanitation Section of the Division of Environmental Health of the
Department of Environment and Natural Resources.
Additionally, as you have read above, elevated slatted decking within 30' of the normal high water line shall be limited
to 200 sq. ft. elevated, slatted, wooden decking not exceeding 200 sq. ft.This is a collective allocation and would apply
to both existing decking associated with the residence as well as any proposed decking (i.e. existing+ proposed =200 sq.
ft. or less).
Please either revised the proposed site plan to eliminate the inconsistency with current CRC Rules, or either apply as
proposed with the certainty of obtaining a permit denial.
In accordance with the Department of Environment and Natural Resources regulations,we note that the application, as
received in our office on December 22, 2017, is incomplete for processing. Upon resubmission of a complete
application, a local decision will be made in 25 days, provided this period is not extended as provided by law. Please
contact me at 910-796-7221 if you have any questions.
Please feel free to give me a call if you have any questions.
Take care,
Jason Dail
Field Representative
NC Department of Environmental Quality
NC Division of Coastal Management
127 Cardinal Drive Ext.
Wilmington, NC 28405
Phone:[phone], Fax:[phone]
Jason.Dail @ncdenr.gov

Date Date Check From Name of Vendor Check Check Permit Number NOTE:
Received Deposit (Name) Permit Holder Number amount
ed
1/23/2018 Charles Riggs & John Koloski First 15402 $100.00 minor fee, Lot 32 JD rct
Associates Citizens Peninsula, TB 5755I
Bank PnCo