20250124_Transfer_Application_66-04

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 Grit Pit
County Northhampton River Basin Roanoke
Latitude(decimal degrees to four
places) 36.2574
Longitude(decimal degrees to four
places) -77.3304
2. Name of Applicant FSC 11, LLC dba Fred Smith Company
Applicant Contact Andrew J.Norton Consultant Contact
Applicant Email [e-mail] Consultant Email
Telephone Telephone
Cell Phone [phone] Cell Phone
3. Permanent Address for Receipt of
Official Mail" 701 Corporate Center Drive, Suite 195
Raleigh, NC 27607
4. Mine Office Address 1367 Chapel Hill Church Road
Rich Square, NC 27869
5. Mine Manager Chad McCaskey
Mine Manager Email [e-mail]
Telephone [phone] Cell Phone
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*'* � Date 01/16/2025
Print Name #Vdrew J.Norton
Title VP and Assistant Secretary
'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 Page 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]
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:
F-1 This is an application for a NEW permit.
Indicate the total acreage at the site to be covered by the permit
(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: Acres leased:
Property owner if leased:
F-1 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?
YES F]NO
If yes,indicate the acreage to be covered by this modification
Does the modification involve acreage outside the previously approved permitted boundary?
FIYES RNO
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 F1 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.
IX7 This is an application for TRANSFER of a mining permit.
Mining Permit Number: 66-04 Total permitted acreage: 117.71
Revised September 21, 2021 Page 12

NORTH CAROLINA MINING State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION Departmentof Environmental Quality Raleigh,NC 27699-1612
Division of Energy,Mineral,and Land Resources [phone]
MINING FEE SCHEDULE
A nonrefundable permit application processing fee when filing 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 1 $100.00 $100.00
Annual Operating Fee 1 $400.00 $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 and Gravel
3. Mining Method:
Hydraulic Dredge Z Front-end Loader&Truck QShovel&Truck
Dragline&Truck Self-loading Scraper aExcavator&Truck
Other(please explain):
4. Expected maximum depth of mine(feet)25
Depth is relative to what benchmark?(e.g.,natural ground level,mean seal level,road elevation,etc.)
natural ground
Expected average depth of mine(feet)22
5. Has an area at this site been mined in the past?
YES X NO r ]
If yes,when and by whom was this activity conducted?1977 b N—ml Odg4mDyMoratoc Sand and Wwderted to Row Brothers Pawtg Company I,FeWuery 1997
6. Estimated life of the operation(years):40
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,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*
IV
Print Name ndrew J. Norton Print Name Andrew J. Norton
Title(if applicable) VP and Assistant Secretary Title VP and Assistant Secretary
Company(if applicable) FSC ii,LLC dba Fred Smith Company Company FSC II,LLC dba Fred Smith Company
Address Mine Name
701 Corporate Center Drive,Suite 195 Grit Pit
Raleigh, NC 27607 Telephone [phone]
Telephone [phone] Date Signed
Date Signed 11&1�005.
*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 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