TB_20-07_ Bosy (2)

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Issued by WiRO TB20-07
Topsail Beach Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
NORTH CAROLINA
Environmental Quality
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 Thomas and Karen Bosy authorizing development in the Ocean Hazard Area of Environmental Concern
(AEC) at 1701 Ocean Boulevard, Topsail Beach, Pender County as requested in the permittee's application package,
dated January 24, 2020, and received by DCM on January 27, 2020. This permit, issued on February 12, 2020, is
subject to compliance with the application and site drawing (where consistent with the permit) dated sealed and revised
on January 27, 2020, all applicable regulations and special conditions and notes set forth below. Any violation of these
terms may subject 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 with amenities(inc. uncovered deck(s),gazebo and beach access
walkway).
(1) All proposed development and associated construction must be done in accordance with the permitted work plat drawing
sealed by Charles F. Riggs on January 23, 2020. The authorized work plat was received by the Division of Coastal
Management on January 27, 2020.
(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, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] for a final inspection at
completion of work.
(5) With exception of a beach access walkway and 500 sq. ft. or less of structurally independent decking, all other structures
shall be set back a minimum of 60 feet from the first line of stable natural vegetation (FLSNV) and static vegetation line
(SVL), as determined by the DCM,the Local Permit Officer(LPO), or another assigned agent of the DCM.
(Additional Permit Conditions on Page 2) 0
Oz
This permit action may be appealed by the permittee or other qualified persons 111 O N
within twenty(20) days of the issuing date. This permit must be on the project Jason Dail o
site and accessible to the permit officer when the project is inspected for LAMA LOC PERMIT OFFICIAL; '11'
compliance. Any maintenance work or project modification not covered under •
this permit,require further written permit approval.All work must cease when this 12 ar in I Drive Extensid& _ m
permit expires on: WIlml t , NC 28405-384
December31,2023
•
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 PERMITTEE
another party without the written approval of the Division of Coastal
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Name: Thomas and Karen Bosy
Minor Permit#TB 20-07
Date: February 12, 2020
Page 2
(6) The permittee is required to contact the LPO at [phone], shortly before he 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.
(7) Any/all structures 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 Area of Environmental Concern
(AEC) standards, the more restrictive provision shall control.
(8) 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. Any excess sand held in storage shall be re-distributed
throughout the site; However, no material shall be deposited any further seaward than the landward toe of
the frontal dune.
(9) This permit does not authorize the removal and/or transportation of sand from the subject property.
(10)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 and also independent of the 200 sq. ft. gazebo. The
deck(s) may be cosmetically attached but shall remain free standing as a single structure (i.e. structurally
independent).
(11)The total floor area of the permitted dwelling shall not exceed 2,472 square feet, per the authorized workplan
drawings.
(12)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 1 CJ-year flood level elevation.
(13)All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(14)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 Coastal Resources Commission (CRC) Rules.
(15)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party. E C E I V D
ON, N(
FEB 2 4 2020
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Issued by WiRO TB20.07
Topsail Beach Permit Number
CAMA
MINOR DEVELOPMENT410.,
PERMITtp.,
NORTH CAROLINA
Environmental Quality
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 Thomas and Karen Bosy authorizing development in the Ocean Hazard Area of Environmental Concern
(AEC) at 1701 Ocean Boulevard, Topsail Beach, Pender County as requested in the permittee's application package,
dated January 24, 2020, and received by DCM on January 27, 2020. This permit, issued on February 12, 2020, is
subject to compliance with the application and site drawing (where consistent with the permit) dated sealed and revised
on January 27, 2020, all applicable regulations and special conditions and notes set forth below. Any violation of these
terms may subject 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 with amenities(inc. uncovered deck(s), gazebo and beach access
walkway).
(1) All proposed development and associated construction must be done in accordance with the permitted work plat drawing
sealed by Charles F. Riggs on January 23, 2020. The authorized work plat was received by the Division of Coastal
Management on January 27, 2020.
(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, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] for a final inspection at
completion of work.
(5) With exception of a beach access walkway and 500 sq. ft. or less of structurally independent decking, all other structures
shall be set back a minimum of 60 feet from the first line of stable natural vegetation (FLSNV) and static vegetation line
(SVL), as determined by the DCM,the Local Permit Officer(LPO),or another assigned agent of the DCM.
(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 Jason Dail
site and accessible to the permit officer when the project is inspected for CAMA LOCAL PERMIT OFFICIAL
compliance. Any maintenance work or project modification not covered under
this permit,require further written permit approval.All work must cease when this 127 Cardinal Drive Extension
permit expires on: Wilmington, NC 28405-3845
December 31,2023
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 PERM ITTEE
another party without the written approval of the Division of Coastal /Cinnofi inn rcniiiror✓if rnnrli4innc ohnun onnly+n ncrmifl

Name: Thomas and Karen Bosy
Minor Permit#TB 20-07
Date: February 12, 2020
Page 2
(6) The permittee is required to contact the LPO at [phone], shortly before he 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.
(7) Any/all structures 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 Area of Environmental Concern
(AEC)standards,the more restrictive provision shall control.
(8) 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. Any excess sand held in storage shall be re-distributed
throughout the site; However, no material shall be deposited any further seaward than the landward toe of
the frontal dune.
(9) This permit does not authorize the removal and/or transportation of sand from the subject property.
(10)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 and also independent of the 200 sq. ft. gazebo. The
deck(s) may be cosmetically attached but shall remain free standing as a single structure (i.e. structurally
independent).
(11)The total floor area of the permitted dwelling shall not exceed 2,472 square feet, per the authorized workplan
drawings.
(12)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 1 CJ-year flood level elevation.
(13)All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure.
(14)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 Coastal Resources Commission(CRC)Rules.
(15)Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third-party.
�, ti

C OTHER PERMITS MAY BE REQUIRED:The activityyou are planningmayrequire permits other than the CAMA
� � gk) Q eq
} Permit Number 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
fazard 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.
AL 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
)WNER person authorized to act as an agent for purposes of applying for a CAMA minor development permit,certify that the person
somas Zachary Bosy and wife,Karen Elizabeth Bosy listed as landowner on this application has a significant interest in the real property described therein.This interest can be
described as:(check one)
8215 Bear Wallow Road
Dan owner or record title,Title is vested in ,see Deed Book
Teuton State VA Zip 20186 Phone [phone]
page in the County Registry of Deeds.
[e-mail]
Flan owner by virtue of inheritance.Applicant is an heir to the estate of •
IRIZED AGENT probate was in County.
;harles F.Riggs&Associates,Inc. of other interest,such as written contract or lease,explain below or use a separate sheet&attach to this application.
P.O.Box 1570 Contract to Purchase
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
:ksonville 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.
[e-mail]
(Name) (Address)
(l) Mr.Kevin T.Combopiano,609 Mountain Pine Drive,Cary,NC 27519
'ION OF PROJECT:(Address,street name and/or directions to site.If not oceanfront,what is the name of the
waterbody.)1701 Ocean Boulevard,Topsail Beach,Pender County(Parcel 4202-81.9870-0000) (2) Sands of Keim,LLC;11543 Auldbury Way,Raleigh,NC 27617
(3)Town of Topsail Beach,820 South Anderson Boulevard,Topsail Beach,NC 28445
IPTION OF PROJECT:(List all proposed construction and land disturbance.) Proposed Two-Story (4)
nq on Pilings with Decks Over Concrete Slab Enclosed below for Entry and Storage with
F LOT/PARCEL: 8,399 square feet 0.193 acresProposed Concrete Drive and All ACKNOWLEDGEMENTS:
Physical Improvements as Shown on Map I,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area which
ISED USE:Residential 0 (Single-family❑ Multi-family 0) 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-
,,ETE EITHER(1)OR(2)BELOW(Contact your Local Permit Officer ijyou are not sure which AEC applies lion and floodproofing techniques.
,roperly):
I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management staff,
EAN HAZARD AECs:TOTAL FLOOR AREA OF PROPOSED STRUCTURE:2,472 square feet(includes the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
itioned living space,parking elevated above ground level,non-conditioned space elevated above ground level but related to this permit application.
ig non-load-bearing attic space) �/ 1
a
ASTAL SHORELINE AECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT ��� This the ��7^ day of.Vg20 2
iURFACES: square feet(includes the area of the roof/drip line of all buildings,driveways,covered decks, /�.�pedi 7 t I
or masonry patios,etc.that are within the applicable AEC.Attach your calculations with the project drawing.) Landowner or person authorized to i ern.•-• • •urpose of filing a CAMA permit application
STORMWATER MANAGEMENT PERMIT:Is the project located in an area subject to a State Stommwater
went Permit issued by the NC Division of Water Quality? This application includes:general or ation(t s form),a site drawing as described on the hack of this application,the
NCI ✓ I ownership statement,the Ocean H.zard AEC Noti e where necessary,a check for S100.00 made payable to the locality and
any information as may be provide, 'rally by th•,pplicant.The details of the application as described by these sources are
st the total built upon area/impervious` surface allowed for your lot or parcel: square feet. incorporated without reference in any . • ich may be issued Deviation from these details will constitute a violation of
RE C E I 'P E D any permit.Any person developing in an AEC without permit is subject to civil,criminal and administrative action.
DCM WILMINGTON, NC
JAN 2 7 2020

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you,if requested.
PHYSICAL DIMENSIONS OE COASTq! ,�PPI,j('.�1I0N FOR�
_lJabelroads , , CAMA MINOR
Label highways right-of-ways
_ZIabel local setback lines
"Label any and all structures and driveways currently existing on property " DEVELOPMENT
Label adjacent waterbody
PHYSICAL 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 slate's sounds and oceanfront.Along with requiring special care by those who
.j)raw and label dune ridges(include spot elevations) build and develop,the General Assembly directed the Coastal Resources Commission
drpraw and label toe of dunes (CRC)to implement clear regulations that minimize the burden on the applicant.
Jdentify and locate first line of stable vegetation(contact LPO for assistance)
4r. aw and label erosion setback line(contact LPO for assistance) This application for a minor development permit under CAMA is part of the
/
hDraw 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 l oworking in a coastal shoreline area: the applicant.Please go over this folder with the Local Permit Officer(LPO)for the
=J�w 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
w and label landward limit of AEC or she needs before you apply.
w and label all wetland lines(contact LPO for assistance)
w and label the 30-foot buffer line Under CAMA regulations,the minor permit is to be issued within 25 days once a
DEYELOPM9iT 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
'yaw and label all proposed structures certain that your application is complete and signed,that your drawing meets the
�w and label areas that will be disturbed and/or landscaped specifications given inside and that your application fee is attached.
/Mote size of piling and depth to be placed in ground
"raw and label all areas to be paved or graveled Other permits are sometimes required for development in the coastal area.While these
_____1§tow all areas to be disturbed are not CAMA-related,we urge you to check with the Local Permit Officer to determine
how landscaping which of these you may need.A list is included on page two of this folder.
NOTE TO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
Have 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?
• signed and dated the application? Coastal Resources Commission
• enclosed the$100.00 fee? Division of Coastal Management
co;
• completed an AEC Hazard Notice,if necessary?(Must be signed by the property owner)
FOR STAFF USE t^
Site Notice Posted_ Final Inspection Fee Received y 2—
❑rr
Site Inspections k
❑C
z
Date of Action:Issued _F-t f� cam,i` 'gb _Appeal Deadline(20 days from permit action) DCM Form EBi952-2010 Revised April 2010
GC;,, 1l!_MINGTON, NC
JAN 2 7 2020

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]
January 24,2020
Mr. Kevin T. Combopiano
609 Mountain Pine Drive
Cary,NC 27519
Re: Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
Submittal for Minor CAMA Permit
Dear Mr.Combopiano:
On behalf of Thomas Zachary Bosy and wife, Karen Elizabeth Bosy,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 at 1701 Ocean Boulevard,
Topsail Beach, Pender County,North Carolina. Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
are planning to construct a two-story dwelling on pilings with decks over a concrete slab enclosed below
for entry and storage with concrete drive and all proposed physical improvements,as shown on map. We
are required to notify the adjoiners of this submittal. If you have objections, please send your comments
in a timely fashion to Mr.Jason Dail, Division of Coastal Management,N.C. Dept. of Environmental
Quality, 127 Cardinal Drive, Wilmington,NC 28405 or by phone at(910) 796-7221 ore-mail at
[e-mail].
Respectfully,
9 /w '_
J mes L. Riggs
RECEIVED
DCM WILMINGTON, NC
JAN 2 7 2020

I. . •osta ervice
CERTIFIED MAIL® RECEIPT
3 Domestic Mail Only
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For delivery information,visit our website at www.usps.cottr.
r
13
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0 Adult Signature Required $ 10.00
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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 pe od. 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 Mail0,First-Class Package Service®, available at retail).
or Priority Mail°service. -Adult signature restricted delivery service,which
I Certified Mail service is not available 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 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,R should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
r 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.
'S Form 3800.April 2015!Reverse)PSN 7530-02-en0-9n47

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]
January 24,2020
Sands of Keim, LLC
11543 Auldbury Way
Raleigh,NC 27617
Re: Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
Submittal for Minor CAMA Permit
To whom it may concern:
On behalf of Thomas Zachary Bosy and wife, Karen Elizabeth Bosy,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 at 1701 Ocean Boulevard,
Topsail Beach, Pender County,North Carolina. Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
are planning to construct a two-story dwelling on pilings with decks over a concrete slab enclosed below
for entry and storage with concrete drive and all proposed physical improvements,as shown on map.We
are required to notify the adjoiners of this submittal. If you have objections,please send your comments
in a timely fashion to Mr.Jason Dail, Division of Coastal Management,N.C. Dept. of Environmental
Quality, 127 Cardinal Drive, Wilmington,NC 28405 or by phone at(910) 796-7221 or e-mail at
[e-mail].
Res Iectfully,
4,,--H-2 /
mes L. Riggs
RECEIVED
DCM WILMINGTON, NC
JAN 2 7 2020

CERTIFIED MAIL° RECEIPT
Domestic Mail Only
t For delivery information.visit our website at wtvw.usps.com .
a
RA �
. FT6CIAL USE
it Certified Mail Fee
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Extra Services&Fees(check box,add/eepete)
0 Return Receipt(hardcopy) $ i'.I_I 1
3 0 Return Receipt(electronic) $ $U-(IQ Postmark
El Certified Mall Restricted Delivery $ $O.00 Here
El Adult Signature Required $ $;I.t00
❑Adult Signature Restricted Delivery$
3 Postage
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$ $7.60
- Sent To ,._ ,( 1Ir
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r A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
r 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 th
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
You may purchase Certified Mall service with signee to be at least 21 years of age(not
First-Class Mail0,First-Class Package Service0, available at retain.
or Priority Mail®service. -Adult signature restricted delivery service,whic
I Certified Mail service is notavailable for requires the signee to be at least 21 years of ar
International mail. and provides delivery to the addressee specific
Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized ager
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
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 podia
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.
.s Form 3800,April 2015(Reverse)PSN 7530-02-000-9047

CHARLES F. RIGGS &ASSOCIATES, INC.
Land Surveyors
Charles F.Riggs,P.L.S.L-2981 Corporate License(C-730) James AN 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]
January 24,2020
Town of Topsail Beach
820 South Anderson Boulevard
Topsail Beach, NC 28445
Re: Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
Submittal for Minor CAMA Permit
To whom it may concern:
On behalf of Thomas Zachary Bosy and wife, Karen Elizabeth Bosy,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 at 1701 Ocean Boulevard,
Topsail Beach, Pender County,North Carolina. Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
are planning to construct a two-story dwelling on pilings with decks over a concrete slab enclosed below
for entry and storage with concrete drive and all proposed physical improvements,as shown on map. We
are required to notify the adjoiners of this submittal. If you have objections, please send your comments
in a timely fashion to Mr. Jason Dail, Division of Coastal Management,N.C. Dept. of Environmental
Quality, 127 Cardinal Drive, Wilmington,NC 28405 or by phone at(910) 796-7221 or e-mail at
[e-mail].
Respectfully,
James L. Riggs
RECEIVED
DCM WILMINGTON, NC
JAN 2 7 2020

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ROY COOPER
MICHAEL S. REGAN
Secretary
BRAXTON DAVIS
;reacr
February 12, 2020
Thomas and Karen Bosy
8215 Bear Wallow Road
Warrenton,VA 20186
Dear Mr. & Mrs. Bosy,
Attached is CAMA Minor Development Permit TB 20-07 for work to be done at 1701 Ocean Boulevard in
Topsail Beach, Pender County. An electronic copy has been sent to the Topsail Beach Inspections
Department and to you 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.
Since ely,
Tany K. P,etil
—Permit Support Technician
N.C. Division of Coastal Management
Enclosures
Cc: WiRO files
TB Inspection Dept.
Charles Riggs-Agent
State of North Carolina I Environmental Quality Coastal Management
127 Cardinal Drive Ext.,Wilmington,NC 28405

,- .
•
A
'"
' -

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]
January 24,2020
To: Mr.Jason Dail
Division of Coastal Management
North Carolina Department of Environmental Quality
127 Cardinal Drive
Wilmington,North Carolina 28405
Re: Thomas Zachary Bosy and wife, Karen Elizabeth Bosy
Submittal for Minor CAMA Permit
Dear Mr. Dail:
On behalf of Thomas Zachary Bosy and wife,Karen Elizabeth Bosy, Charles F. Riggs&Associates,
Inc. submits for your review the enclosed application for a Minor CAMA permit for the property at 1701
Ocean Boulevard, Topsail Beach,Pender County,North Carolina.
Respectfully,
OP fitio
elf es L. Riggs
RECEIVED
DCM WILMINGTON, NC
JAN 2 7 2020

DocuSign Envelope ID:C4C2A383-8C84-4B58-A3DC-9A2F4D5E6F70
AGREEMENT TO AMEND CONTRACT
WARNING: ALL PARTIES, INCLUDING ANY LENDER AND SETTLEMENT AGENT, MUST BE PROVIDED A COPY OF
THIS AGREEMENT
Thomas Zachary Bosy,Karen Elizabeth Bosv , as Buyer, and
Robert Hembry,Nancy Hembry , as Seller,
have entered into a contract on the Offer to Purchase and Contract(form 2-T)or the Offer to Purchase and Contract-Vacant Lot/Land
(form 12-T)("Contract")regarding the purchase and sale of the following property(insert property address): 1701 Ocean Boulevard,
Topsail Beach,NC 28445 ("Property").
Buyer and Seller hereby agree to amend the Contract as set forth below/check applicable box(es)I:
❑X Purchase Price. The Purchase Price is hereby changed from: $ 335,000.00 to: $ 300,000.00 .
? ❑ (Additional)Earnest Money.The(Additional)Earnest Money Deposit is hereby changed from:$
to:$
O (Additional)Earnest Money Deposit Date:The date by which the(Additional) Earnest Money Deposit shall be paid to Escrow
Agent is hereby changed to extend through 5:00 p.m.on:
O Building Deposit.The Building Deposit is hereby changed from:$ to:$
O Due Diligence Fee.The Due Diligence Fee paid to Seller is hereby changed from: $ to:$ .
❑X Due Diligence Period. The expiration date of the Due Diligence Period is hereby changed to extend through 5:00 p.m. on
January 31,2020 , 74419PROPWCWFWMPMEWSP For purpose of obtaining CAMA permit
Escrow Agent. The Escrow Agent is hereby changed to: .
NOTE:Use the ESCROW AGENT ACKNOWLEDGMENT OF RECEIPT OF EARNEST MONEY DEPOSIT
Settlement Date. The Settlement Date is hereby changed to: .
(check only if the following also will apply) Notwithstanding anything to the contrary in the Delay in Settlement/Closing
paragraph in the Contract, if a Delaying Party fails to complete Settlement and Closing within four (4) days following the
Settlement Date above, the Delaying Party shall be in breach and the Non-Delaying Party may terminate the Contract in
accordance with the Delay in Settlement/Closing paragraph.
Expenses. The amount Seller shall pay at Settlement toward Buyer's expenses associated with the purchase of the Property is
hereby changed from: $ to: $
RECEIVED
All terms and conditions of the Contract not specifically amended herein shall remain in full force and bf ct. WILMINGTON, NC
JAN 2 7 2020
Page 1 of 2
This form jointly approved by: FORM 4-T
' . North Carolina Bar Association A Revised 7/2018
REALTOR• North Carolina Association of REALTO Sc ci � I room wnix,v ( 7/2019
Buyer initials ,C? Seller initial • I l�
Sold Buy The Sea Realty.5004 Oleander Dr Wilmington NC 28403 Phone [phone] Fax Thomao and karen
Laurie Stuhrcke Produced with zipForm®by zipLogix 18070 Fifteen Mile Road.Fraser.Michigan 48026 west zioLodix.corn

DocuSign Envelope ID:C4C2A383-8C84-4B58-A3DC-9A2F4D5E6F70
THE NORTH CAROLINA ASSOCIATION OF REALTORS®, INC. MAKES NO REPRESENTATION AS TO THE LEGAL
VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY S E sIFIC TRANSACTION.
Buyer: cas.Faclia , Vas?* °p Pi Date 01,1020200)06 ESI Seller: Date 1/11/2020
Thomas Zachary Bosy 3�07
Buyer:,k.v2e , Vasas tQi Date Seller: lc.H Date 1/11/2020
� al,wrswoo6wwEs*
Karen Elizabeth Bosy yuelvtttrg7
Entity Buyer: Entity Seller:
(Name of LLC/Corporation/Partnership/Trust/etc.) (Name of LLC/Corporation/Partnership/Trust/etc.)
By: By:
Name: Name:
Title: Title:
Date: Date:
RECEIVED
DCM WILMINGTON, NC
JAN 2 7 2020
Page 2 of 2
FORM 4-T
Revised 7/2018
©7/2019
Produced with zipFonn®by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 y0aniy-710t 001X COM Thomas end

CHAR!.ES F. RIGGS&ASS()C1A1'ES, INC.
Land Surveyors
(harks f.KiyM1c,I'i..S I.-2981 ('camirate LicensetC-73()I James A.I.cwrs.I'.I..ti.1.-4562
512 Not liriJs;.Stn.: 5fl,Neu Bridge*eel Landfall Kit tiuih�c
1461 iMt ilk.!weal C X/1111 28tvto Y1) lktx 157(1 I 213 Culbcelh Drive
j55-077 Jacksonville.North(':mnlin;t 78541 Wilmington North l'arotinn 2x4f15
c1_,rl.%rimtc ri rij l;wdrt:.coi i (910)433-Ol1Tt (910i 6X1.7444
jinw-.ku•rciritriypFLmdnc.cot]i
A( I AUTHORIZATION FORM
[)ate, January 15. 2020
Name ol"Propeny Owner Applying ti)r Permit
't'horna, %. Rosy and wile.Karen E. 13osy
Mailing Address:
b
I certify that I have authorized Charles 1. Riggs& Associates. Inc. to act on my behalf, ti)r the purpose
of applying for and obtaining all LAMA Permits necessary to install or construct proposed dwelling,as shown
on attached map and located d on Ocean Boulevard(Lot I. Block 44,New Topsail Beach),and I grant permission
to the t)ivision of Coastal Management to access the property to mark flag:
X The First line of Stable Natural Vegetation
The Coastal Wetlands
The Normal High Water I.tne
This authorization is valid thru Janutm. 15.2021
iTh‘f")
January 15 2020
PrwatyOvonalignature Date
RECEIVED
DCM WILMINGTON, NC
JAN 2 7 2020

OCEAN HAZARD AEC NOTICE
Project is in an: Ocean Erodible Area High Hazard Flood Area inlet Hazard Area
f
Property Owner_ Thomas Z. Bogy and wife, Karen E. Sosy IContract to Purchase)
Property Address: Ocean Boulevard,Topsail Beach, Pender County (Lot 1, Block 44,New Topsail Beach)
Date Lot Was Platted: March 1965
I his notice tt.intended u'n►al.c y.aa_the applr:ast:. assure ..1 the SPECIAL NOTE: This hazard notice n required Ivr
spc:iai n.ks and:ntwtllwrnre ass•K'i cd%III!4rsdd.apment in tilt', .h•cktprncttl in atCIes. ihje-e1 to Wilda'.uua niassrsc sterns and
aria, *hat is suhtctil in natural har.utSs Midi as sa firms.erosion crtrsasm. !'cmiits kucd lin tlesrkspment m this arra cspirc on
and surrenta Mc rules of the Coastal Resources l'ummissin I Ikcxrnhcr ;I of ate that! year Iniksw mg the dear in .shich the
ri.uin that eau reeeise at; NH' II:van! \.disc and pernnt was issued. Shorth be1on work begins lsr the project
asknusskdLre that notice in writr n. txt:ire a permit liar site.the local Prmiit()!licit must be cootacted to dctcr:atinc the
development tan he e'.sieU, s:t'cta11Un line and .ctisak distann.c at s our site. II the ]inn,civ
Iran seen link change since the LUDIC or permit issuance.and the
the ('ommissioe's rules e•n huildmn standards, oceantion: pnspnscd detclopmern .:an still meet the setback requirement,
welbac'ks and Jura alle'ratant,.ih tfcaagtw:d to nuimnrrre. Ina rt.., the I.Pt)will inform s.str that sew teas hew work titrhstnmiai
eliminate. prnperts loss burn hazards. IS) ,granting p n uts. the proves ,sn Ihr project mull be made within bet dabs of this
('nasial Kes.runr commission does not guuranter the Met!. ..t ;cutback determination.Of the setback must he re-n+easured.Also,
the detehopmrn: and assumes no liahilus tar future d.un. Le to the occurrence of a alai+t dateline change as the result of a
Me deseloorncnt. Permits issued in the (kcal' Hatard .aria .07 storm within the M)-dot) penoci well nrcessiuuo rem ster-mem
I nsutntmaual t'eroceun include the r:lnaditeou that stna.tures he i•l the setback. It 1. important that sou .heel, with the LP()
rekx:atrd or dismantled it the? heevme unmtuentls threatened "l fore the permit expires for otfi:iai apprusal to eontinuse the
th change.-,,, Ir.shrsrrl:ne cnnfigunusion. The stmttccurets! must he sssxk after the permit has expired. lid ierallt. if foundation
Rftwated or dismantled within two t25 }cars .rt nes:0111.1mi s ilinys h:'tse been placed and subsume:t :trr5resm,is exn:Inarng,
icntnne ntl.s threatened. and in ans ease upon its :..claps: .tr pe-nnit revessai :an be authoridod. It is Imlaswiul to esvdtmue
suhsuckiuc. titi,rk alter permit expiration
I lee best asailatslc Inl+srrrtaloaa.a,a.:eptcd In Inc.c 0ar0-11 for aware tgforanurienr,dl'gruiY:
Keaourc►s t'oan#tiasisxt. indicates that the annual king-teem
rictus}::s I rs+airan rate for the area where s„ur panlrerts is
11wriest is feet pee ti cat.
ca&,(Perms'(7Thcet
1'he rate aan established by :arctirl asepsis ,.t acnal
ph'ttagraphs of the ei.asadinc taken...net'thy nag'0)cars.
6d !also ttr.li“ite that the shoreline could m se as slues as a4c>IQra43d
reel Iandssard in a mamastorm,
I 1s4'riarer5 in a major storm arc pre-dreice to he Wout
it Ices deep in this area Locality
1'le tee led uecarrtrout luutcuUun oir ere. to teach ii cu d hnuuc
and reins:awn of threatened slruetun-s nand er i&rn emu- i
structure~such as bulkheads.seawall..resennents, gamins,jcttics F't)orre Number
and breakwaters arc prohibited 'tempural. sand bathe min he
authe.ri7cd under certain condition-,
:he appluea.ti: roust aa;i,n.rulnl=e ilu, inl".vvuai.a: and
tcyui r -h hs suEnin the.notice in the spree bKlnss U.ab out
,-Intspriver
s11 nauue the application well n,rt he c<mtptete
I
I, t` �'
Property owner Signa1We Deco
RE:C ' '''
DCM WILMINGTON, NC
JAN 2 7 2020

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:
THOMAS ZACHARY BOSY&WIFE, KAREN ELIZABETH BOSY
A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg.No.)or P.O. Route and Company NAIC Number
Box No.
1701 OCEAN BOULEVARD
City State ZIP Code
TOPSAIL BEACH North Carolina 28445
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 1,BLOCK 44, FOURTH SUBDIVISION OF NEW TOPSAIL BEACH
A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.34d21'07"N Long.77d38'42"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 6
A8. For a building with a crawlspace or endosure(s):
a) Square footage of crawlspace or endosure(s) 280.00 sq ft
b) Number of permanent flood openings in the crawlspace or endosure(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 I 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 ❑x No
SECTION 8—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number 62.County Name 63. State
TOWN OF TOPSAIL BEACH 370187 PENDER North Carolina
B4.Map/Panel B5.Suffix B6. FIRM Index 87.FIRM Panel B8.Flood 89.Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO,use Base Flood Depth)
Revised Date
3720420200 J 02-16-2007 02-16-2007 VE 16.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69:
❑FIS Profile ❑x FIRM ❑Community Determined ❑ Other/Source:
611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 Q NAVD 1988 ❑ Other/Source:
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwisipfg /ti IaL00)? ❑Yes x❑ No
Designation Date: ❑ CBRS ❑ OPA DCM WILMINGTON, NC
JAN 2 7 2020 J -t liiil zV

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:
1701 OCEAN BOULEVARD
City State ZIP Code Company NAIC Number
TOPSAIL BEACH North Carolina 28445
SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑x Construction Drawings* [J Building Under Construction* fl 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-fit 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) 10.00 Eiri feet ❑ meters
b) Top of the next higher floor 21.10 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) 19.10 ❑x feet E meters
d) Attached garage(top of slab) N/A ❑ feet [] meters
e) Lowest elevation of machinery or equipment servicing the building 19.10 x❑ feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building (LAG) 6.40 IZ feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 7.50 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/Afeet
structural support ❑ ❑ 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.
t certify that the information on this Certificate represents my best efforts to interpret the data available. I 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? U Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
ot\iI
JAMES A. LEWIS L-4562 ,\``�N CAP?//.
iiiir
i
Title � E S S . /
PROJECT MANAGER - O T /Q .. ,L
Company Name - �•a� ~r '9 _
CHARLES F. RIGGS&ASSOCIATES, INC. _
Address ti � re
502 NEW BRIDGE STREET °` ( �:.�0
���J ,,'��S• Ur!T;
City State ZIP Code 'icy,' S` \, \‘`�
JACKSONVILLE North Carolina 28540 �//rit AI i iezvA02.0
Signature Date Telephone Ext.
/I 1 (_ w/�� [phone] 41
Alh-t� /?"
Copy all pa s of this Elevation Certificate and all attachments for 1)community official, (2)insurance agent/company,and(3)building owner.
Comments(including type of equipment and location,per C2(e), if applicable)
PROPOSED DWELLING IS TWO STORY ON PILINGS, PARTIALLY ENCLOSED BELOW. THE TOWN OF TOPSAIL BEACH ADDS A
3.0' FREEBOARD TO THE BASE FLOOD ELEVATION. THEREFORE THE ELEVATION OF THE BOTTOM OF THE LOWEST
HORIZONTAL STRUCTURAL MEMBER MUST HAVE AN ELEVATION OF ATLEAST 16.0'- A'tig.q(PROPOSED BOTTOM OF
BAND= 19.1') DCM WILMINGTON, NC
JAN 2 7 2020
CC t,AA C.......naa n 99 /7/4f\ Gnrm Dnnn 9 of Q

li°11:11-1 NC Division of Coastal Management 10 9 51 A B C�
Cashier's Official Receipt
7.e
Date: / ,` " 20
pyCLReceived From: $ / D
Permit No.: Check No.:
Applicant's Name: rAtaleaKa/Lt.,. /Si County:
Project Address: .?-O
/
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applica Date:
17gy,c...
Signature of Field Representati : Date:

Date Date Check From Name of Vendor Check Check Permit Rct. #
'ceived Deposited Permit Holder Number amount Number/Comments
8/2020 Charles F. Riggs Thomas& Karen First 16355 $100.00 minor fee, 1701 Ocean Blvd, JD rct.
and Associates Inc. Bosy Citizens Topsail Beach PnCo 10951
Bank