86517A - Beasley, Dana & Reynolds, Judy

A0fOUrk"t2j"CAMA ❑ DREDGE & FILL
GENERAL PERMIT
No 86517 'A B C D
Previous permit 1 /
Date previous permit issued
New [—]Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC E :1 Rules attached. ❑ General Permit Rules available at the following link: www.dgq.nc.gov/CAMAruIes
Applicant Name
y i Authorized Agent
t. J'*..e_
Address Y- 6 - RCA 214 Project Location (County):
City i 1 �� DO VI I State N L_ zip f � q (4 "(' Street Address/State Road/Lot #(s)
Phone # (Z5 ) 41515 - -4 -1y -4- " W L--
Email 1y tt !d=L V e t,4 o t, (A 7 C," C k"w t✓ w +- Subdivision
City t° U t V1-a tc-zip- -2 -7 qg 0
Affected ❑CW OEW ❑PTA ES �PTS Adj.Wtr.Body +i'C1%ilij ' a N A``I�hki Nya-, (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ti`� L) G'{ V r 1� r �� L4- J,1
ORW: yes/no PNA: yes/no .
Type of Project/ Activity f> , u.f i . +i I -�)'7 ( I of, V) kA—W �V 0cl `�c a e-3 r C., t it"
y )lux d 64A ayy va ovc i 4 % s G! I/ Gi vim+. a K , Vt,t Li. KA Gt ( Wal( L I .)CtAA 0f iJW (Scale:N -r: )
Shoreline Length t 12 1 P t
T-
i
Floating Platform(s)
f
Finger pier(s)
Total Platform area
Groin length/#
yT
1-ulkheaoj�tipraplength t 1
- (C�L
Avg distance offshore 2
r.
Breakwater/Sill
i;Maxdistance/.length I
Basinchannel
_ _iz�
Cubic yards 1
Boat ramp
1❑
Boathouse/ Boatlift
Beach Bulldozing
Other
1�....
Vlvo
SAV observed: yes �`n ?
--M^1417
Moratorium: to == yes no
Site Photos: no
r
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by: i.-
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑* See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
4,
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
Application Feels) Check #/Money Order Issuing Date
on Date

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: 4
Phone Number: YLLZZ't2 7, -S7
Email Address: 0j tg i
I certify that I have authorized SCIOAT SY*""^LA—
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development: Ok.'N>
at my property located at 1 7 c 0 "- t'j C-"Ta—^j
in it County.
I furthermore certify that / am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
�Signature
- r- —
Print or Typ�fta=-m�'e��
it r Z
Title
Date
This certification is valid through .1—/
APi` 6�

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Dana B. Beasley & Judy L. Reynolds
Address of Property: 1217 Colington Road, Kill Devil Hills, NC 27948
Mailing Address of Owner: PO Box 214, Kill Devil Hills, NC 27948
Owner's email: [e-mail]
Agent's Name: Scott C Small
Owner's Phone#: [phone]
Agent Phone*
252-261-1967ofc1252-473-7655Scott cell
Agent's Email: [e-mail] I [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
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.
b,/ I DO NOT have objections to this proposal. I DO have objections to this proposal,
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909, DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift; or
groin must be set back a minimum distance of 15from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 16' setback
Signature of Actiacew Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
APR 0 S 2022
. `
Signature of Adjacent Riparian Property Owner.�_�..,-�� �,R4
Typed/Printed name of ARPO: Willene P. Simpson "°
.G
Mailing Address of ARPO: PO Box 1975, Kill Devil Hills, NC 27949
ARPO's email: ARPO's Phone#:
Date: _ -} *waiver is valid for up to one year from ARPO's Signature*
1
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner Dana B. Beasley & Judy L. Reynolds
Address of Property- 1217 Colington Road, Kill Devil Hills, NC 27948
Mailing Address of Owner: PO Box 214, Kill Devil'Hills, NC 27948
Owner's email: [e-mail] Owner's Phone#, 252-455-7747
Agent's Name: Scott C Small
Agent Phone#: [phone] ofe / 252-473-7695 Scott cell
Agent's Email: [e-mail] / [e-mail]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom gortion to be completed by the Adjacent Property Owner)
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
I DO NOT have objections to this proposal- I DO have objections to this proposal,
if you have objections to what is being proposed, you must notify the N.C. Division of Coastai
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you most sign
the appropriate blank below.)
11 0
I DO wish to waive somelall of the 15' setback
Signature of Adjacent Riparian Property Owner
002
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Printed name of ARPO: Walkabout, LLC
Mailing Address of ARPO: PO Box 117, Kill Devil Hills, NC 27949
ARPO's email: ARPO's Phone#:
VCo-
Date: .waiver is valid for up to one year from ARPO's Signature*
APR 0 8 2022
DCM-EC
Revised July 2021

PROPOSED NEW VINYL BULKHEAD REPLACEMENT @ 1217 COLINGTON RD, KDH RE]
FOR DANA B. BEASLEY & JUDY L. REYNOLDS
RIPARIAN DRAWING 1 OF 1 - 3/31/2022 - NTS BY: SCOTT SMALL OF LSI MARINE, LLC
[e-mail] - 252-473-7695 - WWW.LSIMARINE.COM I
COUNGTON ROAD
1229 COLINGTON RD
PROPERY OF:
SIMPSON
FiL
P.
DRIVE I
i
WAY t,
EXISTING
HOUSE
1217 COL. RD
PROPERTY OF:
BEASLEY
1205
1193 COLINGTON RD
PROPERTY OF:
WALKABOUT, LLC
13 E G I \ NE %k PROPOSED
EX, TRAILER,
BULKHEAD VINYL
BULKHEAD
REPLACEMENT
APPROX. 135 LF
EX. WOLKHEAD
LANE
rx, IR.ULER
APR 0 8 2022
E4, 1"SIN
DCM-EC
EX -TRAILER
END NEW
BULKHEAD
FN' MARSH EX, MARSH APPROX, 1000 LF —
PROMRTV OF; PROPERTY Or. TO OPEN WATER
ROANOKE ARINE
SJMPSON BEASUITY PROPERTY OF: SOLND WAlYLIWOUT I I M
PeL Construction, LLC
MP

r w!16
This map is prepared
from data used for the
inventory of the real
property for tax
purposes. Primary
"'• information sources such
as recorded deeds, plats,
wills, and other primary
public records should be
consulted for verification
of the information
contained in this map.
1217 Colington RD
Kill Devil Hills NC, 27948
Parcel: 008104000
Pin: 988417000295
R
Owners: Beasley, Dana Bruce -Primary
Owner
Reynolds, Judy Lynn -Primary Owner
Building Value: $92,700
Land Value: $227,900
Misc Value: $17,500
Total Value: $338,100
Tax District: Kill Devil Hills Out
Subdivision: Subdivision - None
Lot BLK-Sec: Lot: Blk: Sec:
Property Use: Multi -use
Building Type: Residential 1 Family
Year Built: 1944
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