86399A - Haber, George & Sherri

DREDGE & FILL
CAM `�► Previous permit _ .__....._
Led
`- " PERMIT Date previous permitlSSL
GENERAL____.-._._._—•---
' i Complete Reissue ;pal tint Reissue
"�New
Modification , irsuantto
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ( 15
Mailing Address: / 2
Phone Number:
Email Address:
61
1 certify that I have authorized 1- ,4-2-02
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: %-)e�)4--d
at my property located at Z f� f;L' C-k 1'j uZ-pI /L
in fk), >A'e'� - County.
I furthermore certify that 1 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:
Signature
Print or Type Name
MAR [ 9 2022
Title
DCM-EC
Date
This certification is valid through l I

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 George and Sherri Haber
Address of Property 126 Duck Woods Dr. Southern Shores
Marling Address of Owner 126 Duck Woods Ear Southern Shores. NC 27949
Owner s email habergd@outlook corn
Agent s Name
Agents Email
Owner s Phone# [phone]
Emanuelson and Dad .._._._ Agent Phone# [phone]
emanuelson6705@a outlook corn
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Ownerz
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
i DO NOT have objections to 'his pinix-sal _ = 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 t 5' from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetments it' you wash to waive the setback you must sign
the appropriate blank below 1
i DO wish to waive someiall o? the 15 setbacK
Srgr?at€ire of A `anent Riparian Properly Owner
-OR-
I do not wish to waive the ; 5' setback recitorement onstial the blank i
Signature of Adjacent Riparian Property Owner
TypedfPrinted name of ARPO 62 _._. ........
Mailing Address of ARPO:
ARPO's email: ` = fir .. , r# rfr,l � Es �^ ARPO's Phone#: -7 7 iC
Date _�-`% -` "waiver is valid for up to one year from ARPO's Signature"
a,..= n
Offi,..�
l U N 0 1 2022
`-a I
Revised July 2021

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 _George and Sherri Haber
Address of Property 126 Duck Woods Dr, Southern Shores
Mailing Address of Owner 126 Duck Woods Dr. Southern Shores, NC 27949
Owners email ha bergd@outlook, corn
Agent's Name Emanuelson and Dad
OwnersPhone# 252,256-2197
Agent Phone# [phone]
Agent's Email emanuelson67051,_aoutlook corn
.......... .... .... ...
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
'Bottom Portion to be completed bytheAdjacent Property Owner)
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 drawingwith dimensions must be provided with this letter
;1) — I DO NOT have objections to this proposal __ I DO have objections to this proposal
ivyou —have ---objections to W-1-h-lat' is being proposed, you must notify the N.C. Division of Coastal
Management (DC* 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 rnoor4)g 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 revelments) (if YOU wish to waive the setback, you must si_qn
the appropriate blank below
VED
I DO wish to waive some,,all of the 15'setback
-OR- Sirfr,ahirp of Adjacent Rioartan Property Owner J U N 0 7 2022
I do not wish to wave the 15: setback requiretrient (initial the blank) Jflil-,
Signature na-re
"I Adjacent Riparian Property Owner -� f ,
I ,� w ,
Typed/Printed name of ARPO:
Mailing Address of ARPO,
ARPO's email: ARPO's Phone*
"?M-EC
Date: waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

}yr:.
This map is prepared
from data used for the
inventory of the real
property for tax
purposes. Primary
`� +: information sources such
as recorded deeds, plats,
a— wills, and other primary
public records should be
consulted for verification
of the information
contained in this map.
126 Duck Woods DR
Southern Shores NC, 27949
Parcel: 022357010
Pin: 986710469109
Owners: Haber, George D -Primary
Owner
Haber, Sherri L -Primary Owner
Building Value: $484,600
Land Value: $156,100
Misc Value: $18,000
Total Value: $658,700
Tax District: Southern Shores
Subdivision: So/sh Blk 227-b
Lot BLK-Sec: Lot: 8 Blk: 227b Sec:
Property Use: Residential
Building Type: Traditional
Year Built: 2020