08-24 KH - KH4220 LLC

09
RECEIVED
Ki Hawk 08.24 KH
Local Government JUL 1 0 2024 Permit Number
CAMA
r
MINOR
DEVELOPMENT
PERMIT
;.
as authorized by the State of North Carolina, Department of Environmental Quality and the
Coastal Resources Commission for development in an Area of Environmental Concern
pursuant to the Coastal Area Management Act, Section 113A-118 of the General Statutes.
Issued to KH4220 LLC, authorizing development in the Ocean Hazard (AEC) at 4220 N Virginia Dare Td, in Kitty Hawk,
NC, as requested in the permittee's application, dated June 15, 2024, and received complete on June 17, 2024. This
permit, issued on June 28, 2024, 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
subject permittee to a fine, imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes: Pool and pool deck in rear yard of subject property
All proposed development and associated construction must be done in accordance with the permitted work plat
drawings dated received 6/17/24 [GS 113A-120]
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. [GS 113A•120]
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permiffee or other qualified persons
within twenty (20) days of the issuing date. This permit must be on the project
site and accessible to the permit officer when the project is inspected for
compliance. Any maintenance work or project modification not covered under
this permit, require further written permit approval. All work must cease when this
permit expires on: DECEMBER 31, 2027
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
another party without the written approval of the Division of Coastal
Management.
Check 41145, in the amount of $100, was received on 6117 for the permit fee.
Rob Testerman
CAMA LOCAL PERMIT OFFICIAL
P.O. Box 549
Kitty Hawk, NC 27949
pezG ,y pd lmCUL
PERMITTEE
(Signature required if conditions above apply to permit)

Name: KH4220 LLC
Minor Permit # 08.24 KH
Date: 6/28124
Page 2
RECEIVED
J U L 1 8 2024
DGM-EC
Any change or changes in the plans for development, construction, or land use activities will require a re-
evaluation and modification of this permit. [GS 113A-1201
A copy of this permit shall be posted or available on site. Contact this office at 252-261-3552 for a final inspection
at completion of work. [GS 113A-120]
Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third -party. [GS 113A-1201
SIGNATURE: P &4eg- ® DATE: 07/01/2024
PERMI TEE

Ocean Hazard__ Estuarine Shoreline _ ORw Shoreline _Public Trust Shoreline_ Other_,_
For Official Use Only
LANDOWNER— MAILING ADDRESS
Name KH4220, LLC - Mark Burnstein
AAA,- 69 VanCortlandt Ave
RECEIVED
J U L 1 0 2024
City Ossining State NY Zip 10562 Phone [phone]
E-mail
AUTHORIZED AGENT
Name Atlantic Environmental Consultants, LLC - Doug Dorman
Address PO Box 3266
City Kitty Hawk
E-mail [e-mail]
State NC Zip 27949. Phone [phone]a
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody)
4220 North Virginia Dare Trail, Kitty Hawk, NC 27949
Adjacent water body is the Atlantic Ocean
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance)
Construction of a 10.5' x 29.5' pool with concrete decking. 10'x15' open wood deck with stairs.
SIZE OF LOT/PARCEL: 13�113.
sq ft 3,278 acres
PROPOSED USE: Residential❑✓ (Single-family❑✓ Multi -family Commercial/industrial❑ Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies to your
property):
(1) OCEAN HAZARD AECS: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: 3,276 sq ft (includes air
conditioning 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: 3,276 sq ft (includes the area of the foundation of all buildings, driveways, covered decks, concrete or
masonry patios, etc. that are withing the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a Stat v2
Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)? YES NO ✓
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: ___--sq It

OTHER PERMITS MAYBE 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'` V'E D
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile home Park approval, Highway C n
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
JUL 18 2024
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of the proper��f'drl► A_C/'+
AEC or a person authorized to act as an agent for purposes of applying for a CAMA minor development permi , ce l EC
that the person listed as landowner on this application has a significant in the real property described therein. This
interest can be described as: (check one)
❑✓ an owner otgff rd title, Title is vested in the name of KH4220, LLC
see Deed Book Gti page 0862 in the Dare County Registry of Deeds.
Flan 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 RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of the 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.
(1)
(2)
(3)
(4)
(Name) (Address)
See attached sheet
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the landowner 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 particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and floodproofing 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 connection with evaluating
information related to this permit application.
This the 15 day of .June 2024
Landowner or person authorized to act as his/her/their 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 agreement,
the Ocean Hazard ACE Notice where necessary, a check for $100 made payable to the locality, and any information as may be provided orally by
the applicant. The details of the application as described by these sources are incorporated without reference in any permit which may be issued.
Deviation from these details will constitute a violation of any permits. Any person developing in an AEC without permit is subject to civil, criminal
and administrative action.

Post Office Box 549
101 Veterans Memorial Drive
Kitty Hawk, NC 27949
Date: 06/1 5/2024
Phone [phone]
Fax [phone]
www.kittyhawknc.gov
AUTHORIZATION FOR APPLICATION OF PERMIT
Name of Property Owner Applying for Permit: KH4220, LLC
Mailing address: 69 Cortlandt Ave
Ossining, NY 10562
I certi that I have authorized Doug Dorman —AEC
fY .....__._.._agent/contractor), to act on
my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed
development ofA pool, 10'x15' deck & stairs
at my property located at
4220 North Virgina Dare Trail, Kitty Hawk, NC 27949
This certification is valid through 06/1 5/2025
Property owner's signature
Print or type nameMark Burnstein-KH4220, LLC
Phone Number 914-260-2701
DECEIVED
J U L 1 8 2024
DCM-EC

RECEIVED
OCEAN HAZARD AEC NOTICE JUL 18 2024
Project is in an: X Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: KH4220,LLC
Property Address: 4220 N Virginia Dare Trail, Kitty Hawk, NC 27949
Date Lot Was Platted: 12/07/1984
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 Concem 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 infomtation, as accepted by the Coastal
Resources Commission, indicates that the annual long-term
average ocean erosion rate for the area where your property is
located is 3 feet per year.
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as much as
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.
5� 06/14/2024
Property Owner's Signature Data
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 of permit issuance, and the
proposed 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 re -measured.
Also, the occurrence of a major shoreline change as the result of
a storm within the 60-day period will necessitate re -
measurement 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 been placed and substantial progress is
continuing, permit renewal can be authorized. It is unlawful to
continue work after permit expiration.
For more tafororatim; contact.
be i�as tw Aa _
Local Permit Officer
lot YbTBtL '-. r1EpWh\M... vs,
Address
Locality
;6�) a41 '§F3
Phone Number
Revised May 2010

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAII RPTI =hl Ocrcnn r
e a- X,
t-er�ce 14
Zip
To Whom It May Concem:.
T2
iECEI
J U L 18 2024
DCM-EC
This correspondence is to tify y as a riparian p perty owner that I am applying 1 for a CAMA Minor permit to
g .
on my property at �{3 (i /t1 (/t2 t [t T
in County, which is adjacent to your property. A copy of the application and project
drawing is attacbed/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to: (Rob
Testerman, Town of Kitty Hawk, PO Box 549, NC, 27949)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact Rob Testerman at252-251-3552, or by email at: [e-mail]
Sincerely,
//Proparty Owner's Name Telel)kon�e Number _
19 4 t ✓//1 ItV`50,73'
Address City State
Zip
1 have no objection to the project described in this correspondence.
1 have objection(s) to the project described in this correspondence.
Adjacent Riparian Sig—, mre — —
Date
Print or Type Name Telephone Number
Address City State
Zip
Revised July 2021

VISION
ADJACENT RIPARIANINER
PROPERTY OWNOTIFICATION t
CERTIFIED MAIL. RFTURni
Name of d'a -
V� y geniRipatian Prop y Owner
Addre . O �Vt ��
To Whom It May Concern:
CEIVED
J U L 18 2024
I(/! -EC
This correspondence is to notify you as a riparian property owner that I am applying for a LAMA Minor permit to
>a� F .. 4l2 G Gs `..
Y1 6:L 1
on my property at e"V
in
drawiCounty, which is adjacent to your property. A copy of the application and project
ng is attached/enc►osed for your review.
PERMIT)
Date
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to: (Rob
Testerman, Town of Kitty Hawk, PO Box 549, NC, 27949)
If you have any questions about the project, please do not Hesitate to contact me at my address/number listed below, or
contact Rob Testetman at252-261-3552, or by email at: [e-mail]
Sincerely,
S [�
Property Owner's Name
Address
Telephone Number
- //Y ffx�
City State
1_1-- t have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
i
X
- nt Riparian Signature'
Print or Type Name
Date
Telephone Number
Zip
Address
S�7 Cit State
J �zry Zil:,2 l/
Revised Juty 2021

SIT' kg
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REVISIONS \
6-14-24 SITE PLAN
LOT 20. BLOCK B.
TN SANDERLIN
PG. k85 i/
NQTES;
ADDRESS, 422C N. VIRGINIA DARE TR.
LOT AREA! 13,113 SO FT
PROPOSED
LOT COVERAGE- 3,363 SO FT (P5.8'L)
FIRM REFERENCE,
3720 9876 00 K
CURRENT FLOOD ZONE: SEE PLOT
ZONING R.F.P.Ea 8' NAVD 88
SETBACKS SHOWN ARE AS PER THE TUVN
OF KITTY HAWK ZONING AND CAMA
REGULATIONS, THEY MUST BE VERIFI D
BY ANY ENFORCEMENT ENTITY SUCH AS
AN H.O.A.
THE SIDE SETBACKS MAY VARY
DEPENDING UPON HOUSE SQUARE FOOTAGE
THIS SURVEY IS BASED ON EXISTING
FIELD EVIDENCE AND EXISTING RECORDS
` MICHAEL D. SADLER, P.L.S. DO CERTIFY
THAT THIS PLAT IS OF AN ACTUAL SURVEY
MADE UNDER MY SUPERVISION M.B I PG. 141
THAT THE BOUNDARIES NOT SURVEYED ARE
INDICATED AS DRAWN FROM INFDRMATION IN
M.B 1. PG. 161. THAT THE RATIO OF PRECISION
1S AT LEAST 1'40A W', AND THAT THIS NAP
MEETS THE REQUIREMENTS OF THE STANDARDS
OF PRACTICE FOR LAND SURVEYING IN NORTH
CAROLINA (at NCAC 56,1600)
THIS 14TN DAY OF JUKE, 2024
KITTY HAWK BEACH
REVISED, BLOCK 30,
SECTION A
N.B. 21 PG. 153 0 262
134) Be. Isso,
/ I PG. 201
D.B. 2010, Po. BEd EX 2 A2f)II DCM-E
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EX a' S21021'32"E
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KH4220, LLC
ISO' CAMA SETBACK FOR
V STRUCTURES BETWEEN
m 5.000-9.999 SO FT
O (OTHERS APPLY)
CQ
cIX1ORETE
Omw
owe PA
BY 13,
( 0.4. PpM{IyNE
/ 50121' 18
521" 12' 14"E
VIRGINIA DARE TRAIL
rA6,yo. 60, R/w
434---E—L-—NLY—) 2881 01oE+$
SADLER SURVEYING, PLLC
P-25ilX.
502 FIRST FLIGHT LANE, wl+ EILL DEVIL HILLS, NC 27948
PHONE: [phone]
ALTERATION OF THIS DOCUMENT IS PROHIBITED
SITE PLAN OF
A PORTION OF LOT 17,
BI,OCK 30, KITTY HAWK BEACH
REVISED, SECTION A
D.H. 398, PG. 52B
DATE: 3-18-24 IREC. REFS.: D.B. 2614. PG. 882
SCALE: 1"= 30' IPLE NO.: 24-039
DWG NO.: 24039SF
PIN NUMBER.: 08987615537046
I

•Y 1