86320A - Cam Jan, LLC & Village Idiots, LLC

CAMA >< DREDGE & FILL 9 8 "C' 0 s C D
Previous permit
GENERAL PERMIT Date previous permit issued
qew El Modification j,_l Complete Reissue iPartial Reissue
As authorized by the State of North Carolina. Department of Environmental Quality and the Coastal Resources Commission in an area of environmentals concern pursuant to:
I SA NCAC _._�!ats_1( �d --.--- — --- Rules attached General Pet mit Rules available at the ffoilovAng�,linkk: v ww.d�eft nc eovtCAMAArulcs
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Applicant Nam/�e . __. 1�
Address �1 1LV_.. _ _ _ p� p Project location (County):
City ;,'rate ZIP ... _ f Z Street Addreszl5cato Road/Lot #(s)
R ..# - . �-j 20 42 I�� av C?f� ?A2-t8'�-
f}hw e { �� _._ �/`
tl✓ 4YC, Subdivision f
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Lt^�A✓ tp.�� City.ZiP __ _ ..
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AEC(s): n OEA ! INA L__f Uw EISPIMA € PWS Closest Maj. Wtr, Body _'i.i�^t .._ _
ORW; ye no PNA: nu / ��
Type of Project/ Activity CO�r?i 1I ! 1 � ;�!A]y�`�►4c ._ 4�WilkGL
ri 'el i . � � n C r _ f1 w I it K.Y .i � ('t t A A (Scale: lh O�
Access Length
Pier (dock) length
Fixed Platform(s).
Floating Platform(s) __
Finger pier(s) _
Total Platform area
Groin length/ti � !
Bulkhead Riprap length 1� Ott
Av distan offshore ±.1..........._ _.
�kpssterJ5ii1 _
ax distan / length ___.._..
Basin, channel
Cubic yards _.._.
Boat ramp _
Boathouse/ Boatiift , __.___ .___._._,
Beach Bulldozing __...___...
Other ._ _.
$AV observed. yes 0
Moratorium: n a yes no
Site Photos: Ve no
Riparian Waiver Attached' s nr>
A building Mintt/zoning permit may he fi
Permit Conditions J..5A , N-cl
signati _ "Please read i itt,n,,ovt nil back of Perm it•`
'-40 _6..,�__...... _
Appbuition Fees; whz r',:.t ley i?r ir=
0
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M !--.0—,tD •
TARfPAM NEUS@!BUFFER (circle one)
See note on back regarding, River Basin rules
see aciditional notes; ennditions on back

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �'/� �' J lie Z+
Mailing Address:
Phone Number:
Email Address:
l
vv II
I certify that I have authorized Z'�� (n PCI\4? r.; ;,:1'; ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 'acllt �'a a
at my property located at f zr tv, / A' L.'l�_
in County.
1 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.
Property Owner Information:
MAR 1 7 2022
DCM-EC
Title
Date
This certification is valid through I I

County of Dare, North Carolina
*Owner and Parcel information is based on current data on file and was last updated on April 08 2022
Primary (100%) Owner Information:
CAM JAN LLC
921 W KITTY HAWK RD
KITTY HAWK NC 27949 Q
Parcel Information:
Parcel: 017959000 PIN: 987505089609
District: 08- KITTY HAWK
Subdivision: SUBDIVISION - NONE
LotBlkSect: LOT: LOT 1RR BLK: SEC:
Multiple Lots:
PlatCabSlide: PL: J SL: 77 Units: 0
Deed Date: 09/03/2019
BkPg: 2321/0546
Parcel Status: ACTIVE
Property Use: MULTI -USE
jl�j FEyy �`1,
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fi Illll,III 9� Ww,
1
017959-000 08-987505-040 03/11
BUILDING USE & FEATURES Tax Year Bldg Value: $1,049,000
Building Use: PREFAB WAREHOUSE
Exterior Walls:
Full Baths: Half Baths:
Bedrooms:
Heat -Fuel:
Heat -Type:
Air Conditioning:
MISCELLANEOUS USE Tax Year Misc Value: $30,900
Misc Bldg a: (RS1) FRAME UTILITY SHED Year Built: 1985 sqft: 64
921 W KITTY HAWK RD
Next Year Bldg Value: $1,049,000
Actual Year Built: 2004
Finished sqft for building 1: 26477
Total Finished SgFt for all bldgs: 26477
Next Year Misc Value: $30,900
Misc Bldg b: (PC1) PAVING CONCRETE AVERAGE Year Built: 2004 sqft: 15000
Misc Bldg c: (PA1) PAVING ASPHALT PARKING Year Built: 2004 sqft: 5000
LAND USE Tax Year Land Value: $479,400 Next Year Land Value: $479,400
Land Description : 08-Commercial Village PrimaryLand Description b:: 08-Marsh Acreage
TOTAL LAND AREA: 5.45 acres
Year Total Value: $1,559,300 Next Year Total Value: $1,559,300
*Values shown are on file as of April 08 2022

wnLIMITED LIABILITY COMPANY ANNUAL REPORT
10/2017
NAME OF LIMITED LIABILITY COMPANY: Cam Jan. LLC
SECRETARY OF STATE ID NUMBER: 1855735 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: qnq 1
SECTION A: REGISTERED AGENT'S INFORMATION
1. NAME OF REGISTERED AGENT: CR Services, LLC
2. SIGNATURE OF THE NEW REGISTERED AGENT:
Fling Office Use Only
E - Filed Annual Report
1855735
CA202112003635
4/30/2021 02:30
Changes
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
235 N. Edgeworth Street 235 N. Edgeworth Street
Greensboro, NC 27401 Guilford County Greensboro, NC 27401
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: COZv Home Custom Cabinets Inc
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] x 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
921 KITTY HAWK RD
KITTY HAWK, NC 27949
921 KITTY HAWK RD
KITTY HAWK, NC 27949
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Dianne Narron
TITLE: Chief Accounting Officer
ADDRESS:
921 KITTY HAWKRD
KITTY HAWK, NC 27949
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Dianne Narron
4/30/2021
SIGNATURE DATE
Form must be signed by a Company Official listed under Section C of This form.
Dianne Narron Chief Accounting Officer
Print or Type Name of Company Official Print or Type Title of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

County of Dare, North Carolina
'Owner and Parcel information is based on current data on file and was last updated on April 08 2022
Primary (100%) Owner Information:
VILLAGE IDIOTS LLC
921 W KITTY HAWK RD
KITTY HAWK NC 27949
Parcel Information:
Parcel: 017959003 PIN: 987505089255
District: 08- KITTY HAWK
Subdivision: SUBDIVISION - NONE
LotBlkSect: LOT: LOT 3RR BLK: SEC:
Multiple Lots:
PlatCabSlide: PL: J SL: 77 Units: 1
Deed Date: 09/03/2019
BkPg: 2321/0543
Parcel Status: ACTIVE
Property Use: VACANT LAND (PRIVATE)
BUILDING USE & FEATURES
Building Use:
Exterior Walls:
Full Baths:
Bedrooms:
Heat -Fuel:
Heat -Type:
Air Conditioning:
MISCELLANEOUS USE
Tax Year Bldg Value: $0
Half Baths:
Tax Year Misc Value: $0
0 W KITTY HAWK RD
Next Year Bldg Value: $0
Actual Year Built:
Finished sgft for building 1:
Total Finished SgFt for all bldgs: 0
Next Year Misc Value: $0
LAND USE Tax Year Land Value: $41,100 Next Year Land Value: $41,100
Land Description : 08-Commercial Vlg Undevelopedl-and Description b:: 08-Marsh Acreage
TOTAL LAND AREA: 2.59 acres
Tax Year Total Value: $41,100 Next Year Total Value: $41,100
*Values shown are on file as of April 08 2022

LIMITED LIABILITY COMPANY ANNUAL REPORT
10/2017
NAME OF LIMITED LIABILITY COMPANY: VIIIacle Idiots, LLC
SECRETARY OF STATE ID NUMBER: 1855736 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: gn91
SECTION A: REGISTERED AGENT'S INFORMATION
1. NAME OF REGISTERED AGENT: CR Services, LLC
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E - Filed Annual Report
1855736
CA202112003671
4/30/2021 02:45
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
235 N. Edgeworth Street
Greensboro, NC 27401 Guilford County
SECTION B: PRINCIPAL OFFICE INFORMATION
235 N. Edgeworth Street
Greensboro, NC 27401
1. DESCRIPTION OF NATURE OF BUSINESS: VILLAGE IDIOTS LLC
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
921 KITTY HAWK RD
KITTY HAWK, NC 27949
5. PRINCIPAL OFFICE MAILING ADDRESS
921 KITTY HAWK RD
KITTY HAWK, NC 27949
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Dianne Narron
TITLE: Chief Accountinq Officer
ADDRESS:
921 KITTY HAWKRD
KITTY HAWK, NC 27949
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Dianne Narron
4/30/2021
SIGNATURE DATE
Form must be signed by a Company Official listed under Section C of This form.
Dianne Narron Chief Accounting Officer
Print or Type Name of Company Official Print or Type Title of Company Official
This Annual Report has been filed elecfronically. ----
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

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:
Address of Property:
Mailing Address of Owner: sh!t
Owner's email: y7a�q/ANC rjjP. Ce.►'I Owner's Phone#:
Agent's Name:
Agent's Email:
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
RECEIVED
MAR 17 2022
DCM-EC
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.
!/ioI 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 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 must siqn
the appropriate blank below.)
1 DO wish to waive some/all of the 15' se back j
-OR-
Sign jaic t ipar open wner
I do not wish to waive the 15' setback requirement (initial the blank)
yy
Signature of Adjacent Riparian Property Owner
Typed/Printed name of ARPO./L�'JX dxy //��
Mailing Address of ARPO: t9a3� LGt t? ,04.0 11t�jpu/l , /" 2--7 i `S
4q/ ARPO's email:C'�r ���✓++�GOpe ARPO's Phone# F> Z — •Z`ILLa�-t/ I
Date: "waiver is valid for up to one year from ARPO's Signature`
I
Revised May 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM MAR 1 1 2022
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by/owner or their agent) DCM-EG
Name of Property Owner A -A,--e t �l
�✓w��N 27y
Address of Property:61 C
Mailing Address of Owner
Owner's email Owner's Phone#: 2 5 Z - 7P Z— 227
Agent's Name: Agent Phone#
Agent's Email:
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 h s described to me, as shown on the attached drawing, the development they are proposing. A
descri on or drawing,with dimensions must be provided with this letter.
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 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 must sign
the appropriate blank below.) /
I DO wish to waive some/all of the 15' setback
-OR-
(J/
Siyn r f4dcent Riparian Property Owner
I do not wish to waive the 15' setback requirement (initial the blank)
r
Signature of Adjacent Riparian Property Owner: A;i�yy/j/"
Typed/Printed name of ARPO: / `7 / a
Mailing Address of ARPO: 0 9 9 EM 0// �i t/�2 At/ t �( �k .,/" C 2 / 1 �
ARPO's email.
fff�� Cd�s ti�'� ARPO's Phone#: J5�� 2071151,
Date: waiver is valid for up to one year from ARPO's Signature*
Revised May 2021

CPA
N/T
R FQFtBES
REVOCABLE
L4z 12E. PG. 310
WETLANDS
N21-
5 2 2" \N
SE OF WATER
PER AERIAL c
10TOGRAPHY
art}0
LOT 3RR
()CM -EC
47 -7 . 0 8' �

This map is prepared
from data used for the
}/, •
inventory of the real
property for tax
! f
purposes. Primary
information sources such
as recorded deeds, plats,
�-^'
wills, and other primary
Flu f.
public records should be
__
t .yL, y i,
consulted for verification
of the information
contained in this map.
921 W Kitty Hawk RD
Kitty Hawk NC, 27949
Parcel: 017959000
Pin: 987505089609
Owners: Cam Jan Llc -Primary Owner
Building Value: $1,049,000
Land Value: $479,400
Misc Value: $30,900
Total Value: $1,559,300
Tax District: Kitty Hawk
Subdivision: Subdivision - None
Lot BLK-Sec: Lot: Lot 1rr Blk: Sec:
Property Use: Multi -use
Building Type: Prefab Warehouse
Year Built: 2004
r
!Ill rl r N, J ' .
017959-000 08-987505 040 03/11

IMPOPT.-IM-1