89925A - KMK Outer Banks LLC

et-Mty L�Ds,.AMA ❑ DREDGE & FILL N9 89925 A H C D
GENERAL PERMIT Date Previouspermit
Date previous permit issued
flew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the Stateyof North Carolina. Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC � �'7 L I5Lb (> ❑ Rules attached. General Permit Rules available at the following fink: wwwdeq nc gov/CAMAmles
Applicant Name IN M n 0
Address 57 IRC-Pe-5
City .QI l ellxo. , State f
Phone #(.1ay) SGs t+if2S
ocxn KS_ `Lc —
zip ans0 z.-
Affected ❑CW N.EW MRTA DES ❑PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PINS
ORW: yes no PNA: yeso
type of PrQJect/ Activity
/�A /?.S l3 sa+L+Fi; /o/x lg/ Pl'X c
Shoreline Leneth 2- 3 ✓r Oo r ' 670 ' rO FE
Access Length u
Pier (dock) length / l X rn
Fixed Platform(s)
/oy:19 /os�cf
flleeling PlaHorm(s)
�X rf 2s CM�M'Fi J<
Finger pler(s) ss
Total Platform area '3
Groin length/g
Bulkhead/Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards ^
Boat ramp _
Boathouse Boatlift
Beach Bulidoyz ■n�—
GtheFr 1k-.�1F7w
VaIIr
SAV observed: i yes 0 tic- P(P vh C
Moratorium: n/a yes no LrAE \
Site Photos: no \jI
Riparian Waiver Attached: es no
A building permit/zoning permit maybe required by:�
Permit Conditions ON L41 a S (. / PS _ A Ls'r
�'%^i OK'6
Sas.LdD
Authorized Agent 3) "-
Project Location (County): _
Street Address/State Road/Lot
LJt3WS.
City
oa
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Ad) Wm. Body h o n. t<, V C. S D Mn J (n�arJnan/unk)
Closest Mal. Wtr. Body e � cti. /i u !t4- -Y � st n. tJ �.
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FA O/A PIER NFAn).
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❑ 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 PROTECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) n0i
A CFC1czi� N
gent/or�/p�pliant PRINTED/N�Tfu/a,
Signature'• reaTcompliance statement on back of permit--
c1d t� / D Q,
Application feels) Check g/Money order

�`°"'4 *AMA EDGE & FILL
! GENERAL PERMIT
-New ❑Modification ❑ Complete Reissue ❑Partial Reissue
N° 89925
Previous permit
Date previous permit issued
(A 1 B C D
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:
I SA NCAC � 1IsZ �1 ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name k U.-`I +Z-r W` kS f LLL Authorized Agent D b w f-A' 9-, k
Address
//// 7 VKC-P eis T�c�il Project Location (County): o-ri-
City ,6."'ll /Yjtia� State J ZIP 03'-5 f' ;2- Street Address/State Road/Lot#(s) Lo l 2—
Phone #( &IS1 g25 O N c3 4, s f P aS'cv...1 o L 5 E 89 Y ta
Email I M cLW 1 ¢ A t Q r Subdivision /L 0'- C.CC,
f city IF pOZIP Z� C/ oy /
Affected ❑CW �.EW ®.PTA ❑ES ❑PTS Adj. Wtr. Body ^ %6-A.e hLe-- '.S%b.Ad innaa nan/unk)
AEC(s): ❑OEA ❑IHA W ❑SPIMA ❑PWS Closest Maj. Wtr. Body
ORW: ye no PNA:yes o
Type of Project/ Activity
Ile ,( / '?, S R
Access Length
Pier (dock) length / 7 ® X rc
Fixed Platform(s) ' Y
lo7c1Rf /m 711'
Meabn Platform(s)
Jiff 1
'f``iS k
Finger pier(s)
Total Platform area 3 51 s ac t rl D
Groin length/q
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill —
Max distance/ length
Basin, channel Cubic yards ^
Boat ramp
Boathouse Boatlift
Beach Bulldozin
Otheo-'A.4 i - /5,Ci 4-
t 8 1/r
SAVobserved: yes no fi0 P(bP
ii
Moratorium:
L
J v
Moratorium: n/a yes no r raE
Site Photos: no
Riparian Waiver Attached: es no
A building permit/zoning permit may be required by:
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Permit Conditions
Agent or Applicant PAINTED Name
h-
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❑ TAWPAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
A( `. 4Vt
PRINTED Name
(Please Initial) 0<
v Signature **Please read compliance statement on back of permit** Sigy2ture�
6l6r� / D (9 7 /�`�/2-3
Application Feels) Check q/Money Order Issui il�g a� Expiration Date

vdcomr"N❑CAMA ❑ DREDGE & FILL D(L N4 89925 A t B C D
GENERAL PERMIT Previous permit
Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State (rof North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
S rr",.D C�
I SA NCAC � ❑ ,Rules attached. � General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name X (VP K// () al. `I, t- `i3 .,n, %t. S 1 <... L. (.
Address r.t Ae Pit -, 6.n n e
City /f G��:. I 1 ;1'(.<.:>. •�. State rr�'j ..) zip
Phone # (Y) 8(
Email rYl rt A,-4 I /I ,1 i � cy /11 (• 1 r C "+ -t
Authorized Agent *r, <1 _0 ?. C
Project Location (County): _1T.) ,,/"4
Street Address/State Road/Lot #(s) /.. c7 L`,
A) ( 4k. U Y­ 5 Fr
Subdivision �... <l..(t C...;., �
city 4._ U, 11 c_ >. zip 7 ' /
Affected ❑CW MEW ®PTA DES ❑PTS Adj. Wtr. Body (nat%fnan/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
i
ORW: yes/no PNA: yes/po
Type of Project/ Activity
%n c7 O r 'r-i> C r- 0 6 /
��aa uArLr c t OAS V
* .dic,rr
(Scale: a7-_.s )
il,ci �n Ism pm llc./10
Access Length
-
Pier (dock) length / '/ ? Y,
I
Fixed Platform(s) o `/
Floating Platform(s)--
1-
-
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Ni-
—�
,
Fingerpier(s)
-
I-
sl.,n.
N
Total Platform area 9 '- ;,
Groin length/p
Bulkhead/ Ri ra length
-
---.
-�--
-
Avg distance offshore
Breakwater/Sill
-
Max distance/ length
Basin, channel
T
i
Cubic
-
yards.
Boat ramp
- J
(x
7
_
A'k
,
z
• 11
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Boathouse/ Boatlift
Beach Bulldozing "'.' __
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SAV observed: es no ' `iL
Y
Moratorium:n/a yes no
{ls..<-(__
Site Photos: .yes no
Riparian Waiver Attached: ;yes `; no
A building permit/zoning permit may be required by:
Permit Conditions Q01J 1.- `I " 1 i_ J P 5 0 LA 'I i I
❑ TARtPAM/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.
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
(Please Initial) x_
Signature -*Please read compliance statement on back of permit**
/
Application Feels) Check q/Money Order
Signature
Issuing bate Expiration Date

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CAMA GENERAL PERMIT SITE PLAN
KMK CUTER BANKS LLC
j LOT 2 / CAROLINA CAYS
WANCHESE - DARE COUNTY - NORTH CAROLINA
5 200 300 ATLANT/C £NU/h'ONM -N17 CONSULTANTS, LLC
GRAPHIC SCALE 1"= 100' P, 0. BOX 3266, K/TTY H4�YK, N. C. 27949
[phone], e-moi/ dot1gdoec&0g1no1/. com
DATE: 06/28/23 REVISED FILE: CAROLINA CAYS DRAWN BY: DAD

DocuSign Envelope ID: 92BC7200-t0E0-487F-e757-1740DE096EA7
AUTHORIZATION TO ACT AS REPRESENTATIVE FORM
Property Legal Description:
DEED BOOK: 2684 PAGE NO: 45
STREET ADRESS: l:ot 2. Carolina Cans. 0 NC 345. Wanehese, NC27981
Please Print:
Property Owner: KMK Outer Banks LLC:
Property Owner:
The undersigned property owners of the above noted property. so hereby authorize
Doug Dorman of" Atlantic Environmental Consultants. LI C to,
(Contractor/Agent) (Name of consulting firm)
Act (in my behalf and take all actions necessary for the processing, issuance and
adeeptance of permits and/or certifications and anti all standard and special
conditions attached.
2. Enter the property to obtain site information including inspections with regulatory
agencies (Dare County, North Carolina Department of Environmental Quality,
U.S. Army Corps of Engineers, etc.) for the purpose of obtaining permits and/or
certifications.
Property Owners Address (if different than property above):
5 McPherson Lane. Bell Mead. NJ 08502-4321
Property Owners Telephone Number: 609-865-0825
We hereby certify that the above information submitted in this application is true and
accurate to the best of our knowledge.
E
Docu919�ed b
y:
Member
tc64e�aoaseelignature and "i itle Authorized Signature and Title
Date: 6/12/2023
This certification is valid thru (date) 12/31/2023

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: KMK Outer Banks LLC
Address of Property: Lot 2, Carolina Cays, 0 NC 345, Wanchese, INC 27981
Mailing Address of Owner: 5 McPherson Lane, Bell Mead, NJ 08502-4321
Owner's email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Doug Dorman Agent Phone#: [phone]
Agent's Email: [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 forthis
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.
645- 1 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 943 Washington Square Mail, Washington, NC 27889. 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
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: OBX Land Partners, LLC
Mailing Address of ARPO: 120 Greenwich Road, Charlotte, NG 28211
ARPO's email: art.secor@lwlandmail .comARPO's Phone#: [phone]
Date: 06/23/24
*waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

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Carver, Yvonne
From: Doug Dorman <[e-mail]>
Sent: Wednesday, June 28, 2023 3:27 PM
To: Carver, Yvonne
Subject: Re: [External] Lot 2, Carolina Cays GP
Attachments: Carolina Cays Lot 2 GP 100' Scale.pdf, Carolina Cays Lot 2 GP 20' Scale.pdf
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Yvonne,
Here is an 11x17 @ 100' scale that shows the entire parcel and the other drawing with revised piling dimensions @ 20'
scale.
Looking for water depths of 5.5' for the larger boat. Water depths @ 120' are - S' and @150' its —6' so I went to 140'.
Boat lift dimensions are:
4 pilings @ 12' x 14' on southside with 2 additional tie pilings.
8 pilings @ 17.5'x 16' on northside for larger lift. Each corner of the lift has 2 pilings 4' apart.
The revised drawings show these dimensions.
Doug Dorman
Atlantic Environmental Consultants, LLC
PO Box 3266
Kitty Hawk, NC 27949
252-261-7707 office
252-599-2603 cell

ATLANTIC ENVIRONMENTAL CONSULTANTS, LLC
PO Box 3266, Kitty Hawk, NC 27949
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
June 23, 20232
North Carolina State
C/O State Property Office
1321 Mail Service Center
Raleigh, NC 27699
To whom it may concern,
KMK Outer Banks LLC is applying for a CAMA General Permit to construct a 6'x
200'(maximum) pier with a 10' x 18' platform, 4'x30' finger pier, 4'xl0' kayak platform and
two boat lift/slips. The project is located on Parcel 2 of Carolina Cays Subdivision adjacent to
the Roanoke Sound in Wanchese, Dare County, North Carolina.
As the adjacent riparian property owner to the aforementioned project, I am required to notify
you of the development in order to give you the opportunity to comment on the project.
Please review the attached drawings and should you have any objections or comments
concerning this project, please send your written comments to Ron Renaldi, District Manager,
Elizabeth City Regional Office, 401 South Griffin Street, Suite 300, Elizabeth City, NC 27909,
or call 252-264-3901 within 10 days of your receipt of this notice. Such Comments will be
considered by the Department in reaching a final decision on the application. No comments
within 10 days of your receipt of this notice will be considered as no objection. If you have any
questions on this project please call me at 252-599-2603, or e-mail me at dou [e-mail].
Sincerely,
Doug Dorman
Atlantic Environmental Consultants, LLC
Cell: [phone] Office: [phone] Email: dougdaec@gmaiLcom

ATLANTIC ENVRONME.NTAL CONSULTANTS, LLC
PO Box 3266, Kitty Hawk, NC 27949
CERTHZIED MAIL
RETURN RECEIPT REQUESTED
May 16, 2023
North Carolina State
C/O State Property Office
1321 Mail Service Center
Raleigh, NC 27699
To whom it may concern,
KMK Outer Banks LLC are applying for a CAMA General. Permit to construct a 6'x
200'(maximum) pier with a 10' x 16' platform, 4'x12' kayak platform and two boat lift/slips.
The project is located on Parcel 2 of Carolina Cays Subdivision adjacent to the Roanoke Sound
in Wanchese, Dare County, North Carolina.
As the adjacent riparian property owner to the aforementioned project, I am required to notify
you of the development in order to give you the opportunity to comment on the project.
Please review the attached drawings and should you have any objections or comments
concerning this project, please send your written comments to Ron Renaldi, District Manager,
Elizabeth City Regional Office, 401 South Griffin Street, Suite 300, Elizabeth City, NC 27909,
or call 252-264-3901 within 10 days of your receipt of this notice. Such Comments will be
considered by the Department in reaching a final decision on the application. No comments
within 10 days of your receipt of this notice will be considered as no objection. If you have any
questions on this project please call me at 252-599-2603, or e-mail me at [e-mail].
Sincerely,
Doug Dorman
Atlantic Environmental Consultants, LLC
_Coll:__ 52) 599-2603 Office: [phone] Email: [e-mail]

Carver, Yvonne
From:
Sent:
To:
Subject:
Attachments:
Good morning Doug.
Carver, Yvonne
Friday, July 14, 2023 8:18 AM
Doug Dorman
KMK OUTER BANKS GP
KMK OUTER BANKS LLC GP89925 & RECEIPT.pdf
A copy of general permit (GP) number 89925 issued for KMK's docking facility at Lot 2 Carolina Cays
is attached for your review and signature.
To validate this permit, please address the following:
print and sign the permit on the bottom left-hand corner below your printed name,
initial where indicated on the bottom right of the permit, and
scan and send a signed copy of the GP back to me.
No work can be initiated until after we receive the signed copy. If you have any questions regarding
this correspondence, please don't hesitate to contact me.
Best regards,
Va MW
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-264-3901, ext. 237
Please note that my email address has changed to: yvonne.carver(a)deo.nc.gov
401 S. Griffin St., Ste 300
Elizabeth City, NC 27909

Carver, Yvonne
From: Carver, Yvonne
Sent: Wednesday, June 28, 2023 3:23 PM
To: Walton, Tim
Subject: Adjacent riparian notifications from
Attachments: KMK Outer Banks LLC NC ARPON .pdf; Maddineni Lot 2 Pier GP.pdf
Good afternoon Mr. Walton.
Property owner, KMK Outer Banks LLC, contracted with consultant Doug Dorman, of Atlantic
Environmental Consultants, to obtain a general permit for a docking facility at one of the 'islands' off
INC 345 in the tax district of Wanchese, Dare County. Doug sent the attached drawing and adjacent
riparian notifications to the State Property Office in Raleigh at the 132 Mail Service Center, but
neglected to put to your attention. Doug noted he has not received a signed green card as
verification of the receipt of the notification(s).
Would it be possible for you to confirm receipt of these notifications and that you have no objections?
Best regards,
*wnne
Yvonne B. Carver
Environmental Specialist II
Division of Coastal Management
NC Department of Environmental Quality
252-264-3901, ext. 237
Please note that my email address has changed to: yvonne.carver(aa deq.nc.gov
401 S. Griffin St., Ste 300
Elizabeth City, INC 27909
4!5; E C
tN�Vvi etnifntirur�n,m,etpi Quaiily
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.

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