78530A_M. A. Shoes, LLC_20200303

❑CAMA / ❑ DREDGE & FILL N9 78530 A B C D
GENERAL PERMIT Previous permit #
E New []Modification []Complete Reissue El Partial Reissue Date previous permit issued
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
©Rules attached.
Applicant Name L LC Project Location: County I i"
Address
CityAL5Y�cl State;' C ZIP
Phone # (�, ) tf S9 11CE-Mail
Authorized Agent 1
Affected ❑ CW gtW ETA CAS ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes/ no
Street Address/ State Road/ Lot #(s)
Subdivision
City j FI ZIP Q ?rlC(1
Phone # ( ) River Basin 1 c 5-..
Adj. Wtr. Body 1� (! ,.. _, ,, I -4" d �Li/man /unkn)
Closest Maj. Wtr. Body/1ll;el • 11 4 _c .11
Type of Project/ Activity ! k1 PGt
It
(Scale:
Pier (dock) length
i
Fixed Platform(s) -
Floating Platform(s)
Finger pier(s)
Groin length
number
EBulkhead Riprap length 1L:
avg distance offshore T'
max distance offshore-:)
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach
Other
ry Shoreline Length
SAV: not sure yes (n 1—
Moratorium: n/a) es no
_. _�.._........._.... - ._.._.. ..-- — - -
Photos: no
Waiver Attached: yes no
A building permit may be required by: ^G 1 r , j f e k (-CG,, `i l / ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions /fir lL ✓ Pi i �_ / CJ47 P/L✓C✓(� of .,- to I i a( 4
rx5'"�•. 1L. 'cT e4'4_ c7 !i t., Jalk. L'oC'-
Agent or Applicant Proted Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Kc, t
Permit Officer's Printed N
Signature
>-�;LG
Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent) to act on my
behalf, for the purpose of applying for and obtaining all C MA Permits necessary to
install or construct (activity) ��J�. �� ,
at (my property located at)
This certification is valid thru (date)
3�
Fes;,
-,,7 - 6-ao
Property Owner Signature Date

2/26/2020
North Carolina Secretary of State Search Results
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online
Add Entity to My Email Notification List • View Filings • Print a Pre -Populated Annual Report form • Print
an Amended a Annual Report form
Limited Liability Company
Legal Name
M.A. Shoes, LLC
Information
Sosld: 1158067
Status: Current -Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 7/9/2010
Registered Agent: Hines, Beaman
Addresses
Principal Office
Reg Office
Reg Mailing
Mailing
805 N US Hwy 64
805 N US Hwy 64
805 N US Hwy 64
PO Box 633
Manteo, NC 27954
Manteo, NC 27954
Manteo, NC 27954
Nags Head, NC 27959-0633
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Secretary
Angela Ebertowski
PO Box 633
Manager
Peter E Kauffman
PO Box 633
Nags Head NC 27959-0633 Nags Head NC 27959
https://www.sosnc.gov/online_services/search/Busi ness_Registration_ResuIts 1 /1

Letter to Adjacent Property Owners
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND -DELIVERED
Dear Adjacent Property Owner:
This correspondence is to notify you as a riparian property
to
on my property at
that I am applying for a CAMA Minor permit
C 17�6y
Currituck County. A copy of the application and project drawing is enclosed for your review.
If you do not have objections to the proposed activity, please mark the appropriate statement below and
return to the appropriate office 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 the appropriate office.
If you have any questions about the project, please do not hesitate to contact the local permit officer at the
appropriate office.
Mainland Office
153 Courthouse Road, Suite G107
Currituck, NC 27929
252-232-6026
Debbie. LaShomb a-currituckcountync.aov
Sincerely,
56
Property Ownerts Name
Corolla Office
1 123 Ocean Trail
PO Box 73
Corolla, NC 27927
252-232-6033
Nick.Aisthorpe(a--currituckcountync.gov
aS�2 -q g9- �691
Telephone Number
l` I havp, no ob)ection to the project described in this correspondence.
I ha je ion(s) to the project described in this correspondence.
Adjacent Ripa ian Proper y Owners Signature Date
C ql q C' 21 9f)-0
Print or Type Name
Address City
Telephone Number
yt t'
State
96
Zip
CAMA Minor Application
Page 8 of 10

Letter to Adjacent Property Owners
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND -DELIVERED
Date�11 �n f► �, �f �5 .{
Adjacent iparian Property Owner
�� V6r 2-7 7
ailing AfJ�Jrgss
G� �( ; NCy_19ty
City, State, Zip Code
Dear Adjacent Property Owner:
This correspondence is to notify you as a riparian property owner that I am applyingpp for a CAMA Minor permit
to e
on my property at S in
r
Currituck County. A copy of the application and project drawing is enclosed for your review.
If you do not have objections to the proposed activity, please mark the appropriate statement below and
return to the appropriate office 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 the appropriate office.
If you have any questions about the project, please do not hesitate to contact the local permit officer at the
appropriate office.
Mainland Office
153 Courthouse Road, Suite G107
Currituck, NC 27929
252-232-6026
aShomh&urrituckcourrtync.gov
Sincerely,
NA >7 uc 61 94
Property Owner's N me
Corolla Office
1 123 Ocean Trail
PO Box 73
Corolla, NC 27927
252-232-6033
Nick.Aisthorpe _ urrituckcountync.gov
)-qq - 965'1
Telephone Number
_Z,_ I have no objection to the project described in this correspondence.
I have, lection(s) to the project described in this correspondence.
Adjacent Riparian Property Owners Signature Date
Print or Type Name
Address
City
Telephone Number
State
Zip
CAMA Minor Application
Page 9 of 10

2/26/2020
https://currituckncgov.com/Freeance/Client/PublicAccess 1 /printFrame.html
Parcel ID Number
Global PIN
Number
Apt/Unit/Suite
Street Direction
Street Name
Street Type
Street Suffix Direction
city
Subdivision
Legal Description
Township
Owner Name 1
Owner Name 2
Owner Name 3
Billing Address
Billing Address Continued
Billing City
Billing State
Billing ZIP Code
Acreage (Legal)
Acreage GIS
Tax Value: Land
Tax Value: Buildin s
Tax Value: Total
Tax Value: Deferred
Last Sale Date
Last Sale Price
Qualified Sale?
Deed Book
Deed Page
Plat Cabinet
Plat Slide
Data Date
Owner Name 4
Owner Name 5
Owner Name 6
Owner Name 7
Owner Name 8
Owner Name 9
Owner Name 10
3200001990000
46-41-1820
'2
RIGGS ACRES
R
DINT HARBOR
RIGGS SUBDIVISION
G GRIGGS LOT 16
DPLAR BRANCH ML
I A SHOES LLC
TTN: ANGELA EBERTOWSKI
O BOX 633
IAGS HEAD
C
7959
6
.55
50400
49100
99500
011-12-02
50600
10
180
29
5
020-02-26
https://currituckncgov.com/Freeance/Client/PublicAccess 1 /printFrame. htm I 1 /1

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Currituck County GIS
[phone]
This map should be used for general reference purposes only.
Currituck County assumes no legal liability for the information
www.co.currituck.nc.us/Geographic-Information-Services.cfm
shown on this map.

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