20221103_Application

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
NOTE:It is recommended that you contact the appropriate Regional Office or the Raleigh Central Office for a PRE.
APPLICATION MEETING to discuss your Intentions and address any questions. RECEIVED
1. Name of Mine Buddy Smith Mine NOV 03 2022
County Tyrrell County River Basin PasquotapKND OI IAI ITY SECTION
Latitude(decimal degrees to four
places) 35.902759 N.
Longitude(decimal degrees to four
places) -76.273759 W.
2, Name of Applicant Alvin R. Smith
Applicant Contact Alvin R. Smith Consultant Contact Kenneth Elliott
Applicant Email [e-mail] Consultant Email [e-mail]
Telephone [phone] Telephone n/a
Cell Phone [phone] Cell Phone [phone]
Permanent Address for Receipt of
3' Official Mail " 500 Jonestown Road, Columbia, NC 27925
4. Mine Office Address Travis Road, Columbia, NC 27925
5. Mine Manager Alvin R. Smith
Mine Manager Email [e-mail]
Telephone [phone] Cell Phone [phone]
1 certify that all details contained in this permit application are true and correct to the best of our knowledge.We
fully understand that any willful misrepresentation of facts will be cause for permit revocation.
Signature~* AL/e.Ayn Date 09/15/2022
Print Name Alvin R. Smith
Toe Owner/operator
`This will be the name that the mining permit will be issued to and the name that must be indicated on the reclamation bond(security)that
corresponds to this site.
"The Division of Energy,Mineral,and Land Resources must be notified of any changes In the permanent address or telephone number.
""Signature of oomoanv officer required.
G.S.74-51 provides that the Department shall grant or deny an application for a permit within 60 days of receipt of a complete
application or,if a public hearing is held,within 30 days following the hearing and the filing of any supplemental information
required by the Department.All questions must be addressed,and all required maps provided before this application can
be considered complete.Attach additional sheets as needed.
Revised September 21, 2021 P e g e l l

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
NOTE:All the following questions must be thoroughly answered regarding your mining operation for the intended
life of the mine.All responses must be clearly conveyed on a corresponding,detailed mine map.
A.GENERAL CHARACTERISTICS OF THE MINE
1. Answer all the following that apply:
a This is an application for a NEW permit.
Indicate the total acreage at the site to be covered by the permit 20.27 acres
(This is the acreage the new permit fee will be based upon.)
Of this acreage,how much is owned and how much is leased?
Acres owned: 20.27 Acres leased:
Property owner if leased:
This is an application for a MODIFICATION to a mining permit.
Mining Permit Number, Total permitted acreage:
Does the modification involve acreage within the previously approved permitted boundary?
RYES F]NO
If yes,indicate the acreage to be covered by this modification
Does the modification involve acrea a outside the previously approved permitted boundary?
FIYES NO
If yes,indicate the additional acreage to be covered by this modification
NOTE:You must complete all of Section F of this application form entitled Notification of Adjoining
Landowners
Of the acreage to be added to the permit,will any portion be affected(i.e.:disturbed,ground cover
removed)by the mining operation?
YES NO
If yes,indicate the acreage to be affected within the acreage to be added to the permit
The modification fee is based upon the proposed new affected acreage within the previously
approved permitted boundary plus the proposed total acreage to be added outside the previously
approved permitted boundary.
This is an application for TRANSFER of a mining permit.
Mining Permit Number: Total permitted acreage:
Revised September 21,2021 P a g e 12

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
MINING FEE SCHEDULE
A nonrefundable permit application processing fee when ftling for a new mining permit,permit modification,or transferred permit is
required as follows:
APPLICATION TYPE 0—25 ACRES 26+ACRES
New Permit Applications $3,750.00 $5,000.00
Permit Modifications $750.00 $1,000.00
Permit Transfers $100.00 $100.00
Annual Operating Fee $400.00 1 $400.00
Acres for new permits means the total acreage at the site to be covered by the permit Acres for modification of permits means the
new affected acres within the previously approved permitted boundary plus the proposed total acreage to be added outside the
previously approved permitted boundary.
2. Name of all materials mined: Sand & topsoil
3. Mining Method:
Hydraulic Dredge 0 Front-end Loader&Truck QShovel&Truck
0 Dragline&Truck Self loading scraper QExcavator&Truck
❑Other(please explain):
4. Expected maximum depth of mine(feet)30
Depth is relative to what benchmark?(e.g.,natural ground level,mean seal level,road elevation,etc.)
Natural ground level
Expected average depth of mine(feet) 25 ft
5. Has an area at this site been mined in the past?
YE NO r
If yes,when and by whom was this activity conducted?
6. Estimated life of the operation(years):10
NOTE:The Department may request clarification on how life of mine was calculated.
Revised September 21, 2021 P a g e 3

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC27699-1612
Division of Energy,Mineral,and Land Resources [phone]
B.MAPS
1. Clearly mark and label the location of your mining operation on six(6)copies of a 7.5•minute quadrangle and a county
highway map.These maps,in addition to six(6)copies of all mine maps and reclamation maps,must be submitted
with each permit application.
7.5-minute quadrangles may be obtained from the N.C.Geological Survey:
Mailinc Address Physical Address
1612 Mail Service Center 512 N.Salisbury St.,5e Floor
Raleigh,NC 27699-1612 Raleigh,NC 27604
Http:/Ii)ortal.ncdenr,org/web/Ir/geological home [phone]
County highway maps may be obtained from the N.C.Department of Transportation:
Mailing Address Physical Address
NCDOT GIS Unit NCDOT GIS Unit
1587 Mail Service Center 3401 Cad Sandburg Court
Raleigh,NC 27699-1587 Raleigh,NC 27610
htto://www,ncdot.rgriit/gis [phone]
2. A table/chart must be provided on the mine map that Beady lists the approximate acreage of tailingstsediment ponds,
stockpiles,waste piles,processing areas/haul roads,mine excavations and any other major aspect of the mining
operation that is proposed to be affectedldisturbed during the life of the mining permit.A table/chart similar to the
following will be acceptable:
AFFECTED ACREAGE TABLE:
For new permits,complete only the total affected acreage column.
For modifications,complete all columns.
CATEGORY CURRENT AFFECTED PROPOSED CHANGE TO TOTAL AFFECTED
ACREAGE AFFECTED ACREAGE ACREAGE
TailingslSediment Ponds 0.27
Stockpiles 0.97
Waste piles
Processing AreaslHaul Roads 0.94
Mine Excavations 7.70
Other(Please explain) Unexi avated Buffers 1 .74
Total Affected Acreage 11 .62
Total Permitted Acreage 20.27
Revised September 21, 2021 1 1 14

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
3. Mine maps must be accurate and appropriately scaled drawings,aerial photographs,or enlarged topographic maps of
the entire mine site.All aspects of the mine site must be clearly labeled on the maps along with their
corresponding(approximate)acreage.Thus,all mine and reclamation maps must denote those activities that
are Intended to be conducted during the life of the mining permit.All maps must be of a scale sufficient to clearly
illustrate the following,at a minimum:
a) Property lines of the tract or tracts of land on which the proposed mining activity is to be located including
easements and rights-of-way.
b) Existing or proposed permit boundaries with geographic controls(e.g.metes and bounds,coordinates)labeled
c) Initial and ultimate limits of clearing and grading
d) Outline and width of all buffer zones(both undisturbed and unexcavated)
e) Outline and acreage of all pits/excavations
f) Outline and acreage of all stockpile areas
g) Outline and acreage of all temporary and/or permanent overburden disposal areas
h) Location and acreage of all processing plants(may be described as to location and distance from mine if
sufficiently far removed)
i) Locations and names of all streams,rivers,and lakes
j) Outline and acreage of all settling and/or processing wastewater ponds
k) Outline and acreage of all planned and existing access roads and on-site haul roads
1) Location of planned and existing on-site buildings
m) Location and dimensions of all proposed sediment and erosion control measures
n) Location of 100-year ftoodplain limits and wetland boundaries
o) Names of owners of record,both public and private,of all tracts of land that are adjoining the mining permit
boundary;if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
names of owners of record of tracts adjoining these tracts that are within 1,000 feet of the mining permit boundary
must be provided on the mine map.
p) Names of owners of record,both public and private,of all tracts of land that are adjoining the mining permit
boundary which lie directly across and are contiguous to any highway,creek,stream,river,or other watercourse,
railroad track,or utility or other public right-of-way.If an adjoining tract is owned or leased by the applicant or is
owned by the lessor of the mine tract,names of owners of record of tracts adjoining these tracts,that are within
1,000 feet of the mining permit boundary,must be provided on the mine map(s).NOTE:"Highway"means a road
that has four lanes of travel or less and is not designated as an Interstate Highway.
q) Map legend
1) Applicant name 5) Scale
2) Mine name 6) Symbols used and corresponding names
3) North arrow 7) Date prepared and revised
4) County 8) Name and title of person preparing map
Map scales should meet the following guidelines:
PERMITTED ACREAGE MAP SCALE
0—49 acres 1"=50'
50—199 acres 1"=100'
200+acres 1"=200'
NOTE:Smaller scaled maps may be acceptable if they clearly illustrate the above items.
NOTE:In addition to the above,the maps must also include any site-specific information that is provided in
the answers to the following questions(italicized quesdons/statements)in this application form.This
application will not be considered complete without all relevant items being adequately addressed on the mine
maps.
Revised September 21,2021 P a g e 15

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
C.PROTECTION OF NATURAL RESOURCES
1. Describe in detail the sequence of events for the development and operation of the mine and reference the sequence
to the mine map(s).Attach additional sheets as needed.
See Addendum#1 attached.
2. Describe specific erosion control measures to be installed prior to land disturbing activities and during mining to
prevent offsite sedimentation(include speck plans for sediment and erosion control for mine excavation(s),waste
piles,access/mine roads,and process areas),and give a detailed sequence of installation and schedule for
maintenance of the measures.Locate and label all sediment and erosion control measures on the mine map(s)and
provide typical cross sectionslconstruction details of each measure.Engineering designs and calculations are required
to justify the adequacy of any proposed measures.
a. Operator will construct gravel construction entrance at intersection of new
mine access road and Travis Road.
b. Operator will construct 2-ft tall x 10-ft wide (2:1 slope) vegetated berm for
erosion control along the permit area perimeter of the affected areas.
3. A)Will the operation involve wash in the material mined,recycling process water,or other wastewater handling?
YES X NO
If yes,briefly describe all such processes including any chemicals to be used.
Not applicable.
B)will the operation involve discharging fresh or wastewater from the mine or plant as a point discharge to the waters
of the State?
YES �NO
if yes,briefly describe the nature of the discharge and locate all proposed discharge points(along wifh their method of
stabilization)on the mine map(s).
a.Operator will construct a 0.265-acre above-ground sediment pond 25 feet west of the excavation
boundary. Sediment pond will be 30 feet wide by 385 feet long with 0.265-acre water surface for
sedimentation. Sediment pond berm will be minimum 32 feet wide,6 feet tall,with 18-ft wide exterior
slope at 3:1 grade,and 12-ft wide interior slope at 2:1 grade. Minimum 364n half-pipe flash-board riser
overflow will be located at southwest corner of sediment pond,discharging into minimum 12-in plastic
pipe leading to an un-named blue-line stream ditch draining to Scuppernong River and Albemarle Sound.
b.Operator will Install dewatering pump between northeast comer of sediment pond and excavation
area. Dewatering pump will be 8-in Godwin Dri-Prime model or similar running at idle speed with 250
gallon per minute(12 hours per day,average 180,000 gallons per day)flow into sediment pond.
c.Operator will dewater main excavation down approximately 25 feet below normal groundwater level.
Revised September 21,2021 P a g e 16

Addendum-1
Page 6-Mine Permit Application—Buddy Smith Mine
C. Protection of Natural Resources
1.Sequence of Events for Development and Operation:
a. Operator will obtain all required mining permits from NCDEQ.
b. Operator will construct one gravel construction entrance at intersection of mine access
road and Travis Road.
c. Operator will remove topsoil down to 2.5 feet below natural ground level, and stockpile
overburden for use in erosion control berms.
d. Operator will construct 2-ft tall x 10-ft wide(2:1)vegetated berm for erosion control along
the perimeter of the affected areas.
e. Operator will maintain existing foliage and cultivated field visual screen along perimeter
of the affected area.
f. Operator will construct 0.265-acre above-ground sediment pond 25 feet west of the
western excavation boundary. Sediment pond will be 30 feet wide by 385 feet long with
0.265-acre water surface for sedimentation. Sediment pond berm will be minimum 32
feet wide, 6 feet tall,with 18-ft wide exterior slope at 3:1 grade, and 12-ft wide interior
slope at 2:1 grade. Minimum 36-in half-pipe flash-board riser overflow will be located at
southwest corner of sediment pond,discharging into minimum 12-in plastic pipe leading
to existing blue-line stream ditches flowing to Scuppernong River.
g. Operator will install dewatering pump between northeast corner of sediment pond and
excavation area. Dewatering pump will be 8-in Godwin Dri-Prime model running at 1200
rpm with 15,000 gallon per hour flow into sediment pond. Pump will operate
intermittently for average 12 hours per day upon need.
h. Operator will begin excavation of pond (7.70 acres) approximately 25 feet east of
sediment pond by digging with excavator and removing sand&topsoil to maximum depth
feasible without dewatering the excavation.
i. Operator will dewater main excavation into sediment pond, discharging overflow water
from sediment pond through half-pipe riser water height control through discharge pipe
into blue-line stream ditch leading to Scuppernong River. Operator will dewater main
excavation down approximately 20 feet below normal groundwater level.
j. 3:1 cut slopes will be constructed around excavation edge down to normal groundwater
level. As water is removed from excavation, 2:1 cut slopes will be constructed below
normal groundwater level around excavation edge.
k. Pond will be excavated to average 25 feet and maximum 30 feet below natural ground
level while dewatering is maintained. Excavated material (sand) will be stockpiled in
unexcavated portion of proposed excavation area or 0.26-acre processing area east of
excavation. Sand will be loaded onto trucks and removed from area via construction
entrance to SR 1110 Travis Road.
I. When final excavation of pond is complete, dewatering will be discontinued, and pump
shut down and removed. Groundwater will refill the excavation to normal seasonal high

groundwater level.
m. After all excavation is complete,operator will establish groundcover on 3:1 above-water
slopes of excavation and will construct 8ft wide 4:1 berm around excavation edge to
prevent erosion of pond slopes, with outside edge of berm graded down to natural
ground level.
n. Aboveground sediment pond will be fully drained into excavated pond. Operator will
dismantle and remove sediment pond berms; half-pipe riser and discharge pipe will be
removed. Sediment pond area will be graded,leveled,and sown with groundcover. Area
will be allowed to return to previous field state.
o. Former stockpile/berm areas and processing areas outside of main excavations will be
graded, leveled, and seeded with groundcover. Areas will be allowed to return to
previous non-erosive field state.
p. Internal roadways and haul roads will be graded, leveled, seeded with groundcover and
allowed to return to natural field state. A field path will remain around the perimeter of
the excavated pond.
q. Operator will grade and level access road to Travis Road back to original non-erosive state.
r. Remaining affected areas inside main permit area will be fertilized and returned to natural
field state.
s. Remaining pond will be utilized by landowner for scenic&recreational purposes,and for
wildlife habitat.

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
C)Will any part of the proposed mine excavation(s)extend below the water table?
AYES NO
F-1
If yes,do you intend to dewater the excavation(s)?
aYES El NO
Estimated withdrawal rate in gallons per day: 80 ���•00
If yes,what impact,if any,will mine dewatering have on neighboring wells?Locate all existing wells on the mine
maps)that lie within 500 feet of the proposed excavation area.Provide data to support any conclusions or statement
made,including any monitoring well data,well construction data,and current water withdrawal rates.Indicate whether
the proposed mine locale is served by a public water system or private wells.
The locale served by a public water system.There are no known water supply wells within 500 ft
of the proposed mine excavation area.This is based on there being no buildings located within 1,
200 ft of the excavation area. Dewatering will be performed under an NPDES Stormwater General
Permit NCG02000 noted in(d)below. Replenishment of the groundwater and protection of
adjacent wetland areas north and south of the excavation area is achieved by pre-existing flooded
ditches located between mine activity area and adjacent wetlands. Ditches have direct permanent
connection to Scuppernong River. Dewatering wastewater will be discharged into these ditches.
D)If you answered yes to any of the above questions,provide evidence that you have applied for or obtained the
appropriate water quality permit(s)(i.e.,non-discharge,NPDES,Stormwater,etc.)from the Stormwater Program.In
addition,the applicant is required to register water use with the Division of Water Resources,Ground Water
Management Branch,if the operation withdraws more than 10,000 gallons per day and needs a capacity use permit
from the Division of Water Resources,Ground Water Management Branch,if the operation lies in a capacity use area
and withdraws more than 100,000 gallons per day.
Operator is applying for coverage under NPDES general permit NCG020000 for
mine dewatering, copy of application attached, COC will be provided once
approved. Operator is registering water usage with NCDEQ DWR, copy of
application attached.
4. A)Will the operation involve crushing or any other air contaminant emissions?
FIYES a NO
If yes,indicate evidence that you have applied for or obtained an air quality permit issued by the Division of Air Quality
or local governing body.
Not applicable.
B)How will dust from stockpiles,haul roads,etc.,be controlled?
Spraying or spreading water from water supply trucks or excavator on dirt haul
roads and process areas will control dust. Stockpiles will also be sprayed with
water weekly if necessary, to control dust.
Revised September 21, 2021 P a g e 17

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
5. A)A buffer will be required between any mining activity and any mining permit boundary or right-of-way.It may be an
unexcavated buffer(no excavation,but roadways,berms,and erosion&sedimentation control measures may be
installed within it),an undisturbed buffer(no disturbance within the buffer whatsoever),or a combination of the two,
depending upon the site conditions.Note that all buffers must be located within the mining permit boundaries.
How wide a buffer will be maintained between any mining activity and any mining permit boundary or right-of-way at
this site?A minimum buffer of 25 feet is recommended,although a wider buffer may be needed depending on site
conditions.Show all buffer locations and widths on the mine map(s).
Operator will maintain 40-ft wide unexcavated buffer between mining activity and
existing ditches along permit boundary, and 30-ft wide unexcavated buffer
between mining activity and other permit boundaries. Unexcavated buffers will
contain processing areas and sediment&erosion control measures
B)A minimum 50 foot wide undisturbed buffer will be required between any land disturbing activities within the mining
permit boundaries and any natural watercourses and wetlands unless smaller undisturbed buffers can be justified.
Depending on site conditions,a buffer wider than 50 feet may be needed.
How wide an undisturbed buffer will be maintained between any land disturbing activities within the mining permit
boundaries and any natural watercourses and wetlands at this site?Show all buffer locations and widths on the mine
map(s).
Closest wetlands are 275 feet from current proposed excavation area, no
undisturbed buffers required. Operator will maintain adjacent 8.65-acre field
inside permit boundary as undisturbed from mining activity.
6. A)Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries during mining.
Minimum 2 horizontal to 1 vertical slopes or flatter for clayey material and minimum 3 horizontal to 1 vertical slopes or
flatter for sandy material are generally required unless technical justification can be provided to allow steeper slopes.
Exposed excavation slopes will be constructed at a 3:1 gradient during mining.
All sediment& erosion control berms will be constructed with minimum 2:1 slope
grades, cross-sections attached to mine & reclamation map. Fill slope will be
established at excavation edge during reclamation of mine. Slope will have 4:1
grade.
B)Provide a cross-section on the mine map(s)for all fill slopes(berms,waste piles,overburden disposal areas,etc.),
clearly indicating the intended side slope gradient,installation of any benches and/or slope drains(with supporting
design information)if needed,and the method of final stabilization.
Revised September 21, 2021 p a g e 18

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
C)In excavation(s)of unconsolidated(non-rock)materials,specify the angle of all cut slopes including specifications
for benching and sloping.Cross-sections for all cut slopes must be provided on the mine map(s).
Cut slope from natural ground level to water level will have 3:1 grade and cut
slope from water level to bottom of excavated area will have 2:1 grade.
D)In hardrock excavations,specify proposed bench widths and heights in feet.Provide cross-sections of the mine
excavation clearly noting the angles of the cut slopes,widths of all safety benches and mine benches,and the
expected maximum depth of the excavation.
Not applicable, no hard-rock excavation.
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwelling,house,
public road,or public,commercial or industrial building from any mine excavation.Locate all such structures on the
mine map if they are within 300 feet of any proposed excavation.
No dwellings or buildings within 300 feet of excavation. Access road to Travis
Road goes through farm area owned by mine operator, and will have rock&
gravel construction entrance maintained by operator.
8. Describe what kind of barricade will be used to prevent inadvertent public access along any high wall area and when it
will be Implemented.Vegetated earthen berms,appropriate fencing and adequate boulder barriers may be acceptable
high wall barricades.A construction detaftross-section and location of each type of barricade to be used must be
indicated on the mine map(s).
No high wall areas in permit area. Access to excavation area will be by private
gated access road through landowner's private property. "No Trespassing" signs
will be installed around affected area boundaries.
9. Are acid roducing minerals or soils resent?
YES ZNO
If yes,how will acid water pollution from the excavation,stockpiles,and waste areas be controlled?
Not applicable.
Revised September 21,2021 P a g e 19

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
10. A)Describe specific plans(including a schedule of implementation)for screening the operation from public view such
as maintaining or planting trees,bushes or other vegetation,building berms or other measures.Show the location of all
visual screening on the mine map(s)and provide cross-sections through all proposed berms or proposed spacing,
sizes and species for tree plantings.
Proposed mine activity area is 675 feet from closest public highway, separated
by natural foliage and cultivated fields. Mine will have foliated berm around
active area. No additional screening planned.
B)Could the operation have a significantly adverse effect on the purposes of a publicly owned park,forest,or
recreation area?If so,how will such effects(i.e.,noise,visibility,etc.)be mitigated?
Alligator River Game Lands (undeveloped) located 8 miles east of mining area.
Pettigrew State Park located 10 miles southwest of mining area. Public-owned
areeas will not be affected by mining activities.
11. Will explosives be used?
YES ©NO
If yes,specify the types of explosive(s)and describe what precaution(s)will be used to prevent physical hazard to
persons or neighboring property from flying rocks or excessive air blasts or ground vibrations.Depending on the mine's
location to nearby structures,more detailed technical information may be required on the blasting program(such as a
third-party blasting study).Locate the nearest offsrte occupied structure(s)to the proposed excavation(s)on the mine
map and indicate ifs approximate distance to the proposed excavation.
Not applicable.
12. Will fuel tanks,solvents,or other chemical reagents be stored on-site?
FTES F ]NO
If yes,describe these materials,how they will be stored and method of containment in case of spill.Indicate the
location(s)of all storage facilities on the mine map(s).
An aboveground storage tank will be provided on-site for refueling of equipment.
The tank shall be standard state approved double wall type or placed within a
state approved spill containment structure. See plan for anticipated location.
Revised September 21, 2021 Page 110

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
D.RECLAMATION PLAN
1. Describe your intended plan for the final reclamation and subsequent use of all affected lands and indicate the
sequence and general methods to be used in reclaiming this land.This must include the method of reclamation of
settling ponds and/or sediment control basins and the method of restoration or establishment of any permanent
drainage channels to a condition minimizing erosion,siltation and other pollution. This information must be illustrated
on a reclamation map and must correspond dire*with the information provided on the mine map(s).In addition,
design information,including typical cross-sections,of any permanent channels to be constructed as part of the
reclamation plan and the location(s)of all permanent channels must be indicated on the reclamation map.
The bulk of the reclamation will commence upon the completion of the mining
operation. When possible, reclamation will be conducted simultaneously with
mining operations. Excavated areas that are not backfilled during the mining
operation will be reclaimed as a future lake for possible future development and/or
recreational purposes. At the completion of the operation all disturbed areas
outside of the excavation area, such as overburden piles, stockpiles, sediment
basins, recharge ditches and basins will be graded level, seeded and stabilized.
Entrance road and perimeter haul roads may remain for future site access.
2. Is an excavated or impounded bodnNO
water to be left as part of the reclamation?
©YES
if yes,illustrate the location of the body(s)of water on the reclamation map and provide a scaled cross-sections)
through the proposed body(s)of water.The minimum water depth must be at least 4 feet,measured from the normal
low water table elevation,unless information is provided to indicate that a shallower water body will be productive and
beneficial at this site.
Will the body(s)of water be stocked with fish?
MYES F ]NO
If yes,specify species.
Bass, bream, crappie.
3. Describe provisions for safety to persons and to adjoining property in all completed excavations in rock including what
kind of permanent barricade will be left.Acceptable permanent barricades are appropriate fencing,large boulders
placed end-to-end,etc.Construction details and locations of all permanent barricades must be shown on the
reclamation map.
No rock excavation is anticipated.
Revised September 21, 2021 P a g e 11

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
4. Indicate the method(s)of reclamation of overburden,refuse,spoil banks or other such on-site mine waste areas,
including specifications for benching and sloping.Final cross-sections and locations for such areas must be provided
on the reclamation map.
Overburden and reclaimed mine fill areas will be leveled, seeded, and stabilized
as needed.
S. A)Describe reclamation of processing facilities,stockpile areas,and on-site roadways.
Portions of the on-site roadways may be kept for lake access and/or utilized as
subgrade for possible future development. Stockpile areas will be leveled, seeded
, and stabilized as needed.
B)Will any on-site roadways be left as part of the reclamation?
FIYES ©NO
If yes,identify such roadways on the reclamation map and provide details on permanent road and ditch line
stabilization.
Portions of the on-site roadways may be kept for lake access and/or utilized as
subgrade for possible future development.
6. Describe the method of control of contaminants and disposal of scrap metal,junk machinery,cables,or other such
waste products of mining.(Note definition of refuse in The Mining Act of 1971.)
No off-site generated waste shall be disposed of on the mine site without prior written approval from the NC
Department of Environmental Quality,Division of Energy,Mineral,and Land Resources and either the Division
of Waste Management(DWM)or local goveming body.If a disposal permit has been issued by DWM for the
site,a copy of said permit must be attached to this application.All temporary and permanent refuse disposal
areas must be clearly delineated on the mine map(s)and reclamation map,along with a list of items to be disposed in
said areas.
No off-site generated bulk waste, hazardous waste, commercial waste, garbage,
construction, or demolition waste shall be placed on the site. Waste materials
generated onsite will be removed during reclamation and disposed of at Tyrrell
County waste disposal site in Columbia, NC.
Revised September 21,2021 Page 112

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
7. Describe your plan for revegetation or other surface treatment of the affected areas.This plan must include
recommendations for year-round seeding,including the time of seeding and the amount and type of seed,fertilizer,
lime and mulch per acre.The recommendations must include general seeding instructions for both permanent and
temporary revegetation.Revegetation utilizing only tree plantings is not acceptable.Recommendations can be sought
from:
a. Authorized representatives of the local Soil and Water Conservation District;
b. Authorized representatives of the NC Forest Service,Department of Agriculture and Consumer Services;
c. Authorized county representatives of the North Carolina Cooperative Extension Service,specialists and
research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at North Carolina
State University;
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the NC Forest Service,Department of Agriculture and Consumer
Services;
f. N.C.Erosion and Sedimentation Control Planning and Design Manual;
g. N.C.Surface Mining Manual:A Guide for Permitting,Operation and Reclamation;
h. Others as may be approved by the Department.
Lime Rate of Application(tonslacre): 2000 lbs./acre or follow recommendations of soil test
1000 lbs./acre 8-8-8 or 10-10-10 or follow
Fertilizer Analysis and Rate of Application(lbs/acre): recommendations of soil test
Seed type(s)and rate(s)of application included year-round seeding schedule(lbs/acre):
NOTE:Include legumes
SEED TYPES SEEDING DATES SEEDING RATES Lbs./Acre
Kobe Lespedeza February 15-April 1 10
Bahlagrass 50
Redtop 1
Winter Rye(grain) 15
Common Bermuda April 1-July 31 50
Lespedeza(unscarffied) August 1-October 30
German Millet 40
Rye(grain-temporary) October 25-February 15 120
Mulch Type,Rate of Application(Ibs/acre),and Method of Anchoring:
All seeded areas will be mulched using small grain straw at a rate of 2000 lbs./acre
and anchored appropriately
Other Vegetative Cover(s)Type(s)and Rate(s)of Application Including Seeding Schedule(lbslacre,trees/
acre,spacing of treeslshrubs,etc.):
Plan written from recommendations taken fromNC Surface Mining Manual:A Guide for Permitting,Operation,and
Reclamation
Revegetation and/or reforestation plan approved by:
g Kenneth Elliotte5e! -°�
Signature �n�„tto„� Date 10-25-2022
ss,-.....,...p.,
Print Name Kenneth Elliott
Titre Consultant
Agency Elliott Consulting
Revised July 13, 2021 P a g e 113

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
E.DETERMINATION OF AFFECTED ACREAGE AND BOND
The following bond calculation worksheet is to be used to establish an appropriate bond(based upon a range of$500 to$5,000
per affected acre)for each permitted mine site based upon the acreage approved by the Department to be affected during the
life of the mining permit.Please insert the approximate acreage,for each aspect of the mining operation.that you intend to affect
during the life of this mining permit(in addition,please insert the appropriate reclamation cost/acre for each category from the
Schedule of Reclamation Costs provided with this application krmj OR you can defer to the Department to calculate your bond
for you based upon your maps and standard reclamation costs:
CATEGORY AFFECTED RECLAMATION RECLAMATION
ACREAGE COSTIACRE COST
Tailings/Sediment Ponds 0.27 Ac. X $ 1,500 /Ac. = $405.00
Stockpiles 0.97 Ac. X $ 1,800 /Ac. = $1,746.00
Waste Piles Ac. X $ /Ac. = $ 0.00
Processing Area/Haul Roads 0.94 Ac. X $ 1,800 /Ac. = $ 1,692.00
Mine Excavation 7.70 Ac. X $ 500 /Ac. _ $3,850.00
Other Unexcay.Buff. 1.74 Ac. X $ 1,800 /Ac. _ $3,132.00
TOTAL AFFECTED AC.: 11.62 Ac.
TOTAL PERMITTED AC.: 20.27 Ac.
Temporary&Permanent Sedimentation&Erosion Control Measures:
Divide the TOTAL AFFECTED AC.above into the following two categories:a)affected acres that drain into proposed/existing
excavation and/or b)affected acres that will be graded for positive drainage where measures will be needed to prevent offsite
sedimentation and sedimentation to onsite watercourses and wetlands.
a) Internal Drainage 11.62 Ac.
b) Positive Drainage Ac. X $1,500.00 = $ 0.00
SUBTOTAL COST:$ 1 0 2 825.00
Inflation Factor:
SUBTOTAL COST LIFE OF MINING OPERATION OR LIFE INFLATION COST
OF LEASE(YEARS)
0.02 X $ 109825.00 X 10 = $2,165.00
Total Reclamation Bond Cost:
ETOTALECLAMATION BOND COST= SUBTOTAL+INFLATION = 02,900.00
Round down to the nearest$100.00
NOTE:The reclamation bond cannot exceed$1 million per GS 74-54
Revised September 21, 2021 P a g e 114

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
SCHEDULE OF RECLAMATION COSTS
Based upon range of$500-$5,000 per affected acre
COMMODITY CODES:
SG Sand and/or Gravel DS Dimension Stone PF Pyrophyllite CL Clay/Shale
GS Gemstone FS Feldspar OL Olivine PE Peat
Borrow Borrow/fill dirt MI Mica KY Kyanite/Sillimanite/Andalusite AU Gold
CS Crushed Stone LI Lithium PH Phosphate TI Titanium
OT Other
TYPE T1S PONDS STOCKPILES WASTE PILES P.AREAIH.R. MINE EXCAVATION
$5001ac.(L) $500/ac.(L)
SG,GS,Borrow $1800/ac. $2000/ac. $1800/ac.
1500(FI) 2000(PD)
CS,DS,FS,MI,LI, 500(L) 1800 2000 2000 500(L)
PF,OL,KY 1500(FI) 2500(PD)
1000(L) 2500 5000 5000 2000(L)
PH 2500(FI) 5000(PD)
CL 1000(L) 2500 5000 5000 2000(L)
2500(FI) 3700(PD)
PE,AU,TI,OT 1000(L) 2500 3000 3500 2000(L)
2500(FI) 5000(PD)
(L)=Reclamation to a lake and revegetating side slopes
(FI)=Reclamation by filling in and revegetating
(PD)=Reclamation by grading for positive drainage&revegetating
AS PER NCAC 1SA 56.0003,IF YOU DISAGREE WITH THE BOND AMOUNT DETERMINED BY THE BOND CALCULATION
WORKSHEET,YOU MAY SUBMIT AN ESTIMATE OF RECLAMATION COSTS FROM A THIRD-PARTY CONTRACTOR.
SAID ESTIMATE MUST BE PROVIDED WITHIN 30 DAYS TO THE FOLLOWING ADDRESS: Mining Program,1612 Mail
Service Center,Raleigh,North Carolina 27699.1612
ALL ESTIMATES MUST INCLUDE THE FOLLOWING,AS A MINIMUM:
•FINAL GRADING COSTS PER ACRE
•LIME AND FERTILIZER COSTS PER ACRE
•YEAR-ROUND SEEDING MIXTURE COSTS PER ACRE(FROM APPROVED REVEGETATION PLAN IN
APPLICATIOWPERMIT DOCUMENT)
•MULCH AND ANCHORING COSTS PER ACRE
•ANY OTHER RECLAMATION COSTS NECESSARY TO COMPLY WITH THE APPROVED RECLAMATION PLAN
FOR THE SITE IN QUESTION
YOU WILL BE NOTIFIED AS SOON AS POSSIBLE OF THE DIRECTOR'S FINAL BOND DETERMINATION.
Revised September 21, 2021 Page 115

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
F.NOTIFICATION OF ADJOINING LANDOWNERS
The"Notice"form,or a facsimile thereof,attached to this application must be sent certified or registered mail,return receipt
requested,to:
(1)the chief administrative officer of each county and municipality in which any part of the permitted area is located as
indicated on the mine map(s);
(2)all owners of record,both public and private,of all tracts of land that are adjoining the mining permit boundary;if an
adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,all owners of record of
tracts adjoining these tracts must be notified(that are within 1,000 feet of the mining permit boundary)as indicated on
the mine map(s);and
(3)all owners of record,both public and private,of all tracts of land that are adjoining the mining permit boundary
which lie directly across and are contiguous to any highway,creek,stream,river,or other watercourse,railroad track,
or utility or other public right-of-way.If an adjoining tract is owned or leased by the applicant cr is owned by the lessor
of the mine tract,all owners of record of tracts adjoining these tracts must be notified(that are within 1,000 feet of the
mining permit boundary)as indicated on the mine map(s)."Highway"means a road that has four lanes of travel or less
and is not designated as an Interstate Highway.
The only exception to the above method of giving notice is if another means of notice is approved in advance by the Director,
Division of Energy,Mineral,and Land Resources.
A copy of a tax map(or other alternative acceptable to the Department)must be mailed with the completed"Notice"form(the
proposed overall permit boundaries and the names and locations of all owners of record of lands adjoining said
boundaries must be clearly denoted on the tax map).
The"Affidavit of Notification"attached to this application must be completed,notarized and submitted to the Department,with the
remainder of the completed application form before the application will be considered complete.
NOTES:
THIS SECTION MUST BE COMPLETED FOR ALL APPLICATIONS FOR NEW MINING PERMITS AND ALL MODIFICATIONS
OF A MINING PERMIT TO ADD LAND TO THE PERMITTED AREA,AS REQUIRED BY NCGS 74-50(b1).
SEE THE NEXT TWO PAGES FOR THE"NOTICE"FORM AND THE"AFFIDAVIT OF NOTIFICATION"
Revised September 21,2021 Page 116

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC27699-1612
Division of Energy,Mineral,and Land Resources [phone]
NOTICE (TYPICAL)
Pursuant to provisions G.S.74-50(bl)of The Mining Ad of 1971,Notice is hereby given that
Alvin R. Smith has applied on 08/15/2022 to the Division of Energy,
(Applicant Name) (Date)
Mineral,and Land Resources,North Carolina Department of Environmental Quality, 1612 Mail Service Center,Raleigh,North
Carolina 27699-1612,for(check one):
aa new surface mining permit,
a modification of an existing surface mining permit to add land to the permitted area;or
a modification of an existing surface mining permit to add land to the permitted area with no disturbance in
the area proposed. Please note that future modification(s)may be submitted by the applicant to allow
disturbance within this area without re-notification of adjoining landowners.
The applicant proposes to mine sand 8t topsoil on 11 .62 acres located 1 .50
(Mineral,Ore) (Number) (Number)
miles southwest of Columbia, NC offinearroad Old Columbia Road
(Direction) (Nearest town) (Number,Name)
in Tyrrell County.
`SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING ADJOINING LANDOWNER
NAMES AND LOCATIONS`
In accordance with G.S.74-50(bl),the mine operator is required to make a reasonable effort,satisfactory to the Department,to notify all
owners of record,both public and private,of all tracts of land that are adjoining the mining permit boundary;if an adjoining tract is owned or
leased by the applicant or is owned by the lessor of the mine tract,all owners of record of tracts adjoining these tracts must be noted(that are
within 1,000 feet of the mining permit boundary).In addition,the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may file written oommem(s)to the Department at the above address
within thirty(30)days of the issuance of this Notice or the filing of the application for a permit,whichever is later. Should the Department
determine that a significant public interest exists relative to G.S.74-51,a public hearing will be held within 60 days of the end of the 30-day
comment period specified above.
A copy of the permit application materials is on file and available for public review during normal business hours at the above listed address as
well as at the appropriate regional office.For information regarding the specifics of the proposed mining activity,please contact the
applicant at the following telephone number: 252-796-7558
For information on the mining permit application review process,please contact the Mining Program staff at(919)707-9220. Please note that
the Department will consider any relevant written comments/documentation within the provisions of the Mining Act of 1971 throughout the
application review process until a final decision is made on the application.
David Clegg,Tyrrell County Manager
PO Box 449, Columbia, NC 27925 Alvin R. Smith
Addressee/Omer of Record's Name and Address Name of Applicant Include Contact Person&Company Name,A Applicable
08/01/2022 500 Jonestown Rd., Columbia, NC 27925
Date of Issuance of this Notice/Mailed to Addressee/Omer of Record Address of Applicant
Revised September 21, 2021 P a g e 117

ELLIOTT CONSULTING
October 29,2022
David L. Clegg
Tyrrell County Manager
108 S.Water Street,PO Box 449 (TYPICAL)
Columbia,NC 27925
Dear Mr. Clegg-
I am writing to you on behalf of Mr. Alvin R. `Buddy" Smith, 500 Jonestown Road, Columbia,NC
27925, to let you know that Mr. Smith intends to apply to the State of North Carolina to excavate a
7.85-acre pond,to be known as the Buddy Smith Mine,on land he owns off Travis Road. Total permit
area will be 20.27 acres with 11.62 acres affected. The pond will be located on a cultivated tract of
land, 1.50 miles southwest of Columbia. This letter is to notify you that Mr. Smith is applying to the
NC Department of Environmental Quality, Division of Energy, Mineral and Land Resources, for a
nvning permit to perform the excavation.
One part of the permit process requires Mr. Smith to send all adjacent landowners and the Tyrrell
County Manager an official certified and dated notice of his intention to excavate the pond. This
letter and notice represent only a required part of the paperwork process for his permit with the NC
Department of Environmental Quality, and does not require any action on your part, regarding
NCDEQ.
Mr. Smith seeks to assure you that he will take all measures necessary to prevent physical hazard to
any neighboring dwellings,roads or public facilities and will also provide adequate fencing or notices
to prevent inadvertent public access to the mining permit area. The pond will be located on private
property off Travis Road owned by Mr. Smith, and the excavation area will only be accessible by a
private gated entrance.
Please find attached to this letter a map showing the location of the proposed permit area and new
excavation.
We appreciate your help and cooperation on these matters. Mr. Smith is always available to answer
any questions you may have and can be reached at 252-796-1910. I am also available for any questions
and please do not hesitate to call me at 252-339-9021 if I can be of assistance.
Sincerely,
Ken Elliott
For Alvin R. `Buddy"Smith
PO BOX 112 - AYDLETT, NORTH CAROLINA - 27916
PHONE: [phone] - EMAIL: [e-mail]

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
AFFIDAVIT OF NOTIFICATION
I Kenneth Elliott ,an applicant,or an agent,or employee of an applicant,for a
new Mining Permit,or a modification of an existing Mining Permit to add land to the permitted area,from the N.C.Department of
Environmental Quality,being first duly sworn,do hereby attest that the following are all known owners of record,both public and
private,of all tracts of land that are adjoining the mining permit boundary(including,where an adjoining tract is owned or leased
by the applicant or is owned by the lessor of the mine tract,all owners of record of tracts adjoining these tracts,that are within
1,000 feet of the mining permit boundary)and that notice of the pending application has been caused to be mailed,by certified or
registered mail,return receipt requested,to said owners of record at their addresses shown below,such notice being given on a
form provided by the Department:
Adjoining Landowner Name Address
Henry &Victor D. Skinner, c/o Robyn Skinner PO Box 2366, Merrifield, VA 22116
Thomas W. & Patricia H. Spruill 1745 Hwy. 94 North, Columbia, NC 27925
Darryl D. Skinner 950 Travis Road, Columbia, NC 27925
Scuppernong Enterprises, LLC 100 Chapel Hill Road, Columbia, NC 27925
Attach additional list if necessary.
I do also attest that the following individual is the chief administrative officer of the county or municipality in which any part of the
permitted area is located and that notice of the pending application has been caused to be mailed,by certified or registered mail,
return receipt requested,to said office at the following address:
David Clegg, Tyrrell County Manager PO Box 449, Columbia, NC 27925
Chief Administrative Officer Name Address
(i.e.:City Manager,County Manager,Mayor,etc.)
The above attestation was made by me while under oath to provide proof satisfactory to the Department that a reasonable effort
has been made to notify all known owners of record,both public and private,of all tracts of land that are adjoining the mining
permit boundary(including,where an adjoining tract Is owned or leased by the applicant or is owned by the lessor of the mine
tract,all owners of record of tracts adjoining these tracts,that are within 1,000 feet of the mining permit boundary)and the chief
administrative officer of the county or municipality in which any part of the permitted area is located in compliance with N.C.G.S.
74-50(b1)and 15A NCAC 5B.0004(d).I understand that it is the responsibility of the applicant to retain the receipts of mailing
showing th t the ab noti wercau d to be mailed and to provide them to the Department upon request.
09/12/2022
Signit0e of Applicant or Agent Date
If person executing Affidavit is an agent or employee of an applicant,provide the following information:
Name of Applicant Alvin R. Smith
Title of person executing Affidavit Consultant, Authorized Agent for Alvin R. Smith
I,_ �c� �- ` 1 a�c,r�Es�' ,a Notary Public of the County of k r�- ���t1,111t���i
State of North Carolina,do hereby certify that Cn�..+n 'r-1 Lk' 0 t k appeared b§
day and under oath acknowledged that the above Affidavit was made by him/her. �p ��
Witness my hand and notarial seal,this 1 al day of 20 oa a %%IOTA#A
Notary: 1. Y Q V My commission expires: aca V
9 ,4 a to
G �
Revised September 21,2021 P a gr rIBOV,`% ,
11111

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NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
AFFIDAVIT OF NOTIFICATION
I Kenneth Elliott ,an applicant,or an agent,or employee of an applicant,for a
new Mining Permit,or a modification of an existing Mining Permit to add land to the permitted area,from the N.C.Department of
Environmental Quality,being first duly sworn,do hereby attest that the following are all known owners of record,both public and
private,of all tracts of land that are adjoining the mining permit boundary(including,where an adjoining tract is owned or leased
by the applicant or is owned by the lessor of the mine tract,all owners of record of tracts adjoining these tracts,that are within
1,000 feet of the mining permit boundary)and that notice of the pending application has been caused to be mailed,by certified or
registered mail,return receipt requested,to said owners of record at their addresses shown below,such notice being given on a
form provided by the Department:
Adjoining Landowner Name Address
Ray & Jean McClees 531 Travis Road, Columbia, NC 27925
Ty Fleming, Tyrrell Soil &Water District Mgr. 155E LA Keiser Dr.,USDA Ser.Ctr.,Columbia,NC 27925
Attach additional list If necessary.
I do also attest that the following individual is the chief administrative officer of the county or municipality in which any part of the
permitted area is located and that notice of the pending application has been caused to be mailed,by certified or registered mail,
return receipt requested,to said office at the following address:
David Clegg, Tyrrell County Manager PO Box 449, Columbia, NC 27925
Chief Administrative Officer Name Address
(i.e.:City Manager,County Manager,Mayor,etc.)
The above attestation was made by me while under oath to provide proof satisfactory to the Department that a reasonable effort
has been made to notify all known owners of record,both public and private,of all tracts of land that are adjoining the mining
permit boundary(including,where an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine
tract,all owners of record of tracts adjoining these tracts,that are within 1,000 feet of the mining permit boundary)and the chief
administrative officer of the county or municipality in which any part of the permitted area is located in compliance with N.C.G.S.
74-50(b1)and 15A NCAC 5B.0004(d).I understand that it is the responsibility of the applicant to retain the receipts of mailing
showing that the ab not rQ cau d to be mailed and to provide them to the Department upon request.
09/12/2022
Sig at re of Applicant or gent Date
If person executing Affidavit is an agent or employee of an applicant,provide the following information:
Name of Applicant Alvin R. Smith
Title of person executing Affidavit Consultant, Authorized Agent for Alvin R. Smith
I, a Notary Public of the County of &A TpY L94
State of orth Carolina,do hereby certify that x1n& �r�.�,i c� app�fore me this i
day and under oath acknowledged that the above Affidavit was made by him/her. C'D
Witness my hand and notarial seal,this day of smi 20-&d' cc z0 G
Notary: 3(112kDA My commission expires: l a d d oa E %U Py�v J
Revised September 21,2021

17021 0950 0001 5503 5078
i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete Items 1,2,end 3. A. Signature �: o c
■ Print your name and address on the reverse "JI-Agent 8 •
so that we can return the card to you. ❑Addressee 5
■ Attach this card to the back of the mailpiece, B!relved by 'ntedN )e / C.Date of DeliveryBe ggg gg _
or on the front If space permits. J c1-S 3 C 2 „ p I oF IS,?
1. Article Addressed to: D. Is delively addrw-a" rent from Item 17 ❑Yes o ;E cu c,. g a s
If YES,enter (dress below: �ioo
David Clegg a Z - --- -
(D
Tyrrell County Manager
PO Box 449 '
Columbia, NC 27925 =..
3. Service Type ❑Prionry Mall Express®
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If YES,enter delivery address below: ❑ No m 3
Ty Fleming N
Tyrrell Soil &Water District Mgr. o o °O t n
155B LA Keiser Drive
USDA Service Center
sill,
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NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
G.LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands or operation
during regular business hours for the purpose of making necessary field inspections or investigations as may be reasonably
required in the administration of the Mining Act of 1971 pursuant to G.S.74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the land as may be
reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry out reclamation which the
operator has failed to complete in the event a bond forfeiture is ordered pursuant to G.S.74-59.
LANDOWNER: APPLICANT:
Signature - ` Signature* Ar�2;
Print Name Alvin R. Smith Print Name Alvin R. Smith
Title(if applicable) Owner, operator Ile Owner, operator
Company(if applicable) Company
Address 500 Jonestown Road Mine Name Buddy Smith Mine
Columbia, NC 27925 Telephone [phone]
Telephone [phone] Date signed 09/15/2022
Date Signed 09/15/2022
*Signature must be the same as the individual who signed Page 1 of this application.
One original and five(5)copies of the completed application,six(6)coples of all location maps.mine maps and
reclamation maps,and the appropriate processing fee in the form a check or money order payable to the North Carolina
Department of Environmental Quality must be sent to the Raleigh Central Office at the address listed on the front cover
of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at(919)707-9220.
Revised September 21, 2021 P a g e 119