New ISPs getting of the ground without IPv4?

[nanog-isp () mail com]

Surprisingly enough demand for Internet services did not end when we ran out of IPv4. I'd like to hear from the guys 
and gals starting new ISPs how they are facing this brave new world. 

Is it NATs all the way down?

Is IPv6 the knight in shining armor?

Are you getting enough IPs? If not, how are you coping? Buying/renting some, tunneling to somebody who has some, what?

It's all good and well hearing about how you should dual stack and reading about how established players handle IPv6 
and IPv4 exhaustion, but what do you do when dual stacking isn't an option and IPv6 only takes you so far? 

Now is your chance to shine and bring us some tales from the trenches :)

Jared