HB_15-042_Kozak

Town of Holden Beach 2015.042
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environment,
and Natural Resources and the Coastal Resources Commission for development
in an area of environment concern pursuant to section 113A-118 of the
General Statutes, "Coastal Area Management"
-- -- - - - • •-_— „ „�, y UUVV1VNAIht;rrL III inu r-stuanne snoreline (AEC) at 138 Tuna Drive, in
Holden Beach, and Brunswick County as requested in the permitteB s application, dated December 7, 2015. This
permit, issued on January 4, 2016, is subject to compliance with the application and site drawing (where consistent
with the permit), all applicable regulations and special conditions and notes set forth below. Any violation of these
terms may subiect oermittee to a fine, imprisonment or civil action, or may cause the permit to be null and void,
This permit authorizes: Construct a single family residence, gravel driveway, pool, decking and retention
stormwwater ditches.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated 10-3-2015 and signed by Everett Graham.
(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
modification of this permit, will require a re-evaluation and
(4) A copy of this permit shall be posted or available on site. Contact this office at 910-842-6080 for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the pernitee or other qualified persons
within twenty (20) days of the issuing date. Fmm the date of an appeal, any
work conducted under this permit must cease until the appeal is resolved. This
Permit must be on the project site and accessible to the permit officer when the
project is inspected for compliance. Any maintenance work or project
modification not covered under this permit, require further written permit
approval. All work must cease when this permit expires on.
DECEMBER 31,2019
n issuing this permit it is agreed that this project is consistent with the local Land
Jse Plan and all applicable ordinances. This permit may not be transferred to
mother party without the written approval of the Division of Coastal
danagement
IZEC "",V D
DCM WILMIN'GT N, NC
Rhonda Wooten
CAMA LOCAL PERMIT OFFICIAL
110 Rothschild Street
Holden Beach NC 28462
PERMITTEE
(Signature required if conditions above aooly to vermin

Name:'Richard Kozak Jr.
Minor Permit # 2015-042
Date: January 4, 2016
Page 2
(5) The amountvf impervious surface shall not exceed 30% of the lot area within 75 feet of
(Estuarine Shoreline Area of Environmental Concern), in this case no structure is proposed onlyfit material;
(6) Unless specifically allowed in 15A NCAC 07H. 0209(d)(10), and shown on the permitted plan drawing, all
developmentfconstruction shall be located a distance of 30 feet landward of normal high water.
(7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by
effective sedimentation and erosion control measures. Prior to anv land-Naftwhimn eAmoo.„. .
with a vepetadve cover.
(8) All areas being disturbed on the lot landward of the the normal high water must be contoured to prevent
additional stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and
must remain in a vegetated state.
(9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within'14 days of
construction completion.
(10) Sediment fence shall be place along all property lines and must remain in place during land disturbance and
after site activity ceases to prevent off site sedimentation.
(11) Town ordinance states that you are to control runoff onto adjacent property or water induces soil
erosion in any form, to control within property boundaries, and not drain onto adjacent areas both
private and public (for example streets and roads).
Q�& OX-C"
SIGNATURE: DATE:
PERMITTEE

1�6, 13A&4z
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PLANNING & INSPECTIONS DEPARTMENT
o�«m `":nr
December 21, 2015
Dir*
timothy D. Evans
[e-mail]
Richard Kozak Jr.
Lvo,czo,cFM
175 Moffett Run Road
Rhonda Wooten
nvooten@hbtownhall.c Aliquippa PA
NOTICE TO PUT APPLICATION ON HOLD
CAMA Application #2015-042
Please be advised that the Minor CAMA Application has been placed on hold. On
subsequent review I have found additional information is needed on the site plan so
that I may verify that CAMA regulations are being met. The contractor has been
notified of the information needed. Once the information has been submitted the
review process will continue.
Pursuant to NCGS 113A-121(b), the undersigned hereby gives notice to the applicant
that for good cause, and in order to properly consider all information necessary to
making a decision on this permit application, the time period within which a final
decision shall be made has been extended an additional twenty-five (25) days.
If you have any questions concerning this action, please contact me at 910-842-6080.
Cc: Holley Snider —DCM
Pro Built — Authorized Agent
RECEIVED
DCM WILMINGTON, NC
JAN 14 2016
110 ROTHSCHILD STREET • HOLDEN BEACH, NC 28462 • 910.842.6080 PHONE • 910-842-7003 FAX
Wwvv.hbtownhall.conn

Locality 1 6 Permit Number
Ocean Hazard Estuarine Shoreline--L ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND O ER
Name i Cha(� F r L� F T•
City t % , Q Q 4 State S fT — Zip /5 u 1 Phone -7U Q Y - 7 `ao')
Email f?�klQ( v(�mSYI Loin �l�L
AUTHORIZED AGENT
Address flu, ocit 4a.16"1
City eciE 11 State N C; Zip0 Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) t'', iTL-c r t; ) f • //��
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) �r" �1 c� .L)�'e �5
c
SIZE OF LOT/PARCEL: �-� bb f square feet �` acres
PROPOSED USE: Residential ® (Single-family ® Multi -family ❑ ) Commercial/Industrial ❑ Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Perrnit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: &A— square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: /�t 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.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality?
YES_ NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
RECEIVED
DrCM WILMINGTON. NC
JAN 14 2016

OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
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
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more 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
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
_L_an owner or recor title, Title is vested in , see Deed Book 3'55 i
page p$CD in the Jjun. r �t County Registry of Deeds.
_an owner by virtue of inheritance: Applicant is an heir to the estate of
probate was in County.
_if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
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 CAMApermit.
(I)
(2)
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
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-
tion and floodpmofing techniques.
I furthermore certify that I am authorized to grant, and do in fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in cone_ ection with evaluating information
related to this permit application. Do
s This the d of ; 20 _Jt
Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application
This application includes. general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary,a check for $100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the application as descriB IV thu4 'ources are
incorporated without reference in any permit which may be issued Deviation from these detggs YV rpng(yr i@kyipWtion of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.

AEC HAZARD NOTICE
Project is In An: Ocean Erodible Area x High Hazard Flood Area
Property Owner: Rle-yya(3 LC%2.�_ Tr
Property Address: 13$ /ung Qf.
Date Lot Was Platted: ?14) /9�5
This notice is intended to make you, the applicant, aware of the
special risks and conditions associated with development in this
area, which is subject to natural hazards such as storms, erosion
and currents. The rules of the Coastal Resources Commission
require that you receive an AEC Hazard Notice and acknowledge
that notice in writing before a permit for development can be
issued.
The Commission's rules on building standards, oceanfront
setbacks and dune alterations are designed to minimize, but not
eliminate, property loss from hazards. By granting permits, the
Coastal Resources Commission does not guarantee the safety of
the development and assumes no liability for future damage to
the development. Permits issued in the Ocean Hazard Area of
Environmental Concern include the condition that structures be
relocated or dismantled if they become imminently threatened by
changes in shoreline configuration. The structure(s) must be
relocated or dismantled within two (2) years of becoming
imminently threatened, and in any case upon its collapse or
subsidence.
The best available information, as accepted by the Coastal
Resources Commission, indicates that the annual long-term
average oce ion rate for the area where your property is
located is feet per year.
The rate was established by careful analysis of aerial photographs
of the coastline taken over the past 50 years.
Studs also indicate that the shoreline could move as much as
a feet landward in a major storm.
The flood waters in a major storm are predicted to be about
$_feet deep in this area.
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads, seawalls, revetments, groins, jetties
and breakwaters are prohibited. Temporary, sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and requirements
by signing this notice in the space below. Without the proper
signature, the application will not be complete.
G 0-?`d y(o.2-
Inlet Hazard Area
Call Brunswick County GIS for
this information! 910- q53-23310
This shall be completed.
SPECIAL NOTE: This hazard notice is required for development
in areas subject to sudden and massive storms and erosion. Permits
issued for development in this area expire on December 31 of the
third year following the year in which the permit was issued.
Shortly before work begins on the project site, the Local Permit
Officer must be contacted to determine the vegetation line and
setback distance at your site. If the property has seen little change
since the time ofpermit issuance, and theproposed development
can still meet the setback requirement, the LPO will inform you
that you may begin work. Substantial progress on the project
must be made within 60 days of this setback determination, or
the setback must be remeasured. Also, the occurrence of a major
shoreline change as the result of a storm within the 60-day period
will necessitate remeasurement of the setback. It is important
that you check with the LPO before the permit expires for official
approval to continue the work after the permit has expired.
Generally, if foundation pilings have beenplaced and substantial
progress is continuing, permit renewal can be authorized. It is
unlawful to continue work after permit expiration.
For more information, contact.
04
Local Permit Officer
TOWN OF HOLDEN BEACH
Address 110 ROTHSCHILD STREU
HOLDEN BEACH, N.C. 2902
Locality
aIA-Buy-(�o�o
Phone Number
RECEIVED
DCM WILMINGTON, NC
JAN 14 2016

3 REQUIRED PARKING SPACES
PER HOLDEN BEACH ZONING
CODE 6OF I
RICH KOZAK
138 TUNA DRIVE
CONCRETE SLAB
ELEVATION 5.4'
25 LF EEE ZEE LAY SYSTEM
ACTUAL LOCATION MAY
VARY DUE TO SITE CONDITIONS
N 87'36'27" E 100.00'
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25 LF EEE ZEE LAY SYSTEM
30' CAMA
BUFFER
LINE
ACTUAL LOCATION MAY
VARY DUE TO SITE CONDITIONS
CONCRETE SLAB
ELEVATION 5.2'
NOTES:
'INFORMATION FROM A SURVEY BY BOBBY LONG SURVEYING.
•DO NOT DRIVE VEHICLES OR PLACE HEAVY EQUIPMENT
OVER INFILTRATION TRENCHES.
'ALL SIDES OF THE INFILTRATION TRENCHES MUST BE
LINED NTH FILTER FRABIC.
SUPERSEDES THE DRAWING SEALED ON 09-11-14
SCALE: 1" = 20'
JAN 14 2016
NC

Brunswick County NC G1S
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Hoiden Beach City
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November 24, 2015
PIN: 200505290141 PARCELID: 246AD011 OWNER: KOZAK RICHARD E JR
1 = 40 Feet ADDRESS7: ADDRESS2: 175 MOFFETT RUN ROAD CITY: ALIQUIPPA STATE: PA ZIPCODE: 15001
yNN PARCELDESC:L-123CANAL-2 HARDORACRES PL8/13 DEEDDATE:&8/2014 DEEDBOOK: 3554 DEEDPAGE: 0800 PLATBOOK: null
x, [�0ytE PLATPAGE: null PLATDATE: ACRES: null TOWNSHIP: LOCKWOOD FOLLY DEFERREDVAL:0
14C/Wti•/! LANDVAL: 160000 OTHERVAL: 3430 HOMEVAL: 0 TOTALVAL: 163430 FIRECODEID: 10 FIRECODENAME: Tn-Beach
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EVERETT G. GRAHAM, P.E.
159 BRUNSWICK AVE EAST
HOLDEN BEACH, NC 25462
[phone]
RICK KOZAK
138 TUNA DRIVE
HOLDEN BEACH, N.C.
TOTAL LOT AREA
5,001 SQ. -rT.
TOTAL IT4PERVIOUS AREA
HOUSE AND DECKS (INC. 12" 0/H)................_...1,372 SQ. FT.
1372 sq ft x 1.5 / 12 = 172 cu ft of stormwater containment
required.
• Utilize gutters and downspouts draining to an EEE ZEE LAY drain
system.
• Capacity of EEE ZEE LAY system = 3.75 cu ft / ft.
Length of system required = 172 cu ft / 3.75 cu ft / ft = 45.9 ft.
• Round up to 50 ft.
i This document supersedes the document sealed on 09-11-14.
. Backf+lt �'
32" 3w�ade With
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Without Pip mdhm t ?9Pe
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EEE ZEE LAY DETAIL.
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025971
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DCM wlottATM,tfa'
JAN 14 2016

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Property Owner
Permit on my property at � 3 k (t r/iR Of ) )04'0 662C-� in Brunswick
County
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at Lll -q G 381 qb9 or by mail at the address listed below. If you wish to
Applicant's Telephone
fife written comments or objections with the Town of Holden Beach CAMA Minor Permit Program, you may submit
them to:
Sincerely,
Rhonda Wooten
Local Permit Officer for Town of Holden Beach
110 Rothschild Street
Holden Beach, NC 28462
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Property Owner
175 M Q+ I« ,
Mailing Address
141141kiNc. PA 1566I
City, State, Zip Code
RECEIVED
DCM WILMINGTON, NC
JAN 14 2016

Date
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City, State, Zip Code
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Permit on my property at ) 6 /f rna Dr. fk)Je q jjegG}, in Brunswick
County
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at q1o� & 3$ o ybl or by mail al the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Holden Beach CAMA Minor Permit Program, you may submit
them to:
Rhonda Wooten
Local Permit Officer for Town of Holden Beach
110 Rothschild Street
Holden Beach, NC 28462
Sincerely, j h y
Property Owner
05 ft)br�-4 Lti 98.
Mailing Address
444(. l bpq . l 6 )6 60 )
City, State, Zip Code
RECEIVED
DCM WILMINGTON, INC
JAN 14 2016

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Applying for Permit: LhQ(-j 42 x
Mailing address: 05 fhr CCe-+ i Kern Pc
Phone Number: & 36 / yU
certify that I have authorized Ol bul 1- C,V jd i i Cur)}- l �je D o
Agent / Contractor
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of JF 2 I L61 / bect
at my property located at / 315 114/1cr Elf. }f?jiJeI7
in &L'/)5 wi Ak County,
This certification is valid through t' 76 IZ61(o
Date
(Property Owner Information)
Signature
or Type Name
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Title
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Date
�ll� 1�3g 096�
Phone Number
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Email Address
RECEIVED
DCM WILMINGTON. NC
JAN 14 2016

RECEIVED
DCM WILMINGTON, NC
JAN 14 2016