20210330_Mine_Applicaton_combined

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NORTH CAROLINA
MINING PERMIT APPLICATION
Foster Forbes Mine
Caratoke Highway, Powells Point, NC
Currituck County
RECEIVED
MAR 3 0 2021
LAND QUALITY
MINING PROGRAM
State of North Carolina
Department of Environmental Quality
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: 2017

ELLIOTT CONSULTING
March 19, 2021
North Carolina Department of Environmental Quality
Division of Energy, Mineral and Land Resources
Land Quality Section
1612 Mail Service Center
Raleigh, NC 27699-1612
RE: FOSTER FORBES MINE — PERMIT APPLICATION
To Whom It May Concern:
On behalf of HOM Development, LLC, Elliott Consulting is requesting review of an application for a mining
permit for a new sand mine operation proposed for development in Poplar Branch Township, Currituck
County, North Carolina. The operation will be titled as the Foster Forbes Mine and includes a total permit area
of 41 acres.
The following documents are enclosed to support the application (6 copies each):
• Mining Permit Application
• $5,000 Application Fee
• Overview Map with Adjacent Owners
• Mining and Reclamation Maps
• USGS Quad Map
• NCDOT County Highway Map
• Dewatering Basin Calculations
In addition to this application, submissions have also been made to US Army Corps of Engineers for confirmed
wetlands delineation, Dominion Energy for powerline encroachment agreement, NCDOT for proposed
driveway permit, and NCDEQ Land Quality Section for NPDES Coverage under NCG020000 for dewatering
activities. After receiving approval of the above applications, application to Currituck County for an approved
Use Permit will be submitted.
HOM Development, LLC does hereby request approval for this Mining Permit application and asks that it be
expedited as soon as possible. HOM Development, LLC appreciates your consideration of this mine permit
application.
Best Regards,
Ken Elliott
Elliott Consulting
PO BOX 112 AYDLII'I"I', NOR-1'II CAROLINA • 27916
PIIONIS: 252-339-9021 • F.MAIL: KRNa KBNOIix.COM

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
1. Name of Mine Foster Forbes Mine County Currituck
River Basin Pasquotank
Latitude (decimal degrees to four places) 36.131738 N
Longitude (decimal degrees to four places)-75.842601 W
2. Name of Applicant* HOM Development, LLC
3. Permanent address for receipt of official mail *
PO Box 2405, Manteo, NC 27954
Telephone ( 252 ) 473-6074 Alternate No. ( 252 ) 202-4040
4. Mine Office Address 1002 Driftwood Drive, Manteo, NC 27954
Telephone ( 252 ) 473-6074
5. Mine Manager Jamie Basnight Hatchell
6. E-mail Address: _ [e-mail]
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.
***Siature Rznt"r 1_Ll Date March 18 2021
gn,
Print Name Jamie Basnight Hatchell
Title 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.
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APPLICATION FOR A MINING PERMIT
NOTE: All of 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 of the following that apply:
0/
If 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 that the "new permit" fee will be based upon): 41.0 acres
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: 41.0 acres Property owner if leased: Foster Allen Forbes
If this is an application for a MODIFICATION to a mining permit,
number and the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
indicate the mining permit
Does the modification involve acreage within the previously approved permitted boundary?
Yes ❑ No ❑. If yes, indicate the acreage to be covered by this modification (this is the acreage
that the "major modification" fee will be based upon):
Does the modification involve acreage outside the previously approved permitted boundary?
Yes ❑ No F. 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 this acreage to be added to the permit, will any portion of this acreage be affected (i.e.: disturbed,
ground cover removed) by the mining operation? Yes ❑ No ❑ (If no, a "minor modification"
fee of $100.00 is required, despite the "undisturbed" acreage to be added). If yes, indicate the
acreage to be affected within the acreage to be added to the permit (the total acreage to be 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
the total (overall) acreage covered by the existing permit.
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 THE REQUESTED PERMIT ACTION(S) AND CORRESPONDING ACREAGE NOTED
ABOVE
2. Name of all materials mined: Sand & topsoil
3. Mining method:
Hydraulic Dredge Front-end Loader & Truck ® Shovel & Truck
Dragline & Truck Self -loading Scraper
Other (explain): Excavator
4. a. Expected maximum depth of mine (feet) 35 feet
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation, etc.)
Below natural ground level
b. Expected average depth of mine (feet) 30 feet
5. Has any area(s) at this site been mined in the past? Yes ® No ❑ Less than 1-acre pond permit
If yes, when and by whom was this activity conducted? Foster Forbes, approximately 2007.
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APPLICATION FOR A MINING PERMIT
6. Number of years for which the permit is requested (Life of the Mining Operation or Life of Lease from
Public Entity): 8 years
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:
Mailing Address: Physical Address:
1612 Mail Service Center OR 512 North Salisbury Street, 5t'' Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
litti):Hportal.ncdenr.ora/web/lr/aeolov-ical 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:
NCDOT GIS Unit
1587 Mail Service Center
Raleigh, North Carolina 27699-1587
Physical Address:
NCDOT GIS Unit
3401 Carl Sandburg Court
Raleigh, North Carolina 27610
[phone]
http://www.ncdot.org/it/gis/
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.
g. Outline and acreage of all temporary and/or permanent overburden disposal areas.
h. Location and acreage of all processing plants (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. 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 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. Name of applicant
2. Name of mine
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 I 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 MINING PERMIT
A table/chart must be provided on the mine map that clearly lists the approximate acreage of tailings/sediment
ponds, stockpiles, wastepiles, processing area/haul 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
0.51 acres
Stockpiles
4.43 acres
Wastepiles
Processing Area/Haul Roads
3.24 acres
Mine Excavation
6.23 acres
Other (Explain) - Unexcavated Buffers
2.05 acres
Total Disturbed Acreage
16.46 acres
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 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.
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APPLICATION FOR A MINING 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 sheets as needed.
a. Operator will obtain approved mining and dewatering permits from NC Dept. of Environmental
Quality, and approved Use Permit from Currituck County Dept. of Planning & Community
Development.
b. Operator will construct and maintain 30-ft wide access/haul road from mine activity area across field
to Caratoke Highway.
c. Operator will pave the first 200 feet of access road starting at its intersection with Caratoke Highway
with continuous pavement.
d. Operator will remove topsoil down to 2.5 feet below natural ground level, and stockpile overburden
for use in erosion control berms.
e. 2-ft tall x 8-ft wide perimeter berm will be constructed inside unexcavated buffer around the
excavation area and stockpile area using onsite soils and stabilized with groundcover seeded per
seeding schedule in this application.
f. Operator will maintain existing foliage visual screen along perimeter of the affected area.
g. Operator will construct 5-ft tall by 32-ft wide berm around existing 0.51-acre pond located 85 feet
east of the proposed excavation boundary, which will be utilized as a sedimentation pond for
dewatering the excavation. Sediment pond will be 133 feet wide by 168 feet long with 0.65-acre
water surface for sedimentation. Sediment pond berm will be minimum 32 feet wide, 5 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 north corner of sediment pond, discharging
into minimum 12-in plastic pipe leading to riprap-protected existing ditch draining to Foster Forbes
Ditch and Albemarle Sound.
h. Operator will construct 1200-ft long by 10-ft wide by 6-ft deep hydration ditch for groundwater
recharge along the western edge of the mine activity area inside the unexcavated buffer. Ditch will
be sited between the mining perimeter berm and the adjacent undisturbed buffer. Undisturbed buffer
will serve as filter strip to allow slow overflow of water into the adjacent wetlands without erosion of
the buffer. Hydration ditch will be kept full of water during mine dewatering operation.
i. 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 idle speed with 400-500
gallon per minute flow into sediment pond.
j. Operator will begin excavation of main pond (6.23 acres) approximately 85 feet west of sediment
pond by digging with excavator and removing sand & topsoil to maximum depth feasible without
dewatering the excavation.
k. 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 Foster Forbes
Ditch draining to Albemarle Sound. Operator will dewater main excavation down approximately 25
feet below normal groundwater level.
1. 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.
m. Pond will be excavated to average 30 feet and maximum 35 feet below natural ground level while
dewatering is maintained. Excavated material (sand) will be stockpiled in a 4.43-acre stockpile and
loading area east of the excavation. Sand will be loaded into trucks and removed from area via the
access road leading to Caratoke Highway.
n. When final excavation of pond is complete, dewatering will be discontinued, and pump shut down

APPLICATION FOR A MINING PERMIT
and removed. Groundwater will refill the excavation to normal seasonal high groundwater level.
o. After all excavation is complete, operator will establish groundcover on 3:1 above -water slopes of
excavation and will construct 8-ft wide by 1-ft tall 4:1 berm around excavation edge to prevent
erosion of pond slopes, with outside edge of berm graded down to natural ground level.
p. Sediment pond will be drained of water and filled with sand at request of landowner. Sediment pond
berm will be used as part of fill. Once filled, sediment pond area will be graded, levelled, and sowed
with groundcover. Area will be allowed to return to non -erosive field state.
q. Former stockpile / perimeter berm areas and processing areas outside of main excavation will be
graded, leveled, and seeded with groundcover. Areas will be allowed to return to previous non -
erosive field state.
r. Hydration ditch will be filled with overburden soil and will be graded, levelled and sown with
groundcover. Area will be allowed to return to non -erosive field state.
s. 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.
t. Operator will grade and level dirt portion of access road to Caratoke Highway back to original non -
erosive state. Paved portion of access road will remain as is. Field path will lead from access road
around perimeter of pond.
u. Remaining affected areas inside main permit area will be fertilized and returned to natural field state.
v. Remaining pond will be utilized by landowner for scenic & recreational purposes, and as wildlife
habitat.
2. Describe specific erosion control measures to be installed prior to land disturbing activities and during
mining to prevent offsite sedimentation (include specific 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 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.
a. Operator will construct and maintain 30-ft wide access/haul road from mine activity area across field
to Caratoke Highway.
b. Operator will pave the first 200 feet of access road starting at its intersection with Caratoke Highway
with continuous pavement.
c. 2-ft tall x 8-ft wide perimeter berm will be constructed inside unexcavated buffer around the
excavation area and stockpile area using onsite soils and stabilized with groundcover seeded per
seeding schedule in this application.
d. Operator will construct 5-ft tall by 32-ft wide berm around existing 0.51-acre pond located 85 feet
east of the proposed excavation boundary, which will be utilized as a sedimentation pond for
dewatering the excavation. Sediment pond will be 133 feet wide by 168 feet long with 0.65-acre
water surface for sedimentation. Sediment pond berm will be minimum 32 feet wide, 5 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 north corner of sediment pond, discharging
into minimum 12-in plastic pipe leading to riprap-protected existing ditch draining to Foster Forbes
Ditch and Albemarle Sound.
e. Operator will construct 1200-ft long by 10-ft wide by 6-ft deep groundwater hydration/recharge
ditch along the western edge of the mine activity area inside the unexcavated buffer. Ditch will be
sited between the mining perimeter berm and the adjacent undisturbed buffer. Undisturbed buffer
will serve as filter strip to allow slow overflow of water into the adjacent wetlands without erosion of
the buffer. Hydration ditch will be kept full of water during mine dewatering operation.
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APPLICATION FOR A MINING PERMIT
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes ❑ No Z. 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 ❑. Ifyes, briefly describe the nature of the discharge and locate
all proposed discharge points (along with their method of stabil ization) on your mine map(s).
Operator will construct 5-ft tall by 32-ft wide berm around existing 0.51-acre pond located 85 feet
east of the proposed excavation boundary, which will be utilized as a sedimentation pond for
dewatering the excavation. Sediment pond will be 133 feet wide by 168 feet long with 0.65-acre
water surface for sedimentation. Sediment pond berm will be minimum 32 feet wide, 5 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 north corner of sediment pond, discharging
into minimum 12-in plastic pipe leading to riprap-protected existing ditch draining to Foster Forbes
Ditch and Albemarle Sound.
c. Will any part of the proposed mine excavation(s) extend below the water table? Yes ® No ❑.
If yes, do you intend to dewater the excavation(s)? Yes ® No ❑.
If yes, what impact, if any, will mine dewatering have on neighboring wells? Estimated withdrawal rate
in gallons per day: 0.24 mad. 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 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.
No groundwater wells located within 500 feet of proposed excavation. Closest well located 850 feet
from excavation. Seven parcels with groundwater wells located within 1500 feet of excavation.
Mine operator will install two groundwater level monitoring wells on east side of permit area per
siting recommendations of Currituck County Engineering Department.
Operator will construct 1200-ft long by 10-ft wide by 6-ft deep groundwater hydration/recharge
ditch along the western edge of the mine activity area inside the unexcavated buffer. Ditch will be
sited between the mining perimeter berm and the adjacent undisturbed buffer. Undisturbed buffer
will serve as filter strip to allow slow overflow of water into the adjacent wetlands without erosion of
the buffer. Hydration ditch will be kept full of water during mine dewatering operation.
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 has applied to NCDEQ for an NCG02/NPDES General Permit to dewater the excavation.
Permit application is under review. Operator will register water usage with NCDEQ DWR upon
approval of NCG02 permit.

APPLICATION FOR A MINING PERMIT
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No M.
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?
Operator will pave first 200 feet of access road starting at Caratoke Highway with continuous
pavement. Spraying or spreading water from water supply trucks or excavator on other dirt haul
roads and process areas will control dust. Stockpiles will also be sprayed with water weekly if
necessary, to control dust.
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 bu fer locations and widths on the mine
map(s).
25-ft wide unexcavated buffer around north, south and west side of excavation area,
minimum 25-ft wide unexcavated buffer around north, south and east side of stockpile area,
300-ft undisturbed residential buffer between stockpile area and adjacent residences, 100-ft
wide undisturbed property line buffer around entire mining activity area. 25-ft wide
unexcavated buffer between excavation area or stockpile area and 120-ft wide Dominion
Power transmission line easement.
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).
50-ft wide undisturbed buffer between unexcavated buffer and wetlands to north, south and
west.
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.

APPLICATION FOR A MINING PERMIT
b. Provide a cross-section on the mine map(s) 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.
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.
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, 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.
25-ft wide unexcavated buffer between excavation area or stockpile area and 120-ft wide Dominion
Power transmission line easement. No other structures within 300 feet of excavation.
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 detail/cross-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. Excavation area is located behind existing visual screen of full -growth foliage.
9. Are acid producing minerals or soils present? Yes ❑ No ®.
If yes, how will acid water pollution from the excavation, stockpiles and waste areas be controlled?
Not applicable.
-10-

APPLICATION FOR A MINING PERMIT
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 maps) and provide cross -
sections through all proposed berms or proposed spacing, sizes and species for tree plantings.
Excavation area is located behind existing visual screen of full -growth foliage around north,
south, and west sides of permit area. Foliage will remain in place. Operator will construct 5-ft
tall berm along eastern perimeter of stockpile area. Mine area will be accessible only by gated
mine access road.
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?
Currituck County Rural Center (CCRC horse park) located 1.25 miles southeast of proposed
mine activity area behind heavy foliage and woodland. Mine activity will have no impact on
CCRC operation.
Will explosives be used? Yes ❑ No Z.
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 offsite occupied
slructure(s) to the proposed excavations) on the mine map and indicate its approximate distance to the
proposed excavation.
Not applicable.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ® 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).
Operator will store non -highway diesel fuel onsite for use by mining equipment and dewatering
pump. Fuel will be stored in temporary aboveground double -wall storage tanks approved by State
and Federal rules and regulations.
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APPLICATION FOR A MINING 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 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 directly 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 locations) of all permanent
channels must be indicated on the reclamation map.
a. 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.
b. After all excavation is complete, operator will establish groundcover on 3:1 above -water slopes of
excavation and will construct 8-ft wide by 1-ft tall 4:1 berm around excavation edge to prevent
erosion of pond slopes, with outside edge of berm graded down to natural ground level.
c. Sediment pond will be drained of water and filled with sand at request of landowner. Sediment pond
berm will be used as part of fill. Once filled, sediment pond area will be graded, levelled, and sowed
with groundcover. Area will be allowed to return to non -erosive field state.
d. Former stockpile / perimeter berm areas and processing areas outside of main excavation will be
graded, leveled, and seeded with groundcover. Areas will be allowed to return to previous non -
erosive field state.
e. Hydration ditch will be filled with overburden soil and will be graded, levelled and sown with
groundcover. Area will be allowed to return to non -erosive field state.
f. 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.
g. Operator will grade and level dirt portion of access road to Caratoke Highway back to original non -
erosive state. Paved portion of access road will remain as is. Field path will lead from access road
around perimeter of pond.
h. Remaining affected areas inside main permit area will be fertilized and returned to natural field state.
i. Remaining pond will be utilized by landowner for scenic &. recreational purposes, and as wildlife
habitat.
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(.$) of water on the reclamation map and provide a scaled
cross-section(s) 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 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.
Bass, bream, and perch.
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.
Not applicable, excavation is in sand only, no rock present.
—12—

APPLICATION FOR A MINING 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.
Overburden in berms around excavation area will be used for low 1 ft tall erosion control berm
constructed around pond perimeter during reclamation. Any leftover overburden will be spread over
former berm & processing areas and incorporated into soil. These areas will be graded, levelled,
fertilized, and seeded with groundcover during final reclamation and allowed to return to natural
field state. Overburden in sediment pond berm will be used to fill in the sediment pond during
reclamation of active areas.
5. a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
Overburden in berms around excavation area will be used for low 1 ft tall erosion control berm
constructed around pond perimeter during reclamation. Any leftover overburden will be spread over
former berm & processing areas and incorporated into soil. These areas will be graded, levelled,
fertilized, and seeded with groundcover during final reclamation and allowed to return to natural field
state.
b. Will any on -site roadways be left as part of the reclamation? Yes ❑ No Z.
Ifyes, identify such roadways on the reclamation map and provide details on permanent road and ditch
line stabilization.
Operator will grade and level access road back to original non -erosive state. Field path will be left
around excavation area during reclamation for pond access.
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 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 maps) and reclamation map, along with a list of items to be disposed in said areas.
No plans to bring off -site generated waste for disposal in mine. All scrap metal, junk machinery or
equipment will be removed from mine site and will be transported to the Currituck County Landfill,
Maple, NC for proper disposal there.
-13-

APPLI(KnON FOR A MINING PERMIT
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 revege;tation. Revegetation utilizing only tree
plantings is not acceptable. Recommendations can he 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. Authori~r..ed 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 Norrth Carolina State University:
d. North Carolina licensed landscape architects;
c. Private consulting foresters referred by the Division of I -rarest Resources, Department of
l nvironmcnt and Natural Resources;
is N.C. irosion 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):
2000 lbs/acre or follow recommendations oi'soil test
FERTILIZER - ANALYSIS AND RATE OF APPLICATION (pounds&'acre):
1000 lbs/acre 8-8-8 or 10-10-10 or follow recommendations of soil test.
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING 'NEAR -ROUND SEEDING
SCHEDUI (pounds/acre): [NOTE.: Include I..egumesj
Seed Tvggs Seeding Dates: Scedina Rates Lbs/Acre:
Kobe Le:spedeza Feb 15 .._ Apr 1 10
Bahiagrass 50
Redtop I
Winter rye (grain) 15
Common Bermuda Apr 1 - Jul 31 50
l.espedeza (unscarified) Aug I - Oct 25 30
German millet 40
Rye (grain, temporary) Oct 25 . Feb 15 120
MULCH -TYPE AND RAT (O APPI,IC'ATION (pounds/acre) ANT) METHOD OF ANCHORING:
All seeded areas shall be mulched using small grain straw at a rate of 2000 Ibs/acre and anchored
appropriately.
OTHER VEGETATIVE COVERS -TYPE' (S) ANI.) RATE (S) OF APPLICATION INCLIJI)ING
SEEDING SCHEDUI.E (pounds/acre, trees/Mere, spacing of trees/shrubs, ctc):
Revegetatinn =or ref, St atign p n *Approved by:
Signature Date —
Print Name
Title
Agency

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
The following bond calculation workvheet 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 durin tg he life of this miningpermit (in addition, please
insert the appropriate reclamation cost/acre for each categoa from the Schedule of Reclamation Costs
provided with this application, form) OR you can defer to the Department to calculate your bond for you based
upon vour mans and standard reclamation costs:
AFFECTED RECLAMATION RECLAMATION
CATEGORY ACREAGE COST/ACRE* COST
Tailings/Sediment Ponds:
Stockpiles:
Wastepiles:
Processing Area/Haul Roads:
Mine Excavation:
Other: Unexcavated Buffers
TOTAL AFFECTED AC.:
(TOTAL PERMITTED AC.:
0.51 Ac.
4.43 Ac.
NA Ac.
3.24 Ac.
6.23 Ac.
2.05 Ac.
16.46 Ac.
41.00
Ac.)
X
$
2000
/Ac.
X
$
1800
/Ac.
X
$
0
/Ac.
X
$
1800
/Ac.
X
$
500
/Ac.
X
$
1800
/Ac.
_ $
1020
_ $
7974
_ $
0
_ $
5832
_ $
3115
_ $
3690
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 16.46 Ac.
b) Positive Drainage Ac. X $19500.00 = $
SUBTOTAL COST: $ 21,631
Inflation Factor:
0.02 X SUBTOTAL COST: $ 432.62 X Permit Life Provided by Applicant (Life of the Mining Operation
or Life of Lease from Public Entity (in Years)): 8 years
INFLATION COST: $ 3460.96
Total Reclamation Bond Cost: $ 25,000
(round down to the nearest $100.00)
(NOTE: The reclamation bond cannot exceed $1 million per GS 74-54)
-15-

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 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 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). "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.
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(bl).
SEE THE NEXT TWO PAGES FOR THE "NOTICE" FORM AND THE "AFFIDAVIT OF
NOTIFICATION"
-16-

NOTICE (TYPICAL)
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
HOM Development, LLC has applied on February, 2021
(Applicant Name) (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):
® a 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 and topsoil on 6.23 acres located 2.5
(Mineral, Ore) (Number) (Miles)
south of Powells Point, NC PO off/near road 8180 Caratoke Hw.
(Direction) (Nearest Town) (Number/Name)
in Currituck 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 notified (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 comment(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 DroDosed mininLy activity. Dlease contact the aMlicant at the following telephone number:
[phone] . For information on the mining permit application review process, please contact
the Mining Program staff at [phone]. Please note that the Department will consider any relevant written
comments/documentation within the provisions of the Minine Act of 1971 throughout the application review
process until a final decision is made on the application.
Ben Stikeleather, Currituck County Manager
153 Courthouse Rd., Ste. 204, Currituck, NC 27929
(Addressee/Owner of Record's
Name and Address)
February 15, 2021
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
Jamie Basnight Hatchell, manager
HOM Development, LLC
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
PO Box 2405. Manteo, NC 27954
(Address of Applicant)

APPLICATION FOR A MINING PERMIT
11231IJ:VVIE17JU17tIl4c"41 tlUM
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)
William T., Jr. & Judith D. Griggs, Trustees
Sadie Gallon
Shawn & Shannon O'Sullivan
(Address)
427 Goodspeed Road, Virginia Beach, VA 23451
9 Kings Forest Court, Greensboro, NC 27405
8156 Caratoke Hwy., Powells Point, NC 27966
(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)
[i.e.: City Manager, County Manager, Mayor, etc.]
Ben Stikeleather, Currituck County Manager
(Address)
153 Courthouse Rd., Ste. 204, Currituck, NC 27929
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 pernut boundary) and the chief administrative officer of the county or municipality
in which any part of the permitted area is located in ci
pliance with N.C.G.S. 74-50(bl) and 15A NCAC SB
0004(d). I understand that it is the responsibility of the plicantto renreceipts of mailing showing that the
bove notices were caused to be mailed and to provide em to the Department upon request.
�a
Signature of Applican o Agent
March 18, 2021
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: HOM Development, LLC
Titleofperson executing Affidavit p 1 Agent for HOM Development, LLC
I, Nrt'lO1 r1P-G ii SLY 1 d d 1� 1 a Notary Public of the County of
State of North Carolina, do hereby certify ti
appeared before me this day and under oath
t
was
Witness my hand and notarial seal, this �I day of i w
%
Notary: my h�j
-30- s i '°t/BLlG
'O9�•8�?/2o�;i
cO uw
J % ,

APPLICATION FOR A MINING PERMIT
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)
Assorted Development Com.
Julio Nicolas Castillo
Frasca Holdings, LLC
(Address)
PO Box 402, Kitty Hawk, NC 27949
118 Keller Lane, Grandy, NC 27939
2401 Colinoton Road, Kill Devil Hills, NC 27948
(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)
[i.e.: City Manager, County Manager, Mayor, etc.]
Ben Stikeleather, Currituck County Manager
(Address)
153 Courthouse Rd., Ste. 204, Currituck, NC 27929
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 adjommg 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
wrthm 1,000 feet of the mining�ermit boundary) and the chief administrative of
of the county or municipality
in which any part of the pernvtted area is located in compliance with N.C.G.S. 74-50(bl) and 15A NCAC SB
0004(d). I understand that it is the responsibility of the applicant to retain the receipts of mailing showing that the
above notices were caused to be mailed and to provide them to the Department upon request.
_-K�1-it March 18, 2021
Signature of Applicant or Agent Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: HOM Development, LLC
Title of person executing Affidavit Agent for HOM Development. LLC
I, A►'4yineAbI K - U1Ak&'9— a Notary Public of the County of CG
State of North Carolina do hereby certify that q nP i
appeared before me this day and under oath acknowledge that the above Affidavit was made by him/her.
Witness my hand and notarial seal, this day of K. 20 2l .
Notary: m�zz0/7
�b}�his1s12�rC�:
•� N
-31- Off, °t/Blt�' ice;

na'W LI C6IV I11RI �113 �u 11►11�Ce77 �17i5iY➢
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)
Ambrose Signs, Inc. PO Box 56, Camden, NC 27921
Lilias J. Morrison PO Box 146, Harbinger, NC 27941
Joaquin H. Salazar PO Box 1316, Kill Devil Hills, NC 27948
(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)
[i.e.: City Manager, County Manager, Mayor, etc.]
Ben Stikeleather, Currituck County Manager
(Address)
153 Courthouse Rd., Ste. 204, Currituck, NC 27929
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 adjoming 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
wrthm 1,000 feet of the mining permit boundary) and the chief administrative officer of the county or municipality
in which any part of the perrmtted area is located in compliance with N.C.G.S. 74-50(bl) and 15A NCAC 5B
.0004(d). I understand that it is the responsibility of the in
to retain the receipts of mailing showing that the
above notices were caused to be mailed and to provide them to the Department upon request.
Signature cantor Agent
March 18 2021
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: HOM Development, LLC
Title of person executing Affidavit Agent for HOM Development, LLC
I, An+b i f1G� CL lt�,� �r_t 1 a Notary Public of the County of Dacr/
1 .1 i� .1
State of North Carolina, do hereby certify that 4dS'Ar *A (2 (. • F_111 OT
appeared before me this day and under oath acknowledged that the above Affidavit was made by himther.
Y dayof 1L.
Witness m hand and notarial seal, this 20
Notary: my �s�l4A Aasa
=0-
—32— Puev 1,14E

APPLICATION FOR A MINING PERMIT
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)
Brooke & Bailey. LLC 110 Wamnum Drive, Kitty Hawk, NC 27949
Faye J. Harrell 8222 Caratoke Hwy., Powells Point, NC 27966
(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 j)art 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)
[i.e.: City Manager, County Manager, Mayor, etc.]
Ben Stikeleather, Currituck County Manager
(Address)
153 Courthouse Rd., Ste. 204, Currituck, NC 27929
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 joining tract is owned or leased by the
applicant or is owned by the lessor of the mine tract, al10
oers of record of tracts adjoining these tracts, that are
within 1,000 feet of the mining hermit boundary) and the chief administrative officer of the county or municipality
in which any part of the perrmtted area is located in compliance with N.C.G.S. 74-50(bl) and 15A NCAC SB
0004(d). I understand that it is the responsibility of the applicant to retain the receipts of mailing showing that the
aboven otices were caused to be mailed and to provide them to the Department upon request.
Signature of Applicant or Agent
March 18, 2021
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: HOM Development, LLC
Title of person executing Affidavit Agent for HOM Development, LLC
I, �h�©t 17 Gj L R • Q L � r a Notary Public of the County of �CLro/
State of North Carolina, do hereby certify that 6 n 0 �) - iC I I t o
appeared before me this day and under oath acknowledged that the above Affidavit was made by him/her.
Witness my hand and notarial seal, this --LE—day of ������ �r��11,. 20_4.
Y&
Notary: m �sic� es: -15 o`iDc�
3 3 — _ �BL1G i
a° V
e a
COU111V ,`````.

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 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:
-< I /� L'_"
Signature: -k {
Print Name: Foster Allen Forbes
(Title, if applicable)
Company
(If applicable)
Address: 5104 Lunar Drive
Kitty Hawk, NC 27949
Telephone: ( 252 ) 395-4930
Date Signed: March 18, 2021
APPLICANT:
Signature:*
C,- i
Print Name: Jamie Basnight Hatchell
Title: Manager
Company: HOM Development, LLC
Mine Name: Foster Forbes Mine
Telephone: ( 252 ) 473-6074
Date Signed: March 18, 2021
*Signature must be the same as the individual who signed Page 1 of this application.
One oriainal and five (5) conies of the completed apDlication, six (6) conies of all location mans, mine mans
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].
-34-

APPLICATION FOR A MINING PERMIT
SCHEDULE OF RECLAMATION COSTS
(Based upon range of $500 - $5,000 per affected acre)
COMMODITY CODES: SG = Sand and/or Gravel, GS = Gemstone, Borrow = Borrow/fill dirt, CS = Crushed Stone,
DS = Dimension Stone, FS = Feldspar, MI = Mica, LI = Lithium, PF = Pyrophyllite, OL = Olivine,
KY = Kyanite/Sillimanite/Andalusite, PH = Phosphate, CL = Clay/Shale, PE = Peat, AU = Gold, TI = Titanium, and OT
= Other
Type
T/S Ponds
S.piles
W.piles
P.area/H.R.
Mine Excay.
SG, GS,
$500/ac.(L)
$1800/ac.
$2000/ac.
$1800/ac.
$500/ac.(L)
Borrow
1500(FI)
$2000(PD)
CS, DS,
500(L)
1800
2000
2000
500(L)
FS, MI,
1500(FI)
2500(PD)
LI, PF, OL, KY
PH
1000(L)
2500
5000
5000
2000(L)
2500(FI)
5000(PD)
CL
1000(L)
2500
5000
5000
2000(L)
2500(FI)
3700(PD)
PE, AU,
1000(L)
2500
3000
3500
2000(L)
TI, OT
2500(FI)
5000(PD)
(L) = reclamation to a lake and revegetating sideslopes
(FI) = reclamation by filling in and revegetating
(PD) = reclamation by grading for positive drainage & revegetating
AS PER NCAC 15A 5B.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 APPLICATION/PERMIT 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.
-37-

Dewatering Basin Design *items in red are inputs
Version 2.27.09
The volume of the borrow pit dewatering basin will be based on a 2 hour retention time. Using the
formula V= 8.0203 * Q * t where, V is volume in cubic feet, Q is the pump rate in gallons per
minute (GPM), and t is the retention time in hours. The pump rate is not to exceed 1,000 GPM
(60,000 GPH).
STEP 1: Input required variables
Pump Rate:
Retention Time:
Required Volume:
1000 GPM
g hours
32081.2 ft3
STEP 2: Design of the Dewatering Basin
Final Required Volume: 32081.2 ft'
Design Depth:
Proposed Basin Side Slopes
The volume of the borrow pit dewatering
basin will be based on a 2 hour retention
time. The pump rate shall not exceed 1,000
GPM (60,000 GPH). The contractor may
desire a greater retention time for managing
turbidity; however, work associated with
this increased volume will be considered
incidental.
.0 :1 side slopes *must be at least 1.5:1 or flatter
OPTIONS
EXISTING DIMENSIONS
Suggested Top Width (it):
133
Suggested Top Length (ft):
168
Final Design Top Width (ft):
Final Design Top Length (ft):
168
Final Design Depth (ft):
5
Verily Storage (ft')
97336.67OK
The dewatering basin shall be designed in accordance with the Borrow Pit
Dewatering Basin Detail Drawing.
basin design to serve dewatering of Foster Forbes Mine.

BORROW PIT DEWATERING BASIN DETAIL
OffrowtIE BORN PIT OEMi1TFRINO BASIN *III ualmo
u = 6.0908 ' b � T IMERE Y xR tll,'IL3 t JFOT fii IB
PUMP FUME RATE (64 ) AND T IB DEBATER N8 E (MRj .
UM MMIMUM FLOW RAT OF 1000 GFE AND A ■INIMSiI
DIMMITERIMM TIE OF 2 HOURS.
RISER SRALL BE A NON-PERFORMW BOTH OR OORRUMTED
MATERIAL WMTH A FLABHBWD iiT .
CONSTRUCT THE COIR FIBER OA FLE K I A MTERIAL
TMiAT BEETS THE SPECIFMMY20 0 OF THE COIR FIBER
MAT SPECIAL PROVISION PRDVIDW M THE CMMMT.
PRavwE a' swim . Poet of THE aELF-FASTENM
ANGLE STEEL TYPE. FNSTALL STEEL POGZM
WITH NO MORE, THAN 8 OF THE POST APPEARINN
ABOVE THE MUXMD.
ATTACH THE CUIR FIBER MAT TO THE SUM
P08 MTN MIRE OR OTHER ASTABLE IFJIIr16
AND STAPLED IMM THE BOTTOM AND SASE KOM
OF THE BASIN 'WITH 12" STAPLER.
INSTALL TYPE 2 FILTER FABRIC ON BIDFJN AM AND
BdrITlA OF BASIN AT INLET AB GHODI IN THE DETAIL.
UBE THE TYPICAL. 6EGTtoN 8EI m FOR vm
BMM PIT OEMATERING BASIN AS A GUIDE. THE
BASIN MY HAVE ANY TYPE COIFIOURAT 30M AS L.M AS
SUFFICIEMi VM ME IS PRMIDm AM PRDVISIONB
ARE UWE FOR A NON -PERFORATED RISER_
DO WT EXCEED 3t FT. IN lEI*ff FOR IM EMT"
DIMM REQUIRED FOR WARM PIT newi AUi s amim.
TM DORM PIT DEATERIN13 MWIN SIZE 29 VMZMLE
AND DEPENDENT ON BPEOZFIG SITE RE MREEMffi
AS WELL AS PROPOSED OMB'ift WION tiP MTIOMB.
EMIT THE BIZE. LWATION AM RISER PIPE
MRTMM FOR APF7 WAL PRIOR Td C011gM CTIaN.
PIMP THE EFFLIJEIT INTO' THE 10iM PIT DENATEALNO
SABIN TO A 1MXIMM NEPTM OF Q MN- BELOW TOP OF
EPAM DIKE.
PROVIDE A STMIE ENERGY MISSIPATOR PAID AT THE '' -
OUTLET OF THE PIMP DISCWJM HOSE AIM OUTLET OF `
- 11
THE RISER BARREL IN ACCOMnam WITH RV MIY to
STANDARD ORiM1INO 8M.09 FOR OUiLEr WJO DITCH.
m
Iltjq./iOBIFIED
EARTH MATERIAL
COIR FIBER BAFFLE SREEL POST8
ENERGY
niesipATOR
INCT T4 SCALE

Discharge Outfall Outlet Protection: Construction Details
Practice Standards and Specifications 6.41, 6.31, 6.15
Foster Forbes Mine
8180 Caratoke Hwy., Powells Point, NC
Currituck County
6.41 Outlet Stabilization Structure
6.31 Riprap and Paved Channels
6.15 Riprap
Pipe Outlet to Well-defined
Channel
Trapezoidal Riprap Channel
Design top width
Design depth
Filter layer. gravel
or fabric
Riprap lined apron located at end of mine dewatering overflow pipes (3) to prevent scour and
undermining in existing ditch, and to absorb the impact of the water flow and reduce the velocity to
non -erosive levels, before flow reaches wetlands.
Riprap Apron Size: Overflow pipe discharges directly into well-defined channel. The apron will extend
across the channel bottom and up the channel banks to the top of the bank. length of apron will be 20-
feet downstream to maintain velocity control of maximum 2.0 feet per second.
Grade: Apron will have zero grade and no overfill at end of apron.
Alignment: Apron will be straight throughout entire length if possible. If curve is necessary to align the
apron with the receiving channel, the curve will be located in the upstream section of the riprap.
Materials: Riprap will consist of a well graded mixture of NCDOT Class A (2" to 6") stone or slag.
Thickness: Minimum thickness of riprap will be 1.5 times the maximum stone diameter.

Filter: Operator plans to install a layer of heavy duty silt fence filter cloth between the riprap and the
underlying soil to prevent soil movement into or through the rlprap. Filter cloth will extend to the top of
both channel banks, and edges will overlap 12 inches. Upstream end will be buried 12 inches and
downstream end will be buried if necessary.
Maintenance: inspect riprap outlet structures weekly and after significant rainfall events to see if any
erosion around or below the riprap has taken place, or if stones have become dislodged. Repair all
damage immediately. Maintain all vegetation adjacent to the channel in healthy condition to prevent
scour or erosion during out -of -bank flow. Control weeds and brush growing in the riprap by cutting.
[C-It -CQ.V-
Ken Elliott, consulting
March 19, 2021

Temporary Hydrating Swale Construction Details
Foster Forbes Mine
8180 Caratoke Hwy., Powells Point, NC
Currituck County
Photo 1:New excavated swale
Photo 2: Swale after rain
Similar to a contour bank, this rehydration swale is being constructed to ensure hydration of nearby
wetlands adjacent to the permit boundary of the Marty Hurdle Sand Mine. The swale will consist of 3
100-foot long by 10-foot wide closed -end swales that will parallel the land contour and which will
overlap or butt up to each other. The swales will be located along the western and eastern unexcavated
boundaries between the excavation area and the wetland. Unlike a contour bank, there will be no
water flow but water will collect in the swale from rainfall and by intentional filling from the excavation
during periods of dewatering. The water in the swales will be absorbed by the swale and taken
underground to recharge the adjacent wetland.
Construction: A flat-bottomed V-shaped level closed -end trench 6-foot wide by 1-2 feet deep will be
dug parallel to the contour of the land in 100-foot lengths. The series of 3100-foot closed end swales
will overlap or butt to each other. Trench will have minimum 2-ft wide flat bottom and 2:1 or flatter
sloped sides. The excavated soil will be placed uncompacted along the bottom side of the trench in a
round mound shaped berm minimum 1-ft high and 4-ft wide, which will allow surface run off from
above the swale to flow into the swale and be collected there, and then be absorbed into the ground.
The swale berm will be seeded with ground cover to prevent erosion. The side slopes and swale
depression will be seeded to encourage ground cover growth. There will be a 2-ft tall silt fence erosion
barrier constructed behind and below the swale berm to collect any sedimentation from the swale.
Compacled soil z'
Is min .I
Flow
18" min �l
=III I� III�IU_ IIIF II— H = IlHlllr'
6 yplcal --i

A 6-foot wide rock baffle consisting of rip -rap and smaller gravel will be constructed in each swale berm
at its lowest contour point to allow passive discharge of overflow water during periods of heavy rain,
through a level sill spillway approximately 9-feet long. This will spill a level sheet of water 3-5 mm deep
to run across the surrounding grass, through the silt fence, and into the wetland. This sheet flow water
will prevent concentrated flow and erosion of the landscape.
Cnaraa annranam
Annual Maintenance:
• Inspect rock baffle for clogging and correct the problem.
• Inspect and correct erosion problems in the sand/soil bed of swales.
• Inspect grass along side -slopes for erosion and formation of rills or gullies and correct.
• Based on inspection, plant an alternative grass species if the original grass cover has not been
successfully established.
Maintenance (as needed)
• Inspect swale berms weekly and after every rainfall, repair as needed.
• Till or cultivate the surface of the sand/soil bed of swales if the swale does not draw down
within 48 hours.
• Remove sediment build-up within the bottom of the swale once it has accumulated to 25% of
the original design volume.
• Mow grass to maintain a height of three to four inches
Ken Elliott, consulting
March 19, 2021

Water Height Control: Construction Details
Half -pipe Water Level Control with Flash Board Risers
NRCS Code 587
Foster Forbes Mine
8180 Caratoke Hwy., Powells Point, NC
Currituck County
ernerwcysipll"
rtprap
i
tj I
1�1
/�____ riser
embankment
`_ rL
concrete base
DESCRIPTION
A structure in a water management system that conveys water, controls the direction or rate of flow, maintains a desired
water surface elevation or measures water. Water height control structure is standard structure used by agricultural and
horticultural farms in North Carolina to raise or lower water height in ditches and ponds per need (NRCS). Waterheight
control structure to be installed in the south berm of the sedimentation pond at the Mary L. Sawyer Mine. Overflow to be
directed down stabilized ditch to nearby blue -line stream, eventual outflow to Pasquotank River.

PURPOSE
To convey water from one elevation to a lower elevation within, to, or from a water conveyance system, such as a ditch,
channel, canal, or pipeline designed to operate under open channel conditions. Typical structures: drops, chutes,
turnouts, surface water inlets, head gates, pump boxes, and stilling basins (NRCS). This water management system will
be used to maintain a maximum water surface elevation in the sedimentation pond at the Foster Forbes Mine, 8180
Caratoke Hwy., Powells Point, NC, Currituck County.
Sedimentation pond is a part of the dewatering management system of the Foster Forbes Mine, used to remove settleable
matter and turbidity from mine dewatering wastewater.
CONSTRUCTION
Structure consists of 26' x 3' horizontal galvanized steel culvert running under the sedimentation pond berm. A vertical 6'
half pipe 52" x 30" is attached on the north end of the culvert with stacked flash boards allowing adjustable height of the
water level in the sedimentation pond. Water flows over the flash boards and into the discharge pipe and down the rip -rap
stabilized ditch.
Overflow ditch is lined with riprap for 20 feet down its length. Existing slopes adjacent to the culvert are heavily grassed
with natural grass and weeds with no erosion present.
MAINTENANCE
Structures will be checked and necessary maintenance, including removal of debris, shall be performed after major
storms and at least semi-annually.
Ken Elliott, consulting
March 19, 2021

OOYEAR ---- - '_� �� 1�i1'i �•����•�l Y�'�t 1'_
FLOOD ZONE�f L� ^'ru...IL
1-I`
STOCKPILE
AREA
100 YEAR
FLOOD
ZONE
FLOOD MAP
FOSTER FORBES MINE
8180 CARATOKE HWY.
POWELLS POINT, NC
CURRITUCK COUNTY
OPERATOR:
HOM DEVELOPMENT, LLC
MANTEO,NC

National Flood Hazard Layer FIRMette *FEMA Legend
0 250 500 1,000 1,500 2,000
Basemap: USGS National Map: Orthoimagery: Data refreshed October, 2020
SEE RS REPOW FOR DETAILED LEGEND AND INDFE MAP FOR FlRM IM ULWODf
Without Bow Flood Elevation (BFE)
Zane A. V,A99
SPECIAL FLOOD
With BFE Or Depth IDne AE. AO. AN, W. AR
HAZARD AREAS
Regulatory Floodway
0.2%Annual Chance Flood Hazard, Areas
of 1%annual chance flood with average
depth less than one foot or with drainage
areas of lass than one square mile nine
"Future Conditions 1%Annual
Chance Flood Hazard m-,,
Area with Reduced Flood Risk due to
OTHER AREAS OF
Levee. See Notes. Z.- x
FLOOD HAZARD
Area with Flood Risk due W Levee[nne o
koscam Area of Minimal Flood Hazard a—,x
Effective LOMRs
OTHER AREAS
Area of Undetermined Flood Hazard z„,, o
GENERAL
'--- Channel, Culvert, or Storm Sewer
STRUCTURES
JIIIJII Levee, Dike, or Floodwall
a zo'z Cross Sections with l%Annual Chance
17.3 water Surface Elevation
— — — Coastal Trensect
-- 5,A--- Base Flood Elevation Line (BFE)
Limit of Study
Jurisdiction Boundary
•-- Coastal Transecl Baseline
OTHER _ profile Bawlies
FEATURES Hydrographlc Feature
Digital Data Available N
No Digital Data Available
MAP PANELS 0 Unmapped
7 The pin displayed on the map Is an approximate
point selected by the user and does not represent
an authoritative property location.
This map compiles with FEMNs standards for the one of
digital flood maps If it is not vold as described below.
The basemap shown complies with FEMA's basemap
accuracy standards
The flood hazard Information Is derived directly from the
aulhodlative NFHL web services provided by FEMA. This map
was exported on 1/14/2021 at 7.58 PM and does not
reflect changes or amendments subsequent to this date and
time. The NFHL and effective Information may change or
become supercaded by new data over time.
This map Image is void If the one or more of the following map
elements do not appear. baseman Imagery, flood zone labels,
legend, scale bar, map creation date. community idenbflem
FIRM panel number, and FIRM effective date. Map images for
unmapped and unmodembed areas cannot be used for
regulatory purposes.

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ACREAGES MINE MAP \GALLOP\ \ N/F /' \ 423
EXCAVATION - 6.23 AC �, OPERATOR: N1F ,ITAC 423, LLC ITAC 423, LLC•./''
\ ? FOSTER FORBES MINE HOM DEVELOPMENT, LLC \. SADIE !
STOCKPILES - 4.43 AC /y 8180 CARATOKE HWY PO BOX 2405 '\ GALLOP / / \ \ /'•
SEDIMENT POND -0.51 AC $ Z ° / • N/F / e° • 'ter,•
�� POWELLS POINT, NC 27966 MANTEO, NC 27954 \ / /'' \ \�. PLEASANT BRANCH \. -
ACCESS
ACCESS ROAD -0.32AC o < Zm CURRITUCK COUNTY BAPTIST CHURCH pQ
UNEXCAVATED BUFFERS - 2.05 AC 2 %' / F
P MAP BY ELLIOTT CONSULTING / • RES •\
OTHER UNEXCAVATED - 2.92 AC �m2 ,•' CEMETERY
m tiN a MAP SCALE: 1 IN = 150 FT.� +.
TOTAL AFFECTED - 16.46AC N/F \ \ /• �p5 /'•
i FEBRUARY 12, 2021 e�:r"j o SHAWN &
UNDISTURBED WETLANDS-9.47AC �� c�
UNDISTURBED BUFFERS-3.50AC O'suLLIVAN N/F
CHURL JUS
OTHER UNDISTURBED -11.57AC \off ` s?r''"
TOTAL PERMIT-41.00AC/,.� \ \ /• /•' CASTILLOWETLANDS
!
ASSORTED
150 0 75 150 300 \ ,:..� DEVELOPMENT \ `•./•• /•' / '
,,
� �'�"� �oo��eA�i � ORgES DITCH - OUTFLOW To WETLANDS 8 ALBEIygRLE SOU ��\ CORP _ /•' /' 1 / • • RES
(IN FEET) i \ /•• /•• I / .
1 inch=160ft. �' g ' Q /.�-�, \ /•
�,• N — _ \ FRASCA HOLDINGS, LLC ', N/F
VERONICA ' /
UNEXCAV �•\ ; ELIZABETH /
WETLANDS /' RUPP `— VARGAS
WETLANDS ,\'\ WETLANDS COASTAL /••
RIP - - _ �, j g �F�•�o�Go/ \ •� s \ •1 ROOFING 1 / • /.
i \ RAP
STATE W
ATEW TL /r�OV�°M� ��� STATE WETL /••D��J / /•
_ �y�G / RES
BUFFER--
LEUNEXCAV
�/ EX`��NGOIRSPP�txg 3 UNEXCAV
O /� GATE '"� `�.�_ / �. ` ,• OO�PG /'.�
DDSINd . TOW D _. X \ I I �I •%� /,.
ALBFMA
N/F
` TO 30Y RESIDENTIAL SETBACK _■ /�Gt�3 / DAVID
_ WETLANDS / DOMINION ENERGY EXISTING POND, 0.51 ACRES a° RENTAL DWELLING I /'S� /''/•• I WALKER
TOWER 149 131' TO BE USED AS SEDIMENT POND • MAXWELL
LINE 2064/2073 VER OWNED BY
/• (86 FROM EXCAV EDGE) \ FLOW \ SEDIMENT POND BERM A F FORBES
\ N1 25'W FTALL x 32'WIDE PINEWOOD ACRES /.•
STATE WETL 6� NCAV OD DRIVECL
50, BUFF ti BUFFER \ \ Nl� ' • N/F
_
9 10'W STOCKPILES & \ 49 L I AMBROSE •'
STATE WETL RIM DITCH \ t \ LOADING 2W L x 24' W STEEL SIGNS, INC %
SU BUFF. ` \ �£� 4.43AC N \°$ CONTINUOUS
CULVERT
1 OIR
WETLANDS\, N m D /
0.12AC J W W SEDIMENT 4 C
-- -
/,' POND PU P //
EXCAVATION INTAKE -t \`� HAUL OR �ENTRANCF
TRU
I I. LOCKING GATE I / •' /
i U 6.23 ACRES° \ LOADING AREA — OR CABLE S I / • _
k AVGDEPTH -30FT EQUIPMENT CROSSING \ �r { j� �����
MAX DEPTH - 35 FT � r' N!F
25 W
cn \____,_. ( LILIAS J c 3 G 2021
,
UNEXCAV I, MORRISON
N/F �•t EB BUFFER
WILLIAM THOMAS GRIGGS, JR t 100 PL SG Z FSlO �qC
t e I LAND QUALITY
JUDITH DOWDY GRIGGS orn �m� \°y 25'w f S�BgC I MINING PROGRAM
r 101W fn y` UNEXCAV K ;,` 86�,,�.--•� J
WETLANDS & WOODS RIM DITCH 9L\ BUFFER_ -
DW
c+ 9� m I I``
LEGEND
00 Gc ZO£ (1 N/F RES t, .
25' W �G`\ T x 8' W BERM o \ I EXCAVATION
UNEXCAV Z -1 JOAQUIN ,.,,.I:'-_.
BUFFER � �Q H SALAZAR j PERMIT BOUNDARY
WETLANDS EDGE — -
r �IY' /'' \ £- °J4 nRMX3:- •�J'..�••j WETLANDS BUFFER
•\7T Y. �•• COUNTY UDO BUFFER
SAND BERM —
i j 1
v . N/F DOMINION I� WETLANDS-- 0.69 AC\ \ v r-�. ;. r-'•� — BROOKEAND j FOLIAGE
•. \ I BAILEY, LLC
03
STATE WETL \ \ \ \
5N/F
0'BUFF "f',! •:fir !
\..:�'±..;ter_ FAYEJ
ram= \ HARRELL _
I '
_ THIS MAP IS NOT CERTIFIED CULTIVATED FIELD _ _ I
_ N/FSURVEYAND HAS NOT BEEN REVIEWED DOMINION ENERGY 1
FAYE J TOWER 150
.. �HARRELL BYA LOCAL GOVERNMENTAGENCY FOR LINE2064/2073 \ \ r N!F RES
COMPLIANCE WITH ANY APPLICABLE I BROOKEAND I
WETLANDS & WOODS LAND DEVELOPMENT REGULATIONS. \ BAILEY, LLC ,

ACREAGES RECLAMATION MAP SADIE:N/F NIF
EOPERATOR: N/F \GALLOP\ •.\, ITAC 423, LLC / \, ITAC 423, LLC
EXCAVATION - 6.23 AC /'•/ ,
STOCKPILES -4.3AC FOSTER FORBES MINE HOM DEVELOPMENT, LLC \ SADIE J• /
y
O 8180 CARATOKE HWY PO BOX 2405 GALLOP /
SEDIMENT POND - 0.51 AC \• / /' N!F
CURRITUCKCOUNTY BAPTIST ACCESS ROAD - 0.32 AC POWELLS POINT, NC 27966 MANTEO, NC 27954 \ / ' \ \ \ 5
� /� � ''/•�� r•
PLEASANT BRANCH
UNEXCAVATED BUFFERS - 2.05 AC 1 / F
.� MAP BY ELLIOTT CONSULTING / RES •\ \
OTHER UNEXCAVATED - 2.92 AC �' CEMETERY
TOTAL AFFECTED - 16.46AC 2 MAP SCALE: 1 IN = 150 FT N/F \ \ Og /•'
2021 -- SHAWN & / ti
UNDISTURBED WETLANDS - 9.47 AC FEBRUARY 12, SHANNON \ \ /'• �1�p
UNDISTURBED BUFFERS - 3.50 AC o •'. O'SULLIVAN N/F
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WILLIAM THOMAS GRIGGS, JR 1
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WETLANDS & WOODS LAND DEVELOPMENT REGULATIONS. 1 BAILEY, LLC
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19 FORBES
PARCEL VIEW &
ADJACENT OWNERS
FOSTER FORBES MINE
8180 CARATOKE HIGHWAY
POWELLS POINT, NC 27966
CURRITUCK COUNTY, NC
OPERATOR:
RECEIVED
HOM E LLC
BOX 2405T,
NAR 3
MANTEO, NC 27954
LAND QUALITY MAP BY ELLIOTT CONSULTING
MINING PROGRAM FEBRUARY 12, 2021
SCALE: 1 IN = 400 FT
FOSTER FORBES MINE
FOSTER FORBES MINE ADDITIONAL OWNERS WITHIN
ADJACENT OWNERS NOTIFIED 500 FEET OF PERMIT AREA, OR
BY CERTIFIED MAIL, 1600 FEET OF EXCAVATION EDGE
REQUIRED BY NCDEQ TO BE NOTIFIED BY CERTIFIED MAIL
FEBRUARY 15, 2021 LATE FEBRUARY, 2021
1 -William T., Jr. & Judith D. Griggs, Trustees
427 Goodspeed Road
Virginia Beach, VA 23461
2 - Sadie Gallop
9 Kings Forest Ct.
Greensboro, NC 27405
3 - Shawn & Shannon O'Sullivan
8156 Caratoke Hwy.
Powells Point, NC 27966
4 -Assorted Development Corp.
PO Box 402
Kitty Hawk, NC 27949
5 - Julio Nicolas Castillo
118 N. Keller Lane
Grandy, NC 27939
6 - Frasca Holdings, LLC
2401 Colington Road
Kill Devil Hills, NC 27948
7 - Ambrose Signs, Inc.
PO Box 56
Camden, NC 27921
8 - Lilias J. Morrison
PO Box 146
Harbinger, NC 27941
9 - Joaquin H. Salazar
PO Box 1316
Kill Devil Hills, NC 27948
10 - Brooke & Bailey, LLC
110 Wampum Drive
Kitty Hawk, NC 27949
11 - Faye J. Harrell
8222 Caratoke Hwy.
Powells Point, NC 27966
Ben Stlkeleather
Currituck County Manager
163 Courthouse Rd., Ste. 204
Currituck, NC 27929
12 - Michael A. & Sandra A. Soriente
PO Box 132
Kitty Hawk, NC 27949
13 - ITAC 423 LLC
363 Soundview Drive
Kill Devil Hills, NC 27948
14 - Pleasant Branch Baptist Church
107 Foster Forbes Road
Powells Point, NC 27966
15 - Veronica E. Vargas
103 Pinewood Acres Drive
Powells Point, NC 27966
16 - David W. Maxwell
102 Pinewood Acres Drive
Powells Point, NC 27966
17 - Ronnie J. & Mabel G. Cooper
PO Box 149
Poplar Branch, NC 27966
18 - Roy W. & Millie B. Byrum
PO Box 311
Kitty Hawk, NC 27949
19 -Sarah E. Forbes, Revocable Trust
PO Box 1340
Hampton, VA 23661
20 - Foster A. Forbes
5104 Lunar Drive
Kitty Hawk, NC 27949
HOM Development, LLC
PO Box 2405
Manteo, NC 27954
Currituck Planning Director Laurie LoCicero
Asst. Planning Director Donna Voliva
Currituck County Commissioners
800 0 200 400 800
(IN FEET)
finch = 400 ft.

OPERATION AND MAINTENANCE PLAN
SAND MINE DEWATERING AND WATER LEVEL CONTROL STRUCTURE
Operator: HOM Development, LLC,1002 Driftwood Drive, Manteo, NC 27954
Job Location: Foster Forbes Mine, 8180 Caratoke Hwy., Powells Point, NC 27966
County: Currituck County
Prepared by: Ken Elliott, consulting
Date: March 17, 2021
This plan defines responsibilities for operating, inspecting, and maintaining equipment and structures
used for constructing and dewatering the Foster Forbes Mine safely, and that dewatering will not
degrade or negatively impact any wetlands or waters of the state.
Description and Operation of the Foster Forbes Mine:
The Foster Forbes Mine is a proposed 6.23-acre sand mine excavation operated by HOM Development,
LLC, Jamie Basnight Hatchell, operator, in a 41-acre permit area located at 8180 Caratoke Highway,
Powells Point, NC, in Currituck County. The permit area is on high sandy land and is currently a
cultivated farm field owned by Mr. Foster Allen Forbes, 5104 Lunar Drive, Kitty Hawk, NC. At this time
HOM Development is applying for a mining permit with the NCDEQ Division of Energy, Mineral and Land
Resources to construct the sand mine and begin operation in June 2021. HOM Development is also
applying for a Use Permit from the Currituck County Planning Department for construction of this mine.
Sand Mine Dewatering:
It will be necessary to dewater the pond as it is being excavated to allow excavating equipment to enter
the area safely and efficiently remove the sand from the pond bottom. This will allow for full permitted
depth excavation of the pond and proper reclamation of the edges of the pond. It is the intention of
HOM Development to only dewater the excavation as needed, which will not entail full-time
dewatering.
For excavation purposes, dewatering will occur roughly every 30 days which will allow excavating
equipment to remove approximately 150 loads of sand up to ground level where it will be stockpiled for
later use. When the stockpile is depleted from usage, the excavation area will again be dewatered, and
another quantity of sand will be excavated.
Mine dewatering wastewater will be treated before release to the Waters of the State. Use of a
sedimentation pond separate from the excavated mine is a traditional and effective means to remove
sediment from wastewater generated during mine dewatering operations.
Sedimentation Pond Construction and Overflow Discharge:
HOM Development proposes to utilize an existing 0.51-acre excavation located 90 feet east of the
proposed 6.23-acre excavation as a sedimentation pond. The pond's sides will be enhanced with the
addition of 5-ft tall sand berms 30 feet wide at the base with 3:1 exterior slope and 2:1 interior slope.

All exposed slopes and peaks of the berms will have full ground cover. The pond berms will have a
minimum 1.5 feet of freeboard between the water surface and the top of the sediment pond bank.
Excavation of the main 6.23-acre pond will begin approximately 90 feet from the sediment pond and
work westward and southward. The edge of the sediment pond berm and main excavation will be 75
feet from the nearest wetland swamp. Use of the sediment pond will help forcibly hydrate the nearby
wetlands located north and west of the sediment pond and will minimize dehydration of the wetland
forest.
Sediment pond water level will be controlled by a half -pipe water height control device with a flash
board riser installed in the north edge of the sediment pond berm. This control structure will allow
water to flow across the flash boards into a 25ft long x 15" wide buried PVC pipe leading northward
through the berm 25 feet to a 6-ft wide lined discharge ditch running 195 feet northward until exiting
into the Foster Forbes Ditch blue -line stream. Overflow water will then travel westward and southward
1.12 miles through PFO1/2F (USFWS) semi -permanently flooded Palustrine wetland forest, then 0.17-
mile westward through E2EM1Pd (USFWS) partially flooded estuarine wetlands, and then 0.7-mile
westward through an unnamed tributary to Albemarle Sound.
Dewatering Procedure:
The operator will install an 8-inch diesel engine powered dewatering pump at the south end of the
sediment pond,1300 feet from the closest residence outside of the landowner's property and situated
behind sand berms or below natural ground level to reduce noise. Discharge from the dewatering pump
will flow northward 320 feet from the south end of the sediment pond to the flash board riser overflow
on the northeast end, then eastward 0.7-mile as described earlier to Currituck Sound.
Water will be pumped from the main pond to the sediment pond by the Bin gasoline -powered transfer
pump operating at idle speed. Estimated maximum flow from the pump will be 2,000 gallons/hour,
operating 12 hours per day, 0.024 mgd. The operator proposes to drop the water level in the main pond
approximately 20 - 25 feet below normal ground level when needed.
Time and distance will allow all sedimentation to occur to acceptable levels before the overflow water
reaches outfall and then the waters of the State. Water will have to travel a minimum of 270 feet to
reach the overflow point which will give enough surface area to allow sufficient sedimentation to occur.
Stormwater drainage will be unable to enter the sediment area and damage the sediment pond rates,
due to the height of the surrounding sediment pond berm.
Wetlands Protection:
To minimize wetland impacts, the operator will construct a 1260-foot long by 10-ft wide rim ditch
between the west side of the proposed excavation and the adjacent wetlands 75 feet westward. The
ditch will run along the westward edge of the 25-ft wide unexcavated buffer between the perimeter
berm and the 50-ft wide undisturbed buffer boundary. The ditch will be kept artificially full by having
water pumped into it from the excavated pond on a constant basis. Water will be allowed to overflow
along its length and spread in a sheet flow across the foliated undisturbed buffer into the adjacent

wetlands. This will help forcibly hydrate and enhance groundwater level between the excavation and
adjacent wetlands. This sheet flow will be in addition to the regular overflow water entering the same
wetlands from the sediment pond.
Groundwater Control:
Groundwater level can be controlled by a planned program of dewatering. Mine dewatering typically
provides more efficient working conditions, better diggability and trafficking, improves slope stability
and safety, and maintains or increases safety factors.
The top edge of the southeastern corner of the proposed excavation is located 850 feet from the closest
residence at 8200 Caratoke Highway. There are seven homes and businesses with water supply wells
within 1500 feet of excavation edge. The operator proposes to address possible groundwater impacts
through two methods:
• The operator will install two groundwater level monitoring wells along the eastern permit
boundary adjacent to Caratoke Highway, exact location to be determined by recommendation
from engineers with Currituck Planning and Community Development. Once permits are issued
and wells installed, wells will be monitored and measured monthly during the life of the permit.
Baseline water level measurements will be taken as soon as wells are installed and before
dewatering operations begin, then monthly thereafter. Monthly groundwater level
measurements will indicate abnormal groundwater depletion if it starts to occur, and measures
can be taken to adjust dewatering procedures before reaching damaging levels.
• In response to requirements of the Currituck County Unified Development Ordinance for mine
dewatering activities, the operator will establish and maintain a performance bond of $3000 for
each in -use water well within 1500 feet of the proposed excavation. The bond will be used to
repair or replace any groundwater wells or pumps damaged by dewatering at the proposed
excavation. The bond will be in the form of an irrevocable letter of credit held by Currituck
County Planning, estimated at this time to be $21,000. Exact number of wells to be covered and
total bond amount will be determined before permit is issued.
Sedimentation and Erosion Control:
The wetland swamp west of the proposed excavation, located 75 feet from the excavation edge, runs
parallel to the western permit area boundary. The operator will establish a SO-ft wide undisturbed
buffer (no disturbance of any kind) as a visual screen of existing woodland which is part of the Currituck
County required property line setback. This buffer will be adjacent to, and inside of, the permit
boundary. This buffer will be maintained by the operator as grass and pine tree ground cover.
In addition, there will be a 25ft unexcavated buffer (may contain roadways, stockpiles, and sediment &
erosion control devices) around the entire excavation area, between the excavation and the
undisturbed buffer.

Sediment pond overflow will drain into an operator -maintained 6ft wide feeder ditch that leads 185 feet
to the Foster Forbes Ditch blue -line stream, then two miles to the Albemarle Sound. Overflow into the
feeder ditch will be stabilized by riprap installed in the feeder ditch at the overflow (see diagram) to
prevent erosion of the ditch.
All erosion and sedimentation will remain inside of the permit area. The operator will construct and
maintain an 8-ft wide x 2-ft tall grass -covered sand berm around the perimeter of the current affected
area of the excavation during all phases of operation. During mining operations and dewatering, most
of the water leaving the excavation will remain inside of the permit area and will only overflow through
the sediment pond occasionally. The sediment pond will be approximately 5 feet deep, and there is a
sand layer below the bottom of the area. The porosity of the soil under the sediment pond will allow
most of the water pumped into the pond from dewatering to seep back into the ground naturally. Any
excess water overflowing from the sediment pond will flow downstream two miles to Albemarle Sound.
Maintaining the Sediment Pond Overflow Control Structure, Sedimentation Pond and Ditches:
Inspections and maintenance are required to obtain the intended function of safely dewatering the sand
mine, and to maintain the life of any adjacent wetlands or waters of the State. Items to inspect and
maintain during the anticipated 6-year life of the mine dewatering permit are:
• Inspect the water control structures regularly, especially following heavy rains and runoff, or
during periods of operation of the structure.
• Remove accumulated debris from the overflow control structure.
• Inspect the structure for excessive settlement or seepage.
• Inspect all components of the structure, including appurtenances, and repair or replace any
damaged items as needed.
• Inspect embankments, berms and appurtenant structures, and repair as needed.
• Repair any damage to vegetated areas or berms with compacted earth fill, reshaping, sodding,
reseeding, and mulching as needed.
• Inspect riprap outlet stabilization structures in ditches regularly, replace dislodged rock as
necessary.
• Promptly repair all leaks in delivery facilities by replacing valves, fittings, gaskets, and worn or
damaged parts.
• Maintain all screens, filters, valves, timers, and other electrical and mechanical equipment in
good operating condition, following manufacturer's recommendations
Monitoring the Dewatering Process and Effects of Dewatering:
Analytical and qualitative monitoring of mine dewatering wastewater will be in accordance with the
NCG020000 permit, as follows:
• All ponds in the Foster Forbes Mine permit area will be inspected daily by the operator to
identify any abnormal conditions.

• All berms and erosion control and sedimentation control structures will be inspected for
damages monthly and within 24 hours after every storm event greater than 1.5 inches, and all
structures will be repaired immediately.
• Special inspections will be conducted immediately following severe storms, vandalism, and
other significant events.
• Dewatering process will be inspected daily during periods of dewatering the excavation.
• Overflow of wastewater process will be inspected daily during periods of dewatering the
excavation.
• Outflow of dewatering wastewater will be monitored quarterly at the overflow exit stabilization
structure for chlorides, pH, suspended solids, settleable solids, turbidity, and total flow.
Samples will be collected and tested onsite for pH, and the remainder will be tested for the
remaining parameters by a North Carolina certified lab.
• Rain gauge data will be collected by monitoring rain gauge data monthly and after each rain
event.
Wetlands Monitoring:
Wetlands are located westward and northward of the proposed Foster Forbes Mine site. Level 1
wetlands landscape assessment by US Fish & Wildlife Service indicate two types of wetlands on the
Foster Forbes Parcel parcel:
• Seasonally flooded, partially drained, Palustrine scrub/shrub wetlands, and
• Irregularly flooded, partially drained, emergent estuarine wetlands.
Level 2 wetlands assessment was performed in January 2021 by Quible and Associates and the
delineated wetland line will be confirmed in late March 2021 by USACE. Delineation places the edge of
wetlands 75 feet from the closest edge of proposed excavation.
During mine dewatering activities wastewater will be treated in a sediment pond to allow settlement of
suspended solids and reduction of turbidity. Wastewater overflow will then be discharged into an
existing ditch east of the sediment pond running westward into the wetlands, helping to recharge
wetland water levels that may be affected by dewatering. Quality of water entering the discharge ditch
and wetlands will be monitored at the discharge point for total suspended solids, settleable solids,
turbidity, pH, chlorides, and flow rate. Ditch flowing into the wetlands will be monitored weekly for
evidence of sedimentation or erosion,
Records
Data will be collected as follows:
• Data will be collected from samples taken from the wastewater point source discharge in
operation at the time.

• Point source discharge data: data from the site taken quarterly, date & time, general weather
conditions, pH of sample, status of process at point source, inlet, or outlet, other DWQ required
data.
• Visual monitoring of adjacent wetlands and farmland for potential dehydration during mining or
dewatering activities will take place weekly. Solutions to any degradation caused by any mining
activity will include alteration of dewatering process. DWQwill be consulted as needed;
alterations to process will be recorded.
• Elliott Consulting will maintain the following records in a permanent file at the Elliott Consulting
office at PO Box 112, 202 Elliott Road, Aydlett, NC 27916: a record of all significant actions
taken; as -built drawings; permits; analytical results from sampling; and related material. Copies
of all inspections, monitoring reports and lab analyses shall be provided to NCDWQ on a regular
basis and as requested.
BMP Conditions
• The permittee will utilize best management practices to ensure that dewatering the Foster
Forbes Mine will not degrade or negatively impact any wetlands or waters of the State. BMP's
will include:
o Sediment pond outlet structure with flashboard riser located at edge of pond for ease of
maintenance.
o All berms and erosion control and sedimentation control structures will be inspected for
damages monthly and within 24 hours after every storm event greater than 1.5 inches,
and all structures will be repaired immediately.
o Sediment pond outlet ditch will have rock lining or riprap stone layer to prevent erosion,
scour or sloughing of embankment.
• The permittee shall obtain authorization from the Director of the NCDEMLR and the Stormwater
Program chief prior to utilizing any chemical flocculants at the Foster Forbes Mine.
Signed,
Ken Elliott
for HOM Development, LLC, Jamie Basnight Hatchell, Manager
March 19, 2021

7020 1810 0001 7602 5042
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Julio Nicolas Castillo
118 N. Keller Lane
Grandy, NC 27939
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Frasca Holdings, LLC
2401 Colington Road
Kill Devil Hills, NC 27948
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1. Article Addressed to:
Sadie Gallop
9 Kings Forest Ct.
Greensboro, NC 27405
II 1111111 IN III I 11111111111111111111111111111
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Dominion Energy Virginia
10900 Nudrols Road, Sufte 400
Glen Allen, Virginia 23060
DominionEnergy.com
Reference #: TE021068001
j M Dominion
Energy
Consent Agreement for Right of Way Encroachment
VIRGINIA ELECTRIC AND POWER COMPANY ("Company") and FOSTER ALLEN
FORBES ("Requestor") enter into this Consent Agreement for Right of Way Encroachment
("Agreement") prepared by Company this 11th day of March, 2021.
Company is willing to grant to Requestor, this Agreement to encroach on, over and/or under
a part of Company's easement(s) ("Easement' or "Right of Way") identified as:
• Barco-Point Harbor Corridor, Parcel Number 118 [COR0025/118]
• Shawboro-Point Harbor Corridor, Parcel Number 170 [COR04121170]
• Line/Structure(s) #:2064/149-150, 20731149-150
The encroachment ("Encroachment") is described as:
• Five (5) foot tall sand berm around existing pond
• Two (2) foot tall sedimentation control berm
• Existing pond filled in and levelled
The Encroachment as described above is located as follows:
8180 Caratoke Highway, Powells Point, N.C.
Company, under its Easement(s) identified above, hereby grants Requestor permission to
install the Encroachment, described above, subject to the following terms and conditions
hereinafter set forth.
The minimum distance required by the Occupational Safety and Health Administration
("OSHA") shall be maintained between electrical conductors and any part of the
Encroachment or equipment used in the installation or maintenance of the Encroachment.
Sag of conductors varies with changes in operating and ambient temperatures; therefore,
required clearances will be based upon maximum sag. The minimum clearance shall be
governed by the clearance required for the 230kV line. For current voltage information
see Exhibit "A". Voltage and conductor arrangement is subject to change. It is Requestor's
responsibility to confirm voltage and location of conductors prior to installation,
maintenance or repair of the Encroachment.
2. Company access to its facilities shall not be hampered at any time by the installation, use,
maintenance or presence of the Encroachment. Company shall not be liable for damage
to the Encroachment resulting from exercise of its Easement rights.

03/11 /21
3. Permission for the Encroachment described in Exhibit "B" does not include permission for
storage on Company Easement of material or equipment related to the Encroachment.
4. No portion of any building, house, garage, porch, deck, shed, trailer, barn, playhouse,
above -ground or in -ground swimming pool, dumpster or any other type of structure,
temporary or permanent, shall be permitted on the Easement. This includes, but is not
limited to, any building projection or attachment such as roof overhang, gutters,
garage lighting or window appurtenances. Portions of buildings and other
structures found within Company's Easement(s) are required to be removed when
discovered.
5. Requestor shall restore any erosion or settling, within the Easement, related to the
installation or maintenance of the Encroachment. Requestor shall comply with all state
and local erosion and sedimentation control laws and shall not adversely affect grade
elevations and water drainage. patterns.
6. It is the Requestors responsibility to notify Company of any damage to Company facilities
by Requestor, its employees, contractors or agents. If any counterpoise (ground wire
buried eighteen (18) to twenty-four (24) inches deep) is damaged, cut or severed, notify
William Gatlin - Manager Field Transmission Lines, immediately so necessary repairs can
be made.
Mobile: [phone] E-Mail: [e-mail]
7. Requestor shall be responsible for all associated costs for the repairs of Company facilities
(including but not limited to structures, guys, anchors or counterpoise) damaged by
Requestor, his/her/theirrds employees, contractors or agents.
8. If the Encroachment is determined to be unsafe by the Company at a future date, the
unsafe condition shall be corrected or removed at Requestor's expense within forty-five
(45) days after written notification from the Company. If not so corrected or removed by
Requestor, the unsafe condition may be corrected or removed by the Company at
Requestor's expense without liability by the Company for any resulting damage.
9. This Agreement in no way reduces the Company's rights under the Easement(s) identified
above. The Company may at any time exercise its Easement rights in a way that conflicts
or interferes with the Encroachment described above. Upon notice from the Company,
the Requestor will promptly modify, rearrange or remove the Encroachment to enable the
Company to exercise its Easement rights without conflict or interference with the
Encroachment. Requestor will be responsible for the cost of any such modification,
rearrangement or removal. If Requestor fails to so modify, rearrange or remove the
Encroachment within forty-five (45) days after notice from the Company to do so, the
Company may modify, rearrange or remove the Encroachment without liability for damage
Page 2of7

03/11 /21
resulting therefrom, and Requestor shall promptly reimburse the Company for the cost of
such modification, rearrangement or removal.
10. Requestor shall begin physical installation of the Encroachment within one (1) year of the
date of execution of this Agreement. If installation does not begin within that period, this
Agreement shall become invalid. A new Encroachment application must be submitted
before further consideration and will be subject to a processing fee. For the avoidance of
doubt, Company's permission for this Encroachment in no way implies or assures that
Company will reissue an Agreement for this Encroachment in the future should this
Agreement become invalid.
11. Requestor shall give at least five (5) days advance notice, except in emergencies, of any
activities being performed within the Easement to Timothy Hindman, Sr. Right -of -Way
Management Representative so that the Company, at its discretion, may have an
inspector present while the work is in progress. Requestor pays the costs of the
inspector.
Mobile: [phone] E-Mail: [e-mail]
12. This Agreement provides Requestor only with approval to encroach on Company's electric
transmission Easement. For the avoidance of doubt, Company's approval of this
Encroachment in no way implies or assures that Company will grant Requestor's future
request (if any) that Company quitclaim or subordinate in favor of Requestor any portion
of Company's electric transmission Easement.
13. Requestor, its/their heirs, successors, assigns, contractors or subcontractors hereby
agree to indemnify and save harmless Company, its officers, agents and employees from
any and all claims, demands, damages, including death, and liability of every kind and
nature whatsoever for, on account of or growing out of the Agreement hereby granted,
except when such claims and demands are caused solely by the negligence or willful
misconduct of Company, its agents, employees, successors or assigns.
14. Before Requestor or its contractors, subcontractors and assigns enter upon Company's
Easement, each shall obtain or keep, in full force and effect, with respect to its/their work
within the Company's Easement, with insurance companies authorized to do business in
the Commonwealth of Virginia, the following insurance:
a) Workers compensation insurance as required by the statutory benefit laws of the
Commonwealth of Virginia or approved self-insurance and employer's liability insurance
with limits of at least $1,000,000.00 bodily injury by accident and $1,000,000.00 each
employee for bodily injury by disease.
b) Commercial general liability insurance with coverage limits of at least $2,000,000.00
each occurrence, $2,000,000.00 aggregate. Such insurance shall include, but not be
limited to, specific coverage for contractual liability encompassing the previously
referenced indemnity and liability requirements.
Page 3 of 7

03/11 /21
c) Automobile liability insurance covering bodily injury and property damage with a total
limit of at least $2,000,000.00 per accident. Such insurance shall cover liability arising out
of any automobile (including owned, hired and non -owned automobiles).
The insurance required in paragraph (b) above shall: (1) name Company, its officers,
directors and employees as an additional insured; (2) be primary coverage with respect to
any liability coverage carried by the Company; and (3) provide for claims by one insured
against another such that, except for the limits of insurance, the insurance shall apply
separately to each insured against whom a claim is made or suit is brought.
Requestor and Requestor's contractors, subcontractors and assigns waive, and will
require their insurers to waive, all rights of recovery against Company for damages to the
extent these damages are covered by the insurance required to be maintained pursuant
to the insurance requirements.
Before Requestor, Requestor's contractors, subcontractors and assigns enter upon
Company Easement, and thereafter upon the renewal of their insurance policies,
Requestor, Requestor's contractors, subcontractors and assigns, shall provide certificates
of insurance to Company evidencing the coverage and limits required by this Agreement
and that Company, its officers, directors and employees are an additional insured.
Failure of Company to demand such certificates or other evidence of full compliance with
these insurance requirements or failure of Company to identify a deficiency from evidence
that is provided shall not be construed as a waiver of the obligation of Requestor,
Requestor's contractors, subcontractors and assigns to maintain such insurance.
Requestor, Requestor's contractors, subcontractors and assigns, or their respective
agents, representatives or insurers shall provide thirty (30) days prior written notice of
cancellation to Company, except for non-payment of premium to which ten (10) days'
notice shall apply.
15.Requestor shall notify MISS UTILITY (1-800-552-7001) in a timely manner in advance of
construction to allow existing nearby underground utility conflicts to be identified.
16. Requestor may remove topsoil and gravel from portions of the Easement not occupied by
Company facilities. In such cases Requestor must maintain a minimum island of
undisturbed material with a fifty (50) foot radius on all sides of said facilities. The slope
ratios, normally 3:1 or less, and transmission line access lanes must be maintained.
17. Should it be necessary to verify the final grade of the proposed cut and/or fill, then it will
be the responsibility of Requestor to reimburse Company for all actual costs. If the
verification reveals that the cut/fill/grading was not done as approved, then Requestor is
responsible for all costs involved with correcting the problem(s).
18.There shall be no grading, excavation, filling or other construction activities within fifty (50)
feet of any Company structure, foundation, guy, anchor or any other Company facilities.
Page 4 of 7

03/11 /21
19. Clean fill material may be placed on right-of-way to within fifty (50) feet of any existing or
proposed transmission structure. In all cases, no fill will be allowed until the proposal is
reviewed by the Electric Transmission Right of Way Management to insure proper grade
and operating clearances.
20. Requestor is responsible for acquiring, from the owners of the underlying fee simple or
otherwise, any additional property rights necessary for the Encroachment location. For
the avoidance of doubt, Company does not convey, or otherwise transfer to Requestor
any Easement right that Company may hold nor does Company make any representation
or warranty as to the status or availability of any rights that may be required for Requestor
to make use of the Encroachment or Easement.
21. It is the responsibility of the Requestor to ensure that all contractors or sub -contractors
are aware, informed of and abide by these conditions.
22. The above conditions only apply as specific to and set forth in this Agreement and do not
set a precedent for further Agreements.
23. All notices, requests, demands and other communications required to be given, (except
as otherwise indicated) shall be deemed to have been duly given if in writing and mailed,
as follows:
If to Foster Allen Forbes
Requestor: 5104 Lunar Drive
Kitty Hawk, North Carolina 27949
If to Dominion Energy Virginia
Company: Highwoods One, Suite 400
10900 Nuckols Road
Glen Allen Virginia 23060
Attention: Electric Transmission Rights -of -Way
Page 5 of 7

03/11/21
This Agreement is granted only to Requestor. It is not an interest in real property; it does not
run with the underlying land or benefit any successors in interest to the underlying land, and
it may not be assigned or transferred to anyone else without the prior written approval of
Company, which Company may withhold in its sole discretion. If Requestor is not the owner
of the property on which the Encroachment is to be located; it is Requestor's responsibility to
obtain any and all necessary permission(s) or easement(s) from the property owner(s) for the
Encroachment prior to installation.]
For this Agreement to become effective, Company must be in possession of both the
executed Agreement and the required processing fee.
Requestor must return the executed Agreement and payment to Company by April 19, 2021
to:
Dominion Energy Virginia
10900 Nuckols Road, Suite 400
Glen Allen, Virginia 23060
Attention: Nancy Gustaysson
[phone] or [e-mail]
Additional contact: Dominion Energy Virginia at 1-800-215-8032 or e-mail at
ETROMdominionenergy.com.
[SIGNATURES TO FOLLOW]
Page 6 of 7

03/11 /21
Company, Authorized Representative, will execute and finalize Agreement upon return of
Agreement executed by Requestor or its Authorized Representative. Requestor will be
provided a fully executed copy of Agreement for their records.
In consideration of this Agreement granted by Company for the above -described
Encroachment, Requestor hereby agree(s) to the terms and conditions stated in the foregoing
Agreement.
Company and Requestor hereby cause this Agreement to be executed by their duly
Authorized Representative.
VIRGINIA ELECTRIC AND POWER COMPANY
Mot
Fallon Madrid Date
Supervisor, Rights of Way Management
Electric Transmission
Authorized Representative
PROPERTY OWNER
By.
�� , (� h,
Foster Allen F
Owner
Page 7 of 7
Date

DOMINION ENERGY
TOWER 149 —
LINE 2064/2073
(86' FROM EXCAV EDGE)
25'W
UNEXCAV TT x 8'W BERM
BUFFER FOR SEDIMENTATION
CONTROLAROUND
EXCAVATION AREA,
REMOVED DURING
TCH RECLAMATION
SEDIMENT
PONDoO
INTAKE
EXCAVATION
6.23ACRES
AVG DEPTH - 30 FT
MAX DEPTH - 35 FT
STATE WETL
50'BUFF ..... .
<
.......... 0\
UNEXCAV
10 BUFFER ....... ri
..
EXISTING POND, 0.51 ACRES
rsv
A3A, TO BE USED AS SEDIMENT POND
wo-
OVER
FLOW SEDIMENT POND BERM
STALL x 32'WIDE
UNI
BU
STOCKPILES &
LOADING
4.43 AC
SEDIMENT POND BERM
5'TABOVE NGL, REMOVED
DURING RECLAMATION.
PUMP POND FILLED IN & LEVELLED
0
......................................
LOADING AREA
TE021068001
EXHIBIT "B'r

ominion
EnergyMW
Electric Transmission Encroachment
Invoice
Reference # TE021068001
To the Requestor:
In order for this letter of consent for the encroachment that Kenneth Elliott has
requested on behalf of Foster Allen Forbes to become effective, the requested
processing fee must be returned to Dominion Energy Virginia no later than April
19, 2021.
The total amount due is $ 19000.00
Checks should be made payable to Dominion Energy Virginia. Please include
the reference number listed above on your payment.
Mail your payment with this invoice to:
Dominion Energy Virginia
10900 Nuckols Road, Suite 400
Glen Allen, VA 23060
Attention: Nancy Gustaysson
Please contact Nancy Gustaysson at [phone] or
nancv.l.QustayssonO-dominionenergy.com if you have any questions.

Division of Energy, Mineral and Land Resources /
Land Quality Section — Stormwater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Quality NCG020000
NOTICE OF INTENT - General Permit Application
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG020000:
STORMWATER AND/OR WASTEWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code -14XX Mineral Mining Industry (except as specked below) and
like activities
The following activities are included:
Active or inactive mining operations (including borrow pits —except for NCDOT borrow pits) that discharge
stormwater contaminated with or that has come in contact with, any overburden, raw material, intermediate
products, finished products, byproducts or waste products located on the site of such operations;
Stormwater from vehicle maintenance activities (VMA) at mining operations;
Overflow from facilities that recycle process wastewater; and/or
Mine dewatering (wastewater)
The following activities are specifically excluded from coverage under this General Permit:
Stormwater discharges associated with peat mining, coal mining, and metal mining;
Stormwater discharges from mining operations which are intermixed on site with stormwater from concrete
operations;
Stormwater discharges associated with oil and gas extraction operations; and
Stormwater discharges associated with tourist gem mines
NCDOT borrow pits (covered under individual permit NCS000150)
The following discharges are covered by NPDES general Permit NCG520000 Instead of NCG020000:
Point source discharges of stormwater and wastewater from in -stream sand mining operations (sand dredging
or dipping operations) are covered instead by NPDES General Permit NCG520000, administered by the Division
of Water Resources NPDES Wastewater Permitting Program. Please contact DWR for more information.
Please Print or type all entries in this anolicatfon torn.
1) Mailing address of owner/operator (official address to which all Permit correspondence will be mailed):
Legal Owner Name HOM Development, LLC
(Attach the most recent Annual Report to the NC Secretary or State showing the current legal name or the corporation or entity.
Alternatively this permit can be given to an individual or government authority. This name must be the same name as appears on the
Division of Energy, Mineral, and Land Resources' Mining Permit.)
Signee's Name (as signed for in question 41. at end) Jamie Basnight Hatchell
Street Address 1002 Driftwood Drive, PO Box 2405
City Manteo State NC ZIP Code 27954
Telephone No. 252 473-6074 E-mail [e-mail]
Alternate Contact Name' Derek Hatchell E-mail ('If different)
Alternate Contact Telephone (If different) 252 202-1501
'Alternate contact should be affiliated with the OwnerlOperator. Consultant information can be provided
in question 5.
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2) Location of facility producing discharge:
Facility Name
Foster Forbes Mine
Facility Street Address
8081 Caratoke Highway
Facility City
Powells Point State NC ZIP Code 27966
Facility County
Currituck
Facility Contact
Janmie Basnight Hatchell
Telephone No.
252 473-6074 Fax: [phone]
Contact E-mail
[e-mail]
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection).2.5 miles south of Powells Point Post Office on US158.
8180 Caratoke Hwy., Powells Point, NC 27966
4) Facility Location Coordinates:
5)
Latitude 36,131738 N Longitude-75.842601 W (degrees / minutes / seconds or decimal
degrees)
Consultant Information (if applicable):
Consultant:
Consulting Firm:
Mailing Address:
City:
State: Zip Code:
Phone: Fax: ()
E-mail:
Permits:
6) This NPDES Permit Application applies to which of the following:
d New or Proposed Facility
❑ Existing
7) Standard Industrial Classification:
Elliott Consulting
Ken Elliott
202 Ellian Raud, PO Bo. 112 P: 252-339.9021
Ardic", NC 27916 F: 889-6376241
ken(a'kenobs cola
Date operation is to begin: June 1, 2021
Date began mining:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility SIC Code: 1 4 4 2
8) Provide a description of the types of minerals mined at this facility:
Sand & topsoil
9) Is this a PROCESSING -ONLY facility for materials mined elsewhere? e No ❑ Yes
10) Is this an inactive mine site?
9 No
❑ Yes If yes, have you certified to the Stormwater Permitting Program that all portions of the site where
clearing, grading, and/or excavation activities have occurred have been stabilized?
❑ No ❑ Yes (If yes, the site may be eligible for "Dormant Status" and reduced BMP
inspections. See the General Permit.)
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11) Does this facility already have a valid Mining Permit from DEMLR's Land Quality Section?
d No If no, please indicate the status of the Mining Permit application: Permit application in process
❑ Yes If yes, please provide the Mining Permit number . Also provide a copy of
the DEMLR Mining Permit with this NPDES application.
12) Does this facility have any other NPDES permits?
0 No
❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility:
13) Are you applying for a discharge permit in the same location as a previously permitted mine?
N No
❑ Yes If yes, specify permit number and mine name if known:
14) Does this facility have any Non -Discharge permits from DWR (e.g., recycle permits)?
I No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
16) Does total area of this mine site include ready -mixed concrete plant and/or asphalt plant areas?
N No
❑ Yes If yes, do they have separate NPDES stormwater permits? ❑ No ❑ Yes (provide permit
number(s)
If not owned by the same company, who is the owner?
Development Activities and Buffers:
16) Will this mining operation precede development activities at this site?
P No
❑ Yes
17) Is this mine located within one of the 20 Coastal Counties, and will it add more than 10,000 ft2 of
impervious surface?
❑ Yes (to both)
N No, this mine site IS in one of the 20 Coastal Counties but will NOT add 10,000 ft2 of impervious surface.
❑ No, this mine site is NOT in any of the 20 Coastal Counties.
if this site is in one of the 20 Coastal Counties, you may be required to apply for an additional State
Stonmwater Permit Check with your local Regional Office (see contact information and checklist below).
18) Is this mine located the Neuse, Tar -Pamlico, or Catawba River Basins, or the Randleman or Jordan
Water supply Watersheds?
9 No
❑ Yes If yes, what size stream buffers are included on site? ft. You must show buffers on site
plans. Also include information and plans showing diffuse flow through buffers as required.
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1`&4&T1? r r rZrlkXe1"
Discharge Points, Receiving Waters & Wetlands:
19) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges will end up in? Albemarle Sound
To find the waterbody, please see the NC Surface Waterbody Classifications map at
https://deq.nc.g ov/about/divis i o ns/water-resources/water-resources-science-data
Receiving water classification(s) for the waters: as
If the site will discharge to a separate storm sewer system, name the operator of the separate storm sewer
system (e.g. City of Raleigh municipal storm sewer). N/A
Discharge of wastewater to receiving waters classified as WS-11 through WS-V, or SA, must be
approved by the Division of Water Resources (DWR) or Division of Marine Fisheries
(DMF). DEMLR cannot grant coverage under NCG020000 without that approval. Also be advised that
no new discharges of wastewater are permitted in receiving waters classified as WS-1 or
freshwater ORW. Wastewater discharges to saltwater ORW will not be approved under General Permit
NCG02 but may be eligible for an individual permit.
20) Will this mine site discharge wastewater or stormwater to waters classified as High Quality Waters
(HQW), Primary Nursery Areas (PNA), Trout jr) waters, or a class with a symbol like "+" or "@" that
denotes a special management strategy is in place?
d No ❑ Yes, HQW* ❑ Yes, includes "+" or
❑ Yes, PNA* ❑ Yes, Trout jr)
21) Will this mine site discharge wastewater or stormwater to waters classified as Shellfish (SA) waters?
e No
❑ Yes, SA*
*For questions 19-20, be advised that the NCG02 General Permit limits the discharge volume of total combined
wastewaters to 50 percent of the receiving water in -stream flow under 7Q 10 conditions in HQW waters (PNA and
SA waters are considered HQW by definition). You maybe required to contact USGS to obtain a 7Q 10 flow.
22) Will this mine site discharge wastewater or stormwater to impaired waters, or to waters with an
approved "Total Maximum Daily Load" (TMDL)?
To find impaired waters & TMDLs, please see the Impaired Waters Map & TMDL map on
https://deq.nc.gov/about/d ivisions/water-resou rcestwater-resources-science-data
N No
❑ Yes, these waters are impaired for (list pollutants):
❑ Yes, these waters have a TMDL for (list pollutants):
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23) List discharge points (outfalls) that convey discharge from the mine site (both on -site and off -site) and
location coordinates. Attach additional sheets if necessary, or note that this information is specified
on the site plan. Include proposed maximum daily flow rate for each wastewater outfall.
You must show all discharge points clearly on the submitted site plan. Be advised
that NCDEQ may require you to apply for an individual permit, based on proposed
discharge rates and receiving stream conditions (low flows, impairments, etc.)
Stormwater
Stonnwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Mine Dewatering
Mine Dewatering (Wastewater) Outfall No. 1
Proposed maximum flow rate:0.24 mgd
Latitude (degrees/minutes/seconds or decimal degrees): 36.132956
N
Longitude (degrees/minutes/seconds or decimal degrees): -75.841882
W
Mine Dewatering (Wastewater) Outfall No.
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Process Wastewater
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees): N
Longitude (degrees/minutes/seconds or decimal degrees): W
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees): N
Longitude (degrees/minutes/seconds or decimal degrees): W
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24) Help us understand what will happen to the dewatering water at this mine site:
❑ NIA — this mine is not dewatering at all and will not dewater in the future.
a) Will this mine be dewatering and discharging to waters of the state? (Answer only if dewatering)
❑ No
9 Yes If yes, where to? 9 Surface Waters and/or Wetlands (on -site or off -site)
❑ Other (on -site or off -site) Describe:
b) Will this mine be dewatering but not discharging to waters of the state? (Answer only if dewatering)
9 No
❑ Yes If yes, explain how you are dewatering, and where that water will be directed:
26) Are there wetlands or surface waters within 400' of the mine pit perimeter?
❑ No
9 Yes If yes, what distance are they from the mine pit perimeter? 75 feet.
26) Will mining operations require dewatering near wetlands or other waterbodies, and will dewatering
potentially impact any wetlands or other waterbodies?
❑ No, dewatering will not occur near (within 400') of wetlands or other waterbodies (e.g., streams, lake, etc.)
9 Yes, dewatering will be near wetlands or other waterbodies
Wetlands must be CLEARLY DELINEATED on the site plan. Mine dewatering activities that
have the potential to drain wetlands or otherwise impact surface water or groundwater MUST develop and
Implement a Pumping Operation and Monitoring (POM) Plan that has been approved by the
Department.
For sites that may drain wetlands — approval of a POM Plan may be required prior to coverage under
this permit. The POM Plan should be submitted to the appropriate Regional Office and in all cases m,_ ust be
approved prior to operation.
The plan shall include, but is not limited to: (1) Groundwater monitoring strategies to demonstrate the effect of
pumping and to establish any pumping regime necessary to reduce impacts, and (2) Detailed plans to maintain
surrounding hydrology and respective monitoring to demonstrate compliance. See checklist at the end of the
application. Contact the Regional Once for questions specific to your mine.
27) Have you been required to obtain 404/401 Certification permits?
N No
❑ Yes If yes, please briefly describe below (include information such a required mitigation, BMPs,
setbacks, and/or O&M plans for on or off --site wetlands or other pertinent information). Attach other sheets as
necessary:
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NCG020000 N.O.I.
28) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ No a Yes If yes, please attach to application submission.
Stormwater BMPs and Vehicle Maintenance:
29) Does this facility employ best management practices for stormwater control?
❑ No P Yes If yes, please briefly describe:
30) Does this facility have a Stormwater Pollution Prevention Plan?
d No ❑ Yes If yes, when was it implemented?
31) Are vehicle maintenance activities (VMA) occurring or planned at this mine site?
IN No El Yes. If yes, will VMA area runoff discharge into the wastewater treatment system(s)?
❑ No, VMA runoff will discharge separately through a stormwater ouffall
❑ Yes, VMA runoff will drain back to the mine pit or other wastewater system
Wastewater Treatment Facilities:
32) Will mine dewatering occur? (Yes, we are asking about dewatering again.)
❑ No
e Yes
If yes, will the mine discharge this water? Yes
33) Will this facility wash mined materials?
IN No
❑ Yes If yes, will the mine discharge this water?
34) Will discharges of process wastewater treatment systems occur (including possible recycle system
overflows)?
a No
❑ Yes If yes, describe what kind of systems:
35) Will this facility employ chemical additives to flocculate suspended solids?
e No
❑ Yes If yes, provide the name, manufacturer, and the quantity of average daily usage of the chemical
additive (if known):
Note: Please see our website for a list of evaluated polyacrylamide (PAMS) products for use in North Carolina:
https://deq.nc.gov/about/d ivisions/energy-mineral-land-resources/energy-mineral-land-permits/stormwater-permits/
construction-sw
36) Will any of the wastewater treatment facilities at this mine overflow only during rainfall events that
exceed the 10-yr, 24-hr rainfall event?
❑ Yes If yes, which treatment systems are those?
No, all wastewater treatment facilities will discharge more frequently (i.e., during smaller rain events)
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NCG020000 N.O.I.
37) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
d No
❑ Yes
E 138) A Wastewater treatment alternatives review is required by 15A NCAC 2H.0105 (c)(2)
for any new or expanding water pollution control facility discharges in North Carolina. You may
attach additional sheets. List the types of wastewater this mine site will discharge:
❑ Mine Dewatering
❑ Process Wastewater (such as washing or recycle system overflows, other mining activity wastewater)
a) What wastewaters were considered for this alternatives review? ❑ Dewatering ❑ Process WW
b) Connection to a Municipal or Regional Sewer Collection System:
i) Are there existing sewer lines within a one -mile radius? ..................................... ❑ Yes �✓ No
(1) If Yes, will the wastewater treatment plant (WWTP) accept the wastewater? .... ❑ Yes ❑ No
(a) If No, please attach a letter documenting that the WWTP will not accept the wastewater.
(b) If Yes, is it feasible to connect to the WWTP? Why or why not?'
N/A
c) Closed -loop Recycle System (meets design requirements of 15A NCAC 2T .1000):
i) Are you already proposing a closed -loop recycle system (CLRS)? ......................... ❑ Yes 11 No
(1) If Yes, for what type of wastewater at this mine site? ❑ Dewatering ❑ Process WW
(2) If No, is this option technologically feasible (possible)? Why or why not?'
Would require dredge, not available, no room, not cost effective.
(3) If No, is it otherwise feasible to build a CLRS at this site? Why or why not?'
Would require dredge, not available, no mom, not cost effective.
(4) What is the feasibility of building a CLRS compared to direct surface water discharge?'
None
d) Surface or Subsurface Disposal System (e.g., spray irrigation):
i) Is a surface or subsurface disposal technologically feasible (possible)? ..................... ❑ Yes a No
Why or Why not?' Would not be able to remove enough water from pit to he useful
ii) Is a surface or subsurface disposal system otherwise feasible to implement?'............ ❑ Yes a No
WhyorWhynot?` would require agreement with adscontform operation
.
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NCG020000 N.O.I.
iii) What is the feasibility of employing a subsurface or surface discharge as compared to a direct
discharge to surface waters?* None at this location.
e) Direct Discharge to Surface Waters: Is discharge to surface waters the most environmentally sound
alternative of all reasonably cost-effective options for the wastewaters being considered?*
9 Yes ❑ No
f) If this review Included all wastewater discharge types, would excluding some types (e.g. mine
dewatering) make any of the above non -discharge options feasible for some of the wastewaters?
❑ Yes 8 No
* Feasibility should take into account initial and recurring costs. You may be asked to provide
further information to support your answers to these questions after the initial review.
Other:
39) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
N No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: N/A
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor. —
Vendor address:
40) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? (See
permit text for secondary containment requirements.)
❑ No
a Yes
41) Does your site have an active landfill within the mining permit boundary?
I No
❑ Yes If yes, specify type: ❑ LCID (Land Clearing and Inert Debris) ❑ Other:
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Final Checklist:
WifThis application will be returned as Incomplete unless all of the followin�a items have been included and
initialed for. Please show that the following required information has been included by initialing in each
space below.
x Fee of $100 made payable to NCDEQ.
x Completed application and all supporting documents.
x Copy of the valid approved mining permit (MP) for the facility or indication of MP application status.
x Copy of a county map or other general location map that shows the mining site and nearest major roads
x Copy of USGS topographic map showing the mining site and surrounding areas, or other map that clearly
shows site location in relation to nearby streams, wetlands, and other waters, etc.
x 2 copies of large-scale (minimum 24" x 36") site plan with topographical lines with
all outfalls, applicable buffers and wetlands clearly delineated, receiving waters, and
100-year flood plain line if applicable.
x A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 27 above.
x A line drawing of the water flow through the facility or block flow diagram. A pictorial description of the
nature of any sources of water and any collection and treatment measure,.
x If mine site is in one of the 20 Coastal Counties:
• Applicant has checked with the appropriate regional office to verify the need for a Coastal Staffs
Stormwater permit. Indicate the Regional Office Contact: Thom Edgerton, WaRO
• Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas, and total drainage area.
x If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the followings and contact your local realonal office about a Pumping Operation and
Monitoring (POM) Plan. An approved POM plan may be required odor to NCG02 issuance.
x 2 copies of detailed Full Size Plans (at least 24" x 36") delineating areas on the
plans and listing acreage (including: wetlands, ditches, well -placements, pits,
borrow areas, overburden storage, stormwater controls/BMPs, vehicle
maintenance areas, settling basins, product process (such as screening,
stockpiles, waste piles), total drainage area, impervious surface percentages (if
state SW programs apply), applicable buffers, and access and/or haul roads).
x Pump dewatering size and information on its specifications.
Well information (design, depths, maintenance).
x Physical monitoring for the wetlands areas.
x Settling pond sizing information, if applicable.
Level spreader design, if applicable.
x Details about dewatering method.
Cone of influence calculations.
x Description of measures to prevent erosion and flooding
Description and information about 401/404 permits that have been obtained
.I_Copy of US Army Corps of Engineers wetland delineations or approved wetland delineation
applicable).
x I have contacted my local regional office about a POM Plan.
Regional Office Contact: Thom Edgerton, WaRO . Date contacted: 03-17-2021
-OR-
I will not impact any nearby wetlands, surface waters, or groundwaters by dewatering.
(if
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Certification: North Carolina General Statute 143-216.6 b (1) provides that:
Any person who knowingly makes any false statement, representation, or certification In any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule Implementing this Article; or who knowingly makes a false
statement of a material fact in a nulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission Implementing this Article shall be guilty of a Class 2 misdemeanor which may Include a fine not to
exceed ten thousand dollars ($10,000).
41) Signatory Requirements (per 40 CFR 122.22)
All applications, reports, or Information submitted to the Director shall be signed and certified.
a. All notices of intent to be covered under this General Permit shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the purpose of this permit, a responsible corporate officer means: (a) a president,
secretary, treasurer or vice president of the corporation In charge of a principal business function, or any other person who performs similar
policy or decision making functions for the corporation, or (b) the manager of one or more manufacturing production or operating facilities
employing more than 250 persons or having gross annual sales or expenditures exceeding 25 million on second quarter 1980 dollars), if
authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively; or
(3) For a municipality, state, federal, or other public agency: by either a principal executive officer or ranking elected official.
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit will
constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual
permit.
I agree to abide by the following as a part of coverage under this General Permit:
1. I agree to abide by the approved Mining Permit for this mining activity. (A copy of the valid mining
permit must be attached to this request.)
2. 1 agree to not discharge any sanitary wastewater from this mining activity except under the
provisions of another NPDES permit specifically issued therefore.
3. 1 agree that bulk storage of petroleum products and other chemicals shall have adequate protectbn
so as to contain all spills on the site.
4. 1 agree that solid wastes will be disposed of in accordance with N.C. statutes and rules governing
solid waste disposal.
5. 1 agree that maintenance activities for vehicles and heavy equipment will be performed so as to not
result in contamination of the surface or ground waters.
I agree to abide by the provisions as listed above and recognize that the provisions are to be considered as
enforceable requirements of the General Permit.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Jamie Basnight Hatchell
Title: Mpager, HOM Development, LLC
03-18-2021
of Applicant) Lj (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
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Mail the entire package to:
DEMLR - Stonnwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee coverage under the NPDCS
NCG02 General Permit. Upon review of the submittal, the Division may
determine that coverage under an individual permit is more appropriate. Also be
advised that renewed and continued coverage under NCG02 may be dependent
upon the permittee's compliance success and/or status of the receiving waters.
For questions, please contact the DEMLR/Land Quality Secdon Regional Office for your area.
DEMLR/Land Quality Section Realonal Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
707-9220
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