20240905_Application

RECEIVED
APPLICATION FOR A MINING PERMIT
I0EMLR
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
1. NameofMine L/fltnS 1'11 He County c/FO /z1�
River Basin TAR— PR h+))'L p
Latitude(decimal degrees to four places) 3 S Y 7 9 3
Longitude(decimal degrees to four places) 7 6 7 3 0
2. Name of Applicant*_ TR M-P-s' LA -4/t,64- �/;vij
3. Permanent address for receipt of official mail** '�-A/ w A6 A44y "i✓e.
13z144 fe„r nV. C, z7,VJO
Telephone (_2 y-4 (7 6 t — 2q 24 Alternate No.1
4. Mine Office Address
i3P I{�JgUe� NC , �700/-U Telephone ( 5-2-)
5. Mine Manager J A n- 2 S /1-11`L/
6. E-mail Address: N f/j-�
I 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 �L Date .�
3 7
PrintNa �I-r MSS M i�Zi4H'e 4 d jyviS
Title 0 W h`,e A
* This will be the name that the mining permit will be issued to and the name that must be indicated on the
reclamation bond(securiW 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
-1-

APPLICATION FOR A MINING PERMIT
provided before this application can be considered complete. Attach additional sheets as needed.
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APPLICATION FOR A M ANG PERMIT
NOTE: All of the following questions must be thoroughly answered regarding your mining operation for
h e intended life of the mine. All responses must be clearly conveyed on a corresponding,detailed mine map.
P
A. GENERAL CHARACTERISTICS OF THE MINE
1• Answer all of the following that apply:
❑ If this is an application for a NEW permit,indicate the total acreage at the site to be covered
permit(thus is the acreage that t e"new permit"fee will be based upon): by e
Of this acreage,how much is owned and how much is leased? Acres owned:
Acres leased: Property owner if leased:
If this is an%eptotal
lication for a MODIFICATION to a mining permit, indicate the mining permit
number and (overall —reage coveredby the existin ermit.
Mining Permit No.: 7_ Total permitted acreage P tl Q
Does the MoMpation involve acreage within the previously ap roved permitted boundary?
Yes❑f�No . If yes,indicate the acreage to be covered by thus modification(this is the acreage
that the ma r odifiicahon fee will be based upon): g
Do mo ' -cation involve acreage outside the previously approved permitted boundary?
YeA- tion:
No�. If es indicate the additional Y � honal acreage to be covered by this
mo ___I_3.L/ _,.(NOTE: you must complete all of Section F.of this application form
entitled Notification of Adjomrng Landowners).
Of this acreage to be added to the permit,will any porti n this acreage be affected i.e..
ground cover removed)by the mining operation? Yes No ( 'disturbed,
fee of$100.00 is r aired, despite the "undisturbed" crea e t❑ono,a"minor modification"
g be added). If yes, indicate the
acreage to be affected within the acreage to be added to the permit(the total acreage to b added to
the permit is the acreage that the "major modification" fee will be based upon):
❑ If this is an application for TRANSFER of a mining permit,indicate the mining permit number and
H/ the total(overall)acreage covered y the existing permit.
A Mining Permit No.: Total permitted acreage:
SEE THE FEE SCHEDULE AT THE END OF THIS FORM FOR THE PROPER FEE AMOUNT TO BE
PAID FOR 'I REQUESTED PERMIT ACTIONS) AND CORRESPONDING ACREAGE NOTED
ABOVE
2. Name of all materials mined: ' �=J`� iA
3.PDYragline
g method:
draulic Dredge Front-end Loader&Truck Shovel&Truck&Truck Self-loading Scraper
Other(explain):
4, a. Expected maximum depth of mine(feet) Z a
Depth is relative to what benchmark? (e .,naturalground level meansea
Fv,�JJ Lea gr' level,road elevation,etc.)
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b. Expected average depth of mine(feet) /3
5. Has any area(s)at this site been mined in the past? Yes No ❑
If yes,when and by whom was this activity conducted? %ot e, pok-eSaov7- n v e-
PR-^M' 7'r-e of ✓4i2��,
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APPLICATION FOR A M WG PERMIT
6. Number of years for Jr the permit is requested(Life of the Mining Operation or Life of Lease from
Public Entity)-
B. MAPs
1. Clearly mark and label the location of your mining operation on sic copies of a 7.5-minute e
and a county highway map,.These maps,in addition to six(6)cop es o all maps and reclamationce
maps,must be submitted with each permit application.
7.5-minute quadrangles maybe obtained from the N.C. Geological Survey:
Mailing-Address: Physical Address:
1612 Mail Service Center OR 512 North Salisbury Street,5'Floor
Raleigh,North Carolina 27699-1612(919)733-2423 Raleigh,North Carolina 27604
httu://nortal.ncdenr or web/lr/geolo 'cal home
County highway maps may be obtained from the N.C. Department of Transportation:
North Carolina Department of Transportation—Geographic Information Systems(GIS)
Mailing_Address: Physical Address:
NCDOT GIS Unit NCDOT GIS Unit
1587 Mail Service Center 3401 Carl Sandburg Court
Raleigh,North Carolina 27699-1587 Raleigh,North Carolina 27610
[phone]
htty://www.ngd2l,2 it/ais/
2. 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(see minimum requirements listed below)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.
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.
gg Outline and acreage of all temporary and/or permanent overburden disposal areas.
h. Location and acreage of all processing i
lants(process
distance from mine if suffiiently far removed).
(processing plants may be described as to location and
i. Locations and names of all streams,rivers and lakes.
j. Outline and acreage of all settling and/or processing wastewater ponds.
k. Location 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 floodplain 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.
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APPLICATION FOR A MINING PERMIT
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 adjo i ing 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 ad ouung these tracts, that are within 1,000 feet of the minin permit
provided on the mine map(s). NOTE;"j-ii wa 'means a ro g p rm�t boundary' must be
and is not designated as an Interstate Highway. that four lanes of travel or loss
q. Map legend:
1. Name of applicant
2. Name of mme
3. North arrow
4. County
5. Scale
6. Symbols used and corresponding names
7. Date prepared and revised
8. Name and title of person preparing map
Map scales should meet the following guidelines:
PERMITTED ACREAGE MAP SCALE
0-49 Acres 1 inch=50 feet
50-199 Acres 1 inch= 100 feet
200+Acres 1 inch=200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)
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APPLICATION FOR A MIlIT NG PERMIT
A table/chart must be provided on the mine man that clearly lists the approximate acreage of tailings/sediment
ponds,stoc Iles was ales,�P. A� prOCessxng ar sul roads,mine excavation and any other major aspect of the
mining operation that is proposed to be affected/disturbed during the life of the mining permit. A table/chart
similar to the following will be acceptable:
CATEGORY AFFECTED ACREAGE
Tailings/Sediment Ponds ® ,r 40
Stockpiles 6 3 O
Wastepiles //0I
Processing Area/Haul Roads 61 ,60
pOther
xcavation 01/
Explain} 2 3D
Total Disturbed Acreage
NOTE:
IN ADDITION TO THE ABOVE, THE MAPS MUST ALSO INCLUDE ANY SITE-SPECIFIC
INFORMATION THAT IS PROVIDED IN TEE ANSWERS TO THE FOLLOWING QUESTIONS IN
THIS APPLICATION FORM (PLEASE NOTE THE ITALICIZED QUESTIONS/STATEMENTS
THROUGHOUT THE FORM- THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS,
$ UolµAAr r e,-J 4 CX-y
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APPLICATION FOR A M[NING PERMIT
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 pheets as needed.
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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 g�•ve a detailed sequence of
installation and schedule for maintenance of the measures. Locate and label all sediment
ment and erosion
control measures on the mine maps) and provide typical cross-sections/construction details of each
measure. Engineering designs and calculations are required to justify the adequacy of any proposed
measures.
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3.a. Will the opera ' invo washing the material mined, recycling process water, or other waste water
handling? Yes LJ No . if yes,brieflydescribe all such processes p cesses including any chemicals to be used
b. Will the operation involve dis h g fresh or waste water from the mine or plant as a point discharge to
the waters of the State? Yes No M. Iff'yes,briefly describe the nature of the discharge and locate
all proposed discharge oints ng withh their method o stabilization on our mine of stabilization)) y map,
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APPLICATION FOR A NAG PERMIT
c. Will any part of the proposed mine excavations extend el w the ater table?Yes No❑.
If Yes,do you intend to dewater the excavations)? Yes Novi.,..,
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If yes,what impact,if any will mine dewatering have on eighboring wells? Estimated withdrawal rate
in gallons r day; . Locate all existing wells on the mine maps)that lie within
S00 feet o�e ro osed excavation area P P . Provide data to support any conclusions or statements 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.
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d. If you answered yes to any of the above questions, provide evidence that you have applied for or
obtained the appropriate water duality permit(s)(i.e.,non-discharge,NPDES,Stormwater,etc.)from the
Stormwater Program. In addition,the applicant is required to register water
g1 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 1002000
gallons per day.
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4. a. Will the operation involve crushing or any other air contaminant emissions?Yes ❑ No
If yes, indicate evidence that you have applied for or obtained an air quality '
Division of Air Quality or local governing body. q tY Pernut issued by the
b. How will dust from stockpiles,haul roads, etc.,be controlled?
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APPLICATION FOR A MINING PERAW
5. a. A buffer will be required between any minis activity and an minis g tY Y g permit boundary orright-of-
wayy. It may be an unexcavated buffer (no excavation, but roadways, berms and erosion &
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scdimentation control measures may be installed within it) died
within the buffer whatsoever >an , seed buffer(no disturbance
),or a combination of the two depending upon the site conditions. Note
that all buffers must be located w the mining permit boundaries.
How wide a buffer will be maintained between any minis activity and an minis g tY y g 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).
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b. A minimum 50 foot wide undisturbed buffer will be required between any land disturbing activities
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within the g 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 disturbin#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).
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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.
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APPLICATION FOR A MINING PERMIT
b. Provide a cross-section on the mine maps)for all fill slopes (berms, wastepiles, 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.
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).
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.
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7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwelling
house,public road,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.
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8. Describe what kind of barricade will be used to prevent inadvertent public access along an 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 detail/cross-section and location of each
type of barricade to be used must be indicated on the mine map(s).ble ro CI-f C:A-e ad ^4 ,POYQ .0
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APPLICATION FOR A MNING PERMIT
9. Are acid producing minerals or soils present? Yes❑ No NV
If yes,how will acid water pollution from the excavation,sto les and waste arras be controlled?
10. a. Describe specific plans(including a schedule of implementation)for screening the opperation 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.
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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?
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1 1. Will explosives be used? Yes❑ No
If yes,specify the types of explosives)adescribe what precaution(s)will be used to prevent pphysical
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 thud party blasting study). Locate the nearest offsite occupied
structure(s)to the proposed excavations)on the mine map and indicate its approximate distance to the
proposed excavation.
12. Will fuel tanks,solvents,or other chemical reagents be stored on-site? Yes❑ NAbse
Ifyes,describe these materials,how they will be stored and method of containment infspill. Indicate
the location(s)of all storage facilities on the mine map(s).
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APPLICATION FOR A MINIlVG PERMIT
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 ofrestoration or establishment
of any permanent drainage channels to a condition 'minimizing erosion,siltation and other pollution. This
information must be illustrated on a reclamadOn map and must correspond directly with the information
provided on the mane ntap(s). In addition, design information, including typical cross sections, of any
Permanent channels to be constructed aspart of the reclamation plan and the location(s)of allpermanent
channels must be indicated on the reclam�ation map.
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2. Is an excavated or impounded body of water to be left as a part of the reclamation?Yes No❑.
If yes, illustrate the location of the body(s) of water on the reclamation map and r vide a scaled
cross sections)through the proposed body(s)of water. The minim
um water depth must be at least 4 feet,
measured from the normal low water table elevation,unless information is provided to indicate that a more
shallow water body will be productive and beneficial at this site.
Will the body(s)of water be stocked with fish? Yes No ❑.
If yes,specify species.
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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 le#I. 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.
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APPLICATION FOR A NIEM NG PERMIT
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.
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5. a. Describe reclamation of processing facilities,stockpile areas,and on-site roadways.
b.Will any on:site roadways be left as part of the reclamation? Yes ❑ No rV.
If yes,identify such roadways on the reclamation map and provide details on Prmanent road and ditch
line stabilization.
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 nine 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 governing 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 ma (s)and reclamation map, along with a list of items to be disppsed in sayareas.
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APPLICATION FOR A MINING PERMIT
7. Describe your plan for revegetation or other surface treatment of the affected areas. This plan must
include recommendations for,ear-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 permanent revegetation and, if necessary, 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 Division of Forest Resources, Department of Environment and
Natural Resources;
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 Division of Forest Resources, Department of
Environment and Natural Resources;
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 (tons/acre): two tons/acre
FERTILIZER- ANALYSIS AND RATE OF APPLICATION (pounds/acre):
500 lbs/acre 10-10-10
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Sees: Seeding Dates: Seeding Rates:
Pensacula Bahia April 1 to August 15 60
Common Bermuda April 1 to August 15 10
German Millett April 1 to August 15 10
Tall Fescue August 15 to May 31 10
Pensacola Bahia August 15 to MAy 31 40
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF
ANCHORING: 2 tons straw mulch per acre when required.
OTHER VEGETATIVE COVERS - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Revegetationr�eforti pl approved by:
Signature // `^J Date
Print Name Hood L. Richardson
Title Consultant
Agency Hood Richardson P.A.

APPLICATION FOR A MINING PERMIT
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 miningpermit.Please insert the approximate acreage,for each
as ect o the minin o eratt'on that ou in
to affect d o t is minin ermit in addition lease
insert the gWropriate reclamation cost/acre cote o o Schedule of Reclamation Costs
rovided iWth this application orm OR yo adAfer to the D a t lculate your bond for you based
u on our ma s and s g&krd reclamation(cos
AFFECTED RECLAMATION RECLAMATION
CATEGORY ACREAGE COST/ACRE* COST
Tailings/Sediment Ponds: Ac. X $ /Ac. - $
Stockpiles: Ac. X $ /Ac. _ $
Wastepiles: Ac. X $ /Ac. _ $
Processing Area/Haul Roads: Ac. X $ /Ac. - $
Mine Excavation: Ac. X $ /Ac. W $
Other: Ac. X $ /Ac. - $
TOTAL AFFECTED AC.: Ac.
(TOTAL PERMITTED AC.: 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 off-site sedimentation and sedimentation to onsite watercourses and wetlands.
a) Internal Drainage Ac.
b) Positive Drainage Ac. X $13,500.00 = $
SUBTOTAL COST: $
Inflation Factor:
0.02 X SUBTOTAL COST: $ X Permit Life Provided by Applicant(Life of the Mining Operation
or Life of Lease from Public Entity(in Years)):
INFLATION COST: $
Total Reclamation Bond Cost: $
(round down to the nearest$100.00)
(NOTE: The reclamation bond cannot exceed$1 million per GS 74-54)
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APPLICATION FOR A MINING PERMIT
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 minim
permit boundary,if an adjoining tract is owned or leased by the applicant or is owned by the lesso
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 or is owned by the lessor of the nine 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 tag 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.
THIS SECTION MUST BE COMPLETED FOR ALL APPLICATIONS FOR NEW MJNING PERMITS
AND ALL MODIFICATIONS OF A MINING PERMIT TO ADD LAND TO IM PERMITTED AREA,AS
REQUIRED BY NCGS 74-50(bl).
SEE THE NEXT TWO PAGES FOR THE "NOTICE" FORM AND THE "AFFIDAVIT OF
NOTIFICATION"
-16-

NOTICE
Pursuant to provisions G.S. 74-50(bl)of The Mining Act of 1971,Notice is hereby given that
c�i�r12,� /v!i ��►.�.�Q /�.�vas
(Applicant Name) has applied on
(Date)
to the Division of Energy,Mineral,and Land Resources,North Carolina Department of Environmental Quality,
1612 Mail Service Center,Raleigh,North Carolina 27699-1612, for(check one):
❑ anew surface mining permit,
Ka modification of an existing surface mining permit to add land to the permitted area; or
❑ nModification of an existing surface mining permit to add land to the permitted area with no disturbance
e 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 r"a-I f 1 PIA1--- on l 3
acres located --�
(Mineral,Ore) (Number) (Miles)
5,)",-rH of 8-Z f�t.�✓..e lid offlnear � S�d��y
(D' 'on) (Nearest Town) road �-S� umber N �s
in - /�vFv A i' County. CN ame)
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(b 1), 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 notified(that are within 1,000 feet of the mining ermit
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 mad file written comment(s)to the
Department at the above address within thirty(30)days of the issuance of this Notice or thefiling of the application
for a permit,whichever is later. Should the De
ipartment 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 reg rding
s ecifics of the Drouosed minis lS#V:1L iDlease contact the aDiDlicaut at the following tele hone number:
7 2 . For information on the mining permit application review process,p ease contact
e Mining Program s at(919)707-9220. Please note that the D art7ment will consider any relevant written
commcnts/documentation within the provisions of the Mining Act of 1971 throughout the app ication review
process until a final decision is made on the application. /-A;01s�w� P�
/4 S1, Fen 14oul Ai lases S&,C0H d s ri2-"--Y�
(Addressee/Owner of Record's 14 e ,�/�,�oiu (Name of Applicant: Include Contact Person
Name and Address) L` &Company Name,if Apphca)p)
. ;L
(Date of Issuance of this Not-ice// (Address Py i Applicant)
Mailed to Addressee/Owner of Record) • ll e.,`� D
_17_
4�k � 1�
P

MINING PEWVHT
APPLICATION FOR A
AFFIDAVIT OF NOTIFICATION
l .
c3 rL dS OV,-, an applicant,or an agent,or employee of an applicant,for a
new kining 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)
L;s r A rr/*c C -J
(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:
(Chief Administrative Officer Name) (Address)
[i.e.: City Manager,County Manager,Mayor, etc.] Zl Wt�s T 3/t 4 S
�1 .4� lit Cjv" r/ 1""A
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 pruning 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(b 1)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 above
notices were caus d to be mailed and to rovide them to the Department upon request.
Signature of Applicant or Agen Date
If person executing Affidavit is an agent or a p � h/loyee of an applicant,provide the following information:
PP �� C�
Name of applicant:. � ~ .C-
Title of person executing Affidavit C-04Isrl 1-74 ` -Q�
County
L Notary Public of the of
State of North Carolina,do hereby certify that
(, L. Qi-chont s oy-J
appeared before me this day and under oath acknowledged that the above Affidavit was made by him/her.
Witness NRd and notari is-V. 4day of 20
Notary: my Co 'ssion expires: 1
CANON s _ 8-
-NOTARY PUBLIC .
Beaufort County, North Carolina

DAVIS MINE PERMIT MODIFICATION
Permit Number 07-48
Beaufort County
March 16,2019
Sheet 1 of 2
Craig Richard DeHoog
565 School house Road
Belhaven,N.C.27810
Robert A.Thompson
5755 Sidney Road
Belhaven,N.C.27810
Sidney Free Will Baptist Church
434 Sidney Road
Belhaven,N.c.27810
Cemetery(Satterthwaite)
220 North Market Street
Washington,N.C.27889
Nancy N.Paul
P.O.Box 1861
Kilmarnock,Va.22482
Johnnie B.Brinn,Jr.
5459 Highway 99 South
Belhaven,N.C.27810
Tri-County Telephone
P.O.Bog 520
Belhaven,N.C.27810
Norman Jerol Selby
5724 Sidney Road
Belhaven,N.C.27810
Conetoe Land and Timber company
3820 Stevens Mill Road
Goldsboro,N.C.27530
Mitchell Vanscott
1314 Fantasia Street
Greenville,N.C.27858

Sheet 2 of 2
Robert Killingsworth
105 Hillcrest Drive
Washington,N.C.27889
Janice M.Davis
521 Foreman Lane
Belhaven,N.C.27810
Brian Alligood
Beaufort County Manager
121 West Third Street
Washington,N.C.27889
Sal's Enterprises,Inc.
210 Steeple Chase Drive
Washington,N.C.27889
Betty Dodson
5975 Savanna Road
Belhaven,N.C.27810

APPLICATION FOR A MINING PERMIT
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 forthe 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 abond forfeiture is ordered pursuant to G.S.
74-59.
LANDOWNER: APPLICANT:
e
Signature: ttl
Signature:* I !
Print Name:e//kw7Ls /"I I Ci�1 16!tv1S p tName: U f��`�PS Mr G/1 P.P �J3trts
(Title,if applicable)
Company 0I.y.4-e.12. Title: Q w -P-A
(If applicable)
Address: J 2 C j25ox.�e d23 Zh'wQ Company: ©2 )V-0-9 L
/.z t;/ hA V ,e, �. ?�/a Mine Name: 9)4-v!S
1�z6 Telephone: ) 76 � Telephone: ( ) q
Date Signed: 71 k-7 l Date Signed:
*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)copies of all location maps,mine maps
and reclamation mans,and the appropriate processing fee(see next page for fee schedule)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
[phone].