OI_16-20_Hagerman

Oak Island 0116-20
Local Government Permit Number
CAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environmental,
Quality and the Coastal Resources Commission for development
In an area of environment concern pursuant to section 113A-113 of the
General Statutes, "Coastal Area Managemenr
Issued to Kathleen Hagerman, authorizing development in the Ocean Hazard (AEC) at 6705 W. Beach Dr., in Oak
Island, as requested in the permittee's application, dated 2/26/2016. This permit, issued on 3/23/2016, is subject to
compliance with the application and site drawing (where consistent with the permit), all applicable regulations and
special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment
or civil action, or may cause the permit to be null and void.
This permit authorizes: the placement of beach compatible sand on the Oceanside of the home at the escarpment, 5' in height for
60' toward the ocean only.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 2/E612016.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any charge or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit
(4) A copy of this permit shall be posted or available on site. Contact this office at [phone] for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the penmillee or other qualified persons
within twenty (20) days or the issuing dale. This permit must be on the project
site and accessible to the permit officer when the project Is inspected for
compliance. Any maintenance work or project modification not covered under
this permit, require further written permit approval. All work most cease when ins
permit expires on: _.
DECEMBER 31, 2019
In issuing this pemdt it is agreed that this paper is consistent Win the local Land
Use Plan and air applfcabte ordinances This permit may not he transferred to
another party without the written approval of the Division of Coastal
Management.
l 0 1 w:[ (-1
Donna F. Coleman
CAMA LOCAL PERMIT OFFICIAL
4601 E. Oak Island Dr.
Oak Island, NC 28465
S,,�I.t�,i rz,Z PD•A f)r Vaih(Ce✓)
PERMITTEE Hogs TAan
(Signature required if conditions "ee apply to pemlqrD
DCM WILMINGTON, NC
APR 2 8 2016

Name: Hagerman
Minor Permit # 0116-
Date: 312312016
Page 2
(5) In order to minimize adverse impacts to nesting sea turtles, no work shall occur within the period of May 1 through
November 15 of any year, without prior approval of the Division of Coastal Management, in coordination with the
North Carolina Wildlife Resources Commission and US Fish and Wildlife Service.
(6) Earth moving equipment must be brought onto the beach at an authorized location, not across existing dunes/berm
or unauthorized private property.
(7) The activity must rat exceed the lateral bounds of the permittee's property unless he has permission from the
adjoining landowners.
(8) Sand used shall be of the same general characteristics as the sand in the area in which the material's to be placed.
In order to ensure compliance with this requirement, the permittee shall coordinate the location of the sand borrow
source with a representative of the Division of Coastal Management prior to the initiation of any sand placement.
(9) The conbactor must submit analysis for sediment compatibility prior to any land disturbing activity.
(10)AII unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetatatively stabilized (planted and
mulched) within 14 days of construction completion.
(11)This permit does not authorize any fill seaward of the previous dune restoration and newly planted sea oats.
PO R.fur Ila�l�ltevh I��vmaj'�
SIGNATURE: t� hrL ` ' DATE: �, q./Zt7tm
PERMITTEE
RECEIVED
DCM WILMINGTM NC
APR 2 8 2016

Locale). Oak.- ZSidfla PermitNumber 01
Ocean Hazard Estuarine Shoreline,_ ORW Shoreline _Public Trust Shoreline_ Other,
(For official use mall,)
GENERAL INFORMA770N
LAND OWNER RECEIVED
Name }i Mr- Yrn&o
Address 253LF LDnQ 00.�t Dv -
State _ Zip I (i Phone M//vc
Email AFLQV- 1DA 6L 6) NOTVYwL (nm
AUTHORIZED AGENT
Name Arit41o,-N()UXbG (DftMYitLtr PpA
Addren2-53Lt Lolut))oat Dr,
City i-ytd` lts State -�Zip.3u )A Phone ZN 2 j'- I1)g3
` Email kFLDKIDA6KL_C 140TIYlAI1 (. ro
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacemwaterbody.) U-ID5 W l3etsCH P2 PAV— ISLAOD tJC.
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) Fill 6 •Fehr t
oce_lnkn side of SITui_iuxe otn j fill ''Wzrtytne,l+.
SIZE OF LOT/PARCEL: square feet acres
PROPOSED USE: Residential EJ' (Single-family Elf Multi -family Q ) Commercial/Industrial 0 Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contoctyour Local Permit Officer ijyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: _ square feet (includes the area of the roof/drip line of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT. Is the project located in an area subject to a State Stormwater
Management Permit issued by the NC Division of Water Quality?
YES NO_
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.
DECEIVED
M WILMINGTON,
MAR 1 0 2016

OTHER PERMITS MAYBE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, insulation and Energy Conservation, FIA
Certification, Sand Dune,Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can he
described as: (check one)-p.,
an owner or record title, Title is vested in tJ ��hS �.-.t ( C-AL , see Deed Book i 5�
page 1l'J.iin the 1?3Cuvi5!,K4. County Registry of Deeds.
_an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that 1 have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) �� it _D001 A 0%S5 �a� 1 l meant (Jc.�l sdttli<
(2)
(3)
(4)
ACKNOWLEDGEMENTS: ,..
1, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which ;<
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer bas explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques. ;-
;x
I furthermore certify that I am authorized to grant, and do in fact grant, permission to Division of Coastal Management sta
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating mformatio
related to this permit application.
This the _1 ;1 _ day of_f, 20 1,-).
authonz�ae asto t asto t his/her agent for purpose of film a CAMA permit application
This application includes: general inforn ation (this form), a site drawing as described on the back of this application. t
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to the looaltry, and
any infoa'gwtion as nary be provided orally by the applicant. The details of the application as described by these souroes are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violarion of
any permit Any person developing in an AEC without permit is subject to civil, criminal and administrative action,;
NC
1 o 2016

Project Is In An:
Property Owner:
AEC HAZARD NOTICE
Ocean Erodible Area ✓ High Hazard Flood Area
Property Address: _tD 7t) t W Eitno4 IcJfL
Date Lot Was Platted: J LuNP 12to3
This notice is intended to make you, the applicant, aware of the
special risks and conditions associated with development in this
area, which is subject to natural hazards such as storms, erosion
and currents. The rules of the Coastal Resources Commission
require that you receive an AEC Hazard Notice and acknowledge
that notice in writing before a permit for development can be
issued.
The Commission's rules on building standards, oceanfront
setbacks and dune alterations are designed to minimize, but not
eliminate, property loss from hazards. By granting permits, the
Coastal Resources Commission does not guarantee the safety of
the development and assumes no liability for future damage to
the development. Permits issued in the Ocean Hazard Area of
Environmental Concern include the condition that structures be
relocated or dismantled if they become imminently threatened by
changes in shoreline configuration. The structure(s) must be
relocated or dismantled within two (2) years of becoming
imminently threatened, and in any case upon its collapse or
subsidence.
The best available information, as accepted by the Coastal
Resources Commission, indicates that the annual long-term
average ocean erosion rate for the area where your property is
located is a feet per year.
The rate was established by careful analysis of aerial photographs
of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as much as
�M,Sfeet landward in a major storm.
The flood waters in a major storm are predicted to be about
16feet deep in this area.
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads, seawalls, revetments, groins, jetties
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and requirements
by signing this notice in the space below. Without the proper
signature, the application wil I not be complete.
Apple t Signt t�— Date
Inlet Hazard Area
SPECIAL NOTE: This hazard notice is required for development
in areas subject to sudden and massive storms and erosion. Permits
issued for development in this area expire on December 31 of the
third year following the year in which the permit was issued.
Shortly before work begins on the project site, the Local Permit
Officer must be contacted to determine the vegetation line and
setback distance at your site. If the property has seen little change
since the time of permit issuance, and the proposed development
can still meet the setback requirement, the LPO will inform you
that you may begin work. Substantial progress on the project
must be made within 60 days of this setback determination, or
the setback must be remeasured. Also, the occurrence of a major
shoreline change as the result ofa storm within the 60-day period
will necessitate remeasurement of the setback. It is important
that you check with the LPO before the permit expires for official
approval to continue the work after the permit has expired.
Generally, if foundation pilings have been placed and substantial
progress is continuing, permit renewal can be authorized. It is
unlawful to continue work after permit expiration.
For more information, contact:
1Lo1•sMA (2gDIC("an
Local Permit Officer
4('01 E, Oak.. Ts'6\d 7DIz
Address
oak. �"slarNd, 1-� C'_ 2SLIt05
Locality
(910) Q01 80 49
Phone Number
dco(e.tN-,an@ Ci. 0ak_'ISL4nd. nc. us
RECEIVED
DCM WILMINGTON, NC
MAR 1 0 2016
Revised

PLAT OF SURVEY FOR
ANGELA NOURSE
6705 WEST BEACH DRIVE
LOT 3, BLOCK 139, KINGS LYNN
SMITHVILLE TOWNSHIP, BRUNSWICK COUNTY
OAK ISLAND, NORTH CAROLINA
0' 30, 60' 90,
WEST BEACH DRIVE
NOTES:
THE PROPERTY SHOWN HEREON IS LOCATED
IN A FLOOD HAZARD ZONE 'VE BASE ELEVATION
DETERMINED VARIES. REF., FJLR.M. COMMUNITY
NUMBER 370523, PANEL 2036, SUFFIX 'J'
DATED 6/2/06.
THIS PROPERTY IS LOCATED IN OAK ISLAND
ZONE R-7.
SETBACKS: FRONT 15', REAR 20, SIDES 8'.
THE STATIC VEGETATION LINE SHOWN HEREON
WAS FLAGGED BY CAMA AND FLAGS LOCATED
ON JANUARY 29, 2016.
IMPERVIOUS AREA CALCULATIONS:
TOTAL AREA WITHIN LOT = 7500.0 SO.FT.
USABLE AREA (301Q = 2250.0 SO.FT.
HOUSE = 1107.8 SOFT.
GRAVEL DRIVE - 273.8 SOFT.
TOTAL IMPERVIOUS = 1381.6 SOFT.
60' R/W
c _ EDGE GF PAVEMENT_
o S 80'06'00' E
GRAVEL 0.00,
EBB • `DRIVE' SCO
El P NRB —
'VE' 17'
'VE' 18'
TOP OF
BOTTOM OF !
LOT 4
EXCEPT AS SPECIFICALLY STATED OR SHOWN
ON THIS PLAT, THIS SURVEY DOES NOT PURPORT
TO REFLECT ANY OF THE FOLLOWING WHICH MAY
BE APPLICABLE TO THE SUBJECT REAL ESTATE:
EASEMENTS, OTHER THAN POS98LE EASEMENTS
THAT WERE VISIBLE AT THE TIME OF MAKING
OF THIS SURVEY; BUILDING SETBACK LINES;
RESTRICTIVE COVENANTS: SADIVISION RESTRICT—
IONS: ZONING OR OTHER LAND USE REGULATIONS
AND ANY OTHER FACTS THAT AN ACCURATE AND
CURRENT TITLE SEARCH MAY DISCLOSE.
2
ON
STATIC LINE
AS FOUND
STAKED 1/29/16
e.sr:., ,�. iB•
,x z Irn "VE" 20'
n
TO P.I.
u '
LOT 2
7500.LOT
Sq Feet 4 = RE
0.2 Acree DOM Wr w pvc' !`t
0
MAR
N 80'06'00' W
THE LOCATIONS OF UNDERGROUND UTILITIES
AS SHOWN HEREON ARE BASED ON ABOVE—
DRAVANGS
ATLANTIC OCEAN PROVIDED THND E SURVEYOR. AND LOCATIONS O
UNDERGROUND UTIUTIES/STRUCTURES MAY
VARY FROM LOCATIONS SHOWN HEREON,
ADDITIONAL BURIED UTILITIES/STRUCTURES
MAY BE ENCOUNTERED. NO EXCAVATIONS
WERE MADE DURING THE PROGRESS OF THIS
SURVEY TO LOCATE BURIED UTILITIES/
STRUCTURES.

EXISTING HOUSE 550
T9p
. . . . . . . . . . . i
BERM AREA
4-5' AVERAGE HEIGHT THROUGHOUT BERM
NOURSE RESIDENCE
G706 WEST BEACH DR
OAK ISLAND NC
1"=10' �2/18/2016
by B51.'�

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Mailing Address
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City, State, Zip Code
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---------------
t7iy,'8mie;
This letter is to inform you that I, i� "N R e ( have applied for a CAMA Minor
P operty Owner
Permit on my property at (r�1 v-� {� 7 r • Ok �inl Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at I S°— t oT 3 —or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincerely,
Property Owner
fir' RECEIVED
DCM WILMINGTON, NC
Mailing Address
MAR 1 02016
City, State, Zip Code l�

Domeru
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\�`fJ�-E �--� � �n��l,'C i./c yf� } p Poem easaav°ne.aKrae o.awrS ` `•elf ,1
Adjacent Property wnegr
MTO J Postage aM Feaa
Mailing Address p — k
Sent ToAir
City, State, Zip Code �dApt. �., y,oao=Fa
t
`Y= -- -
Dear Adjacent Property:
This letter is to inform you that I, ave applied for a CAMA Minor
roperty Owner
Permit on my property at 7 o S 1-0 11-1-`� ( {� �i- o y0 in Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at _ 3q - -), I L o - t 1�4 3 or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr,
Oak Island, INC 28465
Sincerely,
Property Owner
to .1- 31 t ,
Mailing Address
O a4t- .p 0(-- D-W tes" r; E C E I V E D
City, State, Zip Code
DCM WILMINGTON, NC
MAR 1 02016

Al t VRNEYS AT LAW
9115 COHSEA DR FONrANA WAY. SUITE 100
NAPLES. FLORIDA 34109
TFum4mE [phone]
FACSIMILE [phone]
M"V (WU NW COM
E-MAI L: ahil fi UrCtgarlaw.com
June 12, 2015
To Whom It May Concern:
We are the attorneys for Kathleen S. Hagerman. We have prepared for her a
Durable General Power of Attorney and Health Care Surrogate Designation. Both of
these documents authorize her daughters, Angela Nourse and Jennifer R. Spangler,
severally (meaning either one can act on her own) to conduct any transaction on behalf of
Kathleen S. Hagerman including medical insurance claims, business matters, consents to
medical procedures, etc.
Pursuant to the United States Constitution, these documents are entitled to
recognition in any state of the United States pursuant to the Full Faith and Credit Clause
of the United States Constitution. In addition, pursuant to Florida law, third parties who
improperly reject a duly authorized act of an attorney -in -fact serving under a valid Power
of Attorney may be liable for damages including reasonable attorneys' fees and costs for
refusing to accept the acts of the attorney -in -fact.
AFH:mrf
Very truly yours,
GARLICK, HILFIKER & SWIFT, LLP
;7
Alan F. Hilfiker
RECEIVED
DCM WILMINGTON, NC
MAR 1 0 2016

CEiMINCAi ION
ALAN F. HILI'MER, an Attcrosy-at-Law
duly licensed to practice in the State
of Florida, do hemby cerft tinct ihls
domraent hvAnu bom compared by met®
the onglnal, is a true and complete copy
therofL�/-7 A `e
ALAN F. HIVIKFR/
Copy
Original Filed in Office of
Garlick, Hilfiker & Swift, LLP
Attorney -at -Law
9115 Corsea del Fontana Way, Suite 100
Naples, Florida 34109
239-597-7088
DURABLE GENERAL POWER OFATTORNEY
�y DURABLE GENERAL POWER OF ATTORNEY made thisi day of
r r 1(iG 2013.
I, KATHLEEN S. HAGERMAN, revoke all other Powers of Attorney
previously made by me before the date hereof and instead hereby appoint my daughters,
ANGELA NOURSE and JENNIFER R. SPANGLER, my lawful attorneys -in -fact, to act
SEPARATELY (SEVERALLY) (MEANING EITHER ONE MAY ACT ALONE WITHOUT THE
CONSENT OR PARTICIPATION OF THE OTHER), with a general power of attorney to do all
acts whatsoever for me and on my behalf with the same effect as though I had done them
myself, including without limitation, the following:
1. To manage any and all of my property wherever located, real or personal
(including my interest in any property jointly owned, including, without limitation, a
tenancy -in -common, a joint tenancy with right of survivorship or a tenancy by the
entireties, or over which I have or may have a power of appointment, and including
homestead property) as though the absolute owner thereof, including the power to lease
the same for any term with or without options to renew, to make ordinary or
extraordinary repairs or alterations to buildings, to borrow on the security of such
property, to insure or not to insure it, to pay or not to pay taxes and maintenance charges
thereon, and to do or not to do any other act in connection therewith;
2. To buy, sell, convey, exchange, mortgage, lease, maintain or otherwise
dispose of any such property as in the sole discretion of my attorney -in -fact seems best at _
public or private sale, wholly or partly for cash or on credit or for any other consideration
NC
MAR 1 0 2016

whatsoever, and to execute any and all documents necessary to effectuate a sale,
mortgage or lease, including but not limited to contracts, closing statements, affidavits,
leases, bills of sale, deeds, notes, mortgages and such other instruments required to carry
out the within purposes, and to retain or abandon any such property if deemed to be of
little or no value;
3. To withdraw funds from any bank account, brokerage account or other cash
account in my name alone or jointly with any other person, to enter any safe deposit box
in my name alone or jointly with others and to remove any or all of the contents thereof,
and no lessor of such box shall be liable for damages by reason of such delivery to my
said attorney -in -fact, including the authority to conduct all banking transactions as
provided by section 709.2209(i), Florida Statutes, as follows:
(a) Establish, continue, modify, or terminate an account or other
banking arrangement with a financial institution;
(b) Contract for services available from a financial institution, including
renting a safe-deposit box or space in a vault;
(c) Withdraw, by check, order, electronic funds transfer, or otherwise,
money or property of mine deposited with or left in the custody of a
financial institution;
(d) Receive statements of account, vouchers, notices, and similar
documents from a financial institution and act with respect to them;
(e) Purchase cashier's checks, official checks, counter checks, bank
drafts, money orders, and similar instruments;
(f) Endorse and negotiate my checks, cashier's checks, official checks,
drafts, and other negotiable paper or payable to me or my order,
transfer money, receive the cash or other proceeds of those
transactions, and accept a draft drawn by a person upon me and pay
it when due;
(9) Apply for, receive, and use debit cards, electronic transaction
authorizations, and traveler's checks from a financial institution;
MPM
RECEIVED
DCM WILMINGTON, NC
MAR 1 0 2016

(h) Use, charge, or draw upon any line of credit, credit card, or other
credit established by me with a financial institution; and
(i) Consent to an extension of time of payment with respect to
commercial paper or a financial transaction with a financial
institution.
4. To buy, sell, transfer or retain any security held in my name or for my
account, to exercise or sell any option and any conversion, subscription, voting or other
right pertaining to any such property and to grunt proxies, discretionary or otherwise, in
respect thereof, including the authority to conduct investment transactions as provided in
section 709.2208(2), Florida Statutes as follows:
(a) Buy, sell, and exchange investment instruments;
(b) Establish, continue, modify, or terminate an account with respect to
investment instruments;
(c) Pledge investment instruments as security to borrow, pay, renew, or
extend the time of payment of a debt of mine;
(d) Receive certificates and other evidences of ownership with respect to
investment instruments;
(e) Exercise voting rights with respect to investment instruments in
person or proxy, enter into voting trusts, and consent to limitations
on the right to vote; and
(f} Sell commodity futures contracts and call and put options on stocks
and stock indexes.
For purposes of this subsection, "investment instruments" means
stocks, bonds, mutual funds, and all 'other types of securities and financial
instruments, whether held directly, indirectly, or in any other manner,
including, but not limited to, shares or interests in a private investment
fund, including, but not limited to, a private investment fund organized as a
limited partnership, a limited liability company, a statutory or common law
business trust, a statutory trust, or a real estate investment trust, a joint
venture, or any other general or limited partnership; derivatives or other
-3- RECEIVED
DCM Wit.MINGTON, NC
MAR 1 0 2016

interests of any nature in securities such as options, options on futures, and
variable forward contracts; mutual finds; common trust funds; money
market funds; hedge funds; private equity or venture capital funds;
insurance contracts; and other entities or vehicles investing in securities or
interests in securities whether registered or otherwise, except commodity
futures contracts and call and put options on stocks and stock indexes.
5. To consent to and participate in any plan of reorganization, consolidation,
merger, combination, recapitalization, any contract, lease, mortgage, purchase, sale or
other action by any corporation;
6. To pursue, settle, compromise, arbitrate or abandon any claim in favor of or
against me;
7. To purchase for me and in my name U. S. Treasury bills, notes, certificates
of indebtedness and bonds which may be used or redeemed in payment of income, estate
or gift taxes;
S. To make and file any tax return, as my attorney -in -fact may elect pursuant
to any federal, state, county or other governmental laws, ordinances or regulations,
including without limitation income taxes, gift taxes; real property taxes, state, county,
municipality and school taxes; to make any election in connection therewith and to pay
any and all sums which may be due to any governmental entity for any such taxes;
9. To transfer any asset or property (real or personal) or interest therein,
standing in my name to the Trustee or successor Trustee of any revocable trust which I or
my attorney -in -fact may have established for my benefit;
10. To perform any act or make any decision that I may make as Trustee of any
trust which I have created for my benefit as my agent without the necessity of becoming a
successor trustee of such trust;
11. To exercise all contractual or statutory rights or elections, including, but not
limited to, any right or election in any probate proceeding or similar proceeding to which
I am or may become entitled;
12. To exercise all of my rights and privileges that are granted to me under
federal and state law (including the HIPAA Privacy Rules) with respect to the
-4-
RECEIVED
DCM WILMINGTON, NC
MAR 1 0 2016

confidentiality, use and disclosure of my confidential medical information (sometimes
referred to as my "protected health information"), including the right to obtain copies of
my confidential medical information;
13. To engage in Medicaid estate planning for the purpose of achieving
eligibility for Medicaid benefits, including but not limited to: the creation, establishment
or amendment of trusts required for Medicaid planning purposes; the transfers of
properties (real and personal) held in trust; and the execution of any document required
by a financial or governmental institution for the purpose of completing application for
Medicaid benefits or consummating the property transfers described herein;
I DO authorize my attorney -in -fact to have the foregoing
power in this paragraph number 13
I DO NOT authorize my attorney -in -fact to have the foregoing
power in this paragraph number 13
K To buy, sell, convey, exchange, mortgage, lease or otherwise transfer any
property held in a Qualified Personal Residence Trust, Grantor Retained Income Trust, or
similar trust to which I have rights as grantor;
15. To make a disclaimer of some or all of any interest passing to me as a result
of the death of an individual (whether by Will, intestacy, trust agreement, beneficiary
designation or otherwise), even if the effect of such disclaimer is that the interest
disclaimed will pass to my attorney -in -fact or the spouse or issue of my attorney -in -fact;
YSA I DO authorize my attorney -in -fact to have the foregoing
power in this paragraph number 15
I DO NOT authorize my attorney -in -fact to have the foregoing
power in this paragraph number 15
16. To make gifts not in excess of the amounts available to me as annual
exclusions from the gift tax imposed by the Internal Revenue Code to any descendant of
mine or spouse of a descendant of mine, expressly without the necessity of obtaining a
court order therefor, and which my attorney -in -fact considers to be beneficial in terms of
reducing eventual estate taxes for my estate or for other estate planning, 'Oerations;
and
MAR 1 0 201t
-5-

_ I DO authorize my attorney -in -fact to have the foregoing
power in this paragraph number 16
I DO NOT authorize my attorney -in -fact to have the foregoing
power in this paragraph number 16
17. To do all acts, take all proceedings, and exercise all rights and privileges
although not specifically mentioned herein with relation to any of my property as though
the absolute owner thereof, and in that connection to make, execute and deliver any
instruments, to enter into any agreements binding me, and to do all other acts reasonably
necessary to implement these powers.
I hereby release all persons from any liability arising from their reliance on
this power of attorney if they have no actual knowledge that I have revoked it. To the
fullest extent possible, I release my attorney from all liability to me, my estate, and any
other person for any actions taken hereunder in good faith.
This Durable Power of Attorney shall be effective beginning on the date
hereof and shall not be terminated by my subsequent incapacity except as provided in
chapter 709 of the Florida Statutes. It shall continue in full force and effect until duly
revoked by me.
Signed, sealed and delivered in our
presence:
o ,�i S
Signatures/
Margaret M.R. Foss KATHLEEN S. HAGOmAN
RECEIVED
DCM WIUMINGTON, NC
MAR 1 02A

STATE OF FLORIDA
COUNTY OF COLLIER
/y The foregoing instrument was acknowledged before me this 3 Ma/ day of
2013, by KATHLEEN S. HAGERMAN,
No ubiic 1 `�
Printed Name:
My Commission Expires:
® personally known or
[]produced as identification
Prepared By:
GARLICK, HILFIKER & SWIFT, LLP
Attorneys at Law
9115 Corsea del Fontana Way, Suite 100
Naples, Florida 34109
Telephone: [phone]
Fax Number. 239-597-6984
a 07017 UDAM
-7-
�++" Notary 1'04 Sta�o cp Flahtla
Alan F Hitfiker
F CMpnls,Ipn EEa5py10
°• lxpltea o7/i5Ro77
RECEIVED
DCM WILMINGTON, NC
MAR 1 0 2016