20230124_name_correction

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. =2FCFI VFD
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1. Name of Mine Buddy Smith Mine -- -nu 3
County Tyrrell County River Basin Pasquot UQuauTY
Latitude(decimal degrees to four AM
places) 35.902759 N.
Longitude(decimal degrees to four
places) -76.273759 W.
2. Name of Applicant Alvin R. Smith, Jr.
Applicant Contact Alvin R. Smith, Jr. Consultant Contact Kenneth Elliott _
Applicant Email smithdemo3Qgmail.com 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, Jr.
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 underst at any willful mis presentation of facts will be cause for permit revocation.
signature.. Date 01/13/2023
Print Nam Ivin R. Smith, Jr.
Tille 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 company officer reouired.
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 a g e l

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NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Department of Environmental Quality sleigh,NC 27699-1612
Division of Energy,Mineral,and Land ResoiRR 0 E I V E [phone]
G.LAND ENTRY AGREEMENT JAN 2 4 Z9Z3
L No QUALITY
We hereby grant to the Department or its appointed representatives the right of entry @llnpr mIaftds 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:
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Signature'
i
Print Name Alvin R. Srrli h, Jr. Print Name Alvin R. Smith, Jr.
Title(if applicable) Owner, operator rue Owner, operator
Company(if applicable) Company
Address 500 Jonestown Road Mine Name Buddy Smith Mine
Columbia, NC 27925 Telephone [phone]
Telephone [phone] Date Signed 01/13/2023
Date Signed 01/13/2023
'Signature must be the same as the individual who signed Page 1 of this application.
One original and five(5)conies of the completed application,six(6)copies 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.
Inquires 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

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