NT21113 03-25-24 Mine App. Page 1 Revised

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.
1. Name of Mine Coastal Land and Sand Company, LLC Mine
County Brunswick River Basin Lumber
Latitude(decimal degrees to four
places) 34.0605
Longitude(decimal degrees to four
places) -78.2607
2. Name of Applicant Coastal Land and Sand Company, LLC
Applicant Contact Dave Tripp Consultant Contact J. Phillip Norris, P.E.
Applicant Email [e-mail] Consultant Email [e-mail]
Telephone [phone] Telephone [phone]
Cell Phone [phone] Cell Phone [phone]
3 Permanent Address for Receipt of
Official Mail** 3540 Ash-Little Road, Ash NC 28420
4. Mine Office Address P.O. Box 126 Ash, NC 28420
5. Mine Manager Dave Tripp
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*** ��� -� .� °� ,., Date A.'As lar{
Print Name Dave Tripp
Title Mine Manager
*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 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 a g e 11