20210809_ADI_Received

Hanover Design Services, P.A.
Land Surveyors, Engineers, Land Planners
July 30, 2021
Mr. Adam Parr
RECEIVED
AUG 0 9 2021
LAND QUALITY
MINING PROGRAM
Assistant State Mining Engineer
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, N.C. 27699-1612
Re: Rosindale Sand Mine, Bladen County, N.C.
IVE
NOV
am
Dear Adam,
Enclosed you will find the latest revisions and additional information requested for review of
the proposed Rosindale Mine. I have also included a copy of your request for additional
information and my response for items 1-6 are below:
1. The chart on plan sheet 2 of 4 was showing one area to the nearest 1/1000 of an acre
whereas the areas shown on the table of page 7 and the bonding calculations on page
18 were all shown to the nearest 1/100 of an acre. All areas are now shown to the
nearest 1/100 of an acre.
2. Copies of the signed return receipts are attached. They were not available at the time
of the initial submittal.
3. Section 36 has been changed to show discharge (see brief description).
4. The statement concerning a hydrogeologic report has been removed. That mistakenly
was included from a past application for another project.
5. Proof of application for NPDES permit is attached. Again that was mistakenly included
from a past application for another project.
6. Additional labeling of streams has been added to the mine map.
7. A map of survey has been included of the wetland areas and more labeling has been
shown on the mine map.
Than aforr help. We look forward to hearing from you soon.
A. Wayne, PLS
1123 Floral Parkway Wilmington, N.C. 28403 Phone [phone] Fax [phone]
Business Firm License No. C-0597

NORTH CAROLINA
MINING PERMIT APPLICATION
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

NOTE:
It is recommended that you contact the appropriate
Regional Office (see Regional Office listing in the back of this
booklet) or the Raleigh Central Office for a
PRE -APPLICATION MEETING
to discuss your intentions and address any questions.

MINING PERMIT APPLICATION REVIEW
PROCESS FLOWCHART
BEGINNING OF
I
Application received by
Ctatp Minina Gnprinlict
I
EApplication assigned to
A,.Rqi.qtant State Mining
I
Assistant State Mining Specialist/Program
Asm
Secretary
- U.S. Fish & Wildlife Service
- N. C. Geological Survey
- Wildlife Resources
Commission
- Division of Water Resources
- Division of Archives & History
I
Applicant issues
Public Notice
I
- Regional Office
- Division of Air Quality
- Division of Water
I
All application review comments :Review Public
Comments:
forwarded to • • 0060.0 • • • • • • • • • • . • • ..........
I
Is application
If "YES", Assistant State
Mining
Cnprialict drafts the nranncM
If "NO", Assistant State Mining
Specialist drafts a letter
rPnnPctira a�lrlitinnal
Additional information from
applicant received and routed
to/reviewed by Assistant State
Mining Specialist and Regional
Office Staff
(f-ro to *l

Application & proposed permit
action reviewed by State Mining
Is application &
proposed permit
action
If "Yes", the following permit
actions
are issued by the State Mining
Specialist:
- Draft Permits
- Permit Transfers/Name Changes
- Bond Substitutions/Cancellations
- Permit Releases
- High Airblast Remediation Plans
I
END OF
If "YES", application &
proposed permit action
fnrwarded to anti rPviPwPA by
I
Is application &
proposed permit
artinn
I
E
", the proposed permit
issued by the Division
END OF
If "No", application & proposed
permit action returned to
Assistant State Mining
Specialist for revision
For other permit actions, if
"Yes", application & proposed
permit action forwarded to and
Is application &
proposed permit
artinn rnrnnlPtP/
If "NO", application & proposed permit
action returned to State Mining
Specialist/
Assistant State Mining Specialist for
If "NO", application & proposed permit
action returned to Section Chief/State
Mining Specialist for revision
fan to *l

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
APPLICATION FOR A MINING PERMIT
�^t (PLEASE PRINT OR TYPE)
Name of Mine 11 IolI;IL County. 6wpyl al
River Basin
Latitude (decimal degrees to four places)
Longitude (decimal degrees to four places)
2. Name of Applicant*
3. Permanent address for receipt of official mail**
• 111/1ti!iJj1'1L1'
4. Mine Office
Telephone A I(7 ) alb M
5. Mine
6. E-mail Address:
I certify that all details contained in this IWrmit 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.
Date "
Print Name,; 10-1 0 1s�f_4L
TitleJc e
* 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
-1-

APPLICATION FOR A MINING PERMIT
needed.
-2-

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:
X 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): 5.90
n
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: 5.90 Property owner if leased: William E. Clark ETUX
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 ❑ NoEl. 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 ❑. 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 ACTIONS) AND CORRESPONDING ACREAGE
NOTED ABOVE
2. Name of all materials mined: SAND
3. Mining method:
Hydraulic Dredge Front-end Loader & Truck X Shovel & Truck
Dragline & Truck Self -loading Scraper
Other (explain):
4. a. Expected maximum depth of mine (feet) 35 FT.
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation, etc.)
b. Expected average depth of mine (feet)
-3-

APPLICATION FOR A MINING PERMIT
5. Has any area(s) at this site been mined in the past? Yes ❑ No X
If yes, when and by whom was this activity conducted?

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): 10 YEARS
B. MAPS
I. 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 covies 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, 5`h Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
litti):Hportal.ncdenr.orp,/webAr/.2eolo-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 Iakes.
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.
-5-

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
1 inch = 50 feet
50-199 Acres
1 inch = l 00 feet
200+ Acres
1 inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)
aV

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
Stockpiles
Wastepiles
Processing Area/Haul Roads
6.63
Mine Excavation (includes sediment
pond)
2.90
Other (Explain) BUFFER AREAS
3.00
Eotal Disturbed Acreage
12.53
NOTE:
I ADDITION DITION 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.
-7-

APPLICATION FOR A MINING PERMIT
C. PROTECTION OF NATURAL RESOURCES
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.
SEE NARRATIVE
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 map(s) and provide typical cross-sections/construction
details of each measure. Engineering designs and calculations are required to justify the adequacy of
any proposed measures.
SEE NARRATIVE
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes ❑ No ®. If yes, briefly describe all such processes including any chernicals to be
used.
b. Will the operation involve discharging fresh or waste water from the mine or plant as a point
discharge to the waters of the State? Yes X No [ If yes, briefly describe the nature of the
discharge and locate all proposed discharge points (along with their method of stabilization) on your
mine map(s).
Pumping will only occur on an as needed basis. Seeping groundwater into the excavated areas will be
pumped into the sediment trap. As the trap dewaters it will replenish ground supply and nearby wetland
areas. Given the small amount of pumping expected, the small amount of water expected to leave the
sediment trap overground, and the existing natural vegetation surrounding the site, no negative impacts
are to be expected. The site will be monitored to insure there will be no erosion or negative impacts.

APPLICATION FOR A MINING PERMIT
WE

APPLICATION FOR A MINING PERMIT
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: as needed basis<100,1000 GPD ., _ . Locate all existing
wells on the mine map(s) 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.
There are no wells within 500' of the proposed project area. The mine will only be dewatered on an
as needed basis for excavation to replenish the stockpile. The mine will be dewatered using Godwin
Dri-Prime CD150M portable pumps to control ground water levels and surface runoff in the pit. The
method of dewatering will be sump pumping. Seeping groundwater into the excavation will be
channeled to the low point in the excavation and pumped out as needed with the above -mentioned
pump. The water then will be pumped from the sump in the main pit as needed and allowed into the
adjacent sediment trap. As the sediment trap dewaters it will replenish ground supply and wetlands
located nearby. The pump will be set up at the location between the two basins. At the excavation
elevations shown on the map, no negative impacts are expected on any surrounding wells. See
narrative and hydrogeologic report for further explanation.
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.
See attached cover letter and airbill.
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No ®.
If yes, indicate evidence that you have applied for or obtained an air quality pem-dt issued by the
Division of Air Quality or local governing body.
b. How will dust from stockpiles, haul roads, etc., be controlled?
A water truck will be utilized as needed,
-10-

-APPLICATION FOR A MINING PERMIT
-11-

APPLICATION FOR A MINING PERMIT
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 buffer locations and widths
on the mine map(s).
50' minimum -- see plans
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' minimum - see plans
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.
3:1 slopes will be maintained and a 50 ft. buffer will ensure no affect.
-12-

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 andlor slope drains (with supporting design information) if needed, and the method of
final stabilization.
See plans
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).
See plans
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.
N/A
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.
No structure exists within 500 ft. of the proposed mine.
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 detaiUcross-section and
location of each type of barricade to be used must be indicated on the mine map(s).
Gated access road (see plans)
-13-

APPLICATION FOR A MINING PERMIT
9. Are acid producing minerals or soils present? Yes ❑ No Z.
If yes, how will acid water pollution from the excavation, stockpiles and waste areas be controlled?
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 map(s) and
provide cross -sections through all proposed berms or proposed spacing, sizes and species for
tree plantings.
Screening will not be necessary due to the remote location of the site and the large wooded areas between the
site and the adjacent property owners.
b. Could the operation have a significantly adverse effect on the purposes of a publicly owned parts,
forest or recreation area? If so, how will such effects (i.e., noise, visibility, etc.) be mitigated?
No adverse affects will be experienced given the remote location of the proposed facility
11. Will explosives be used? Yes ❑ No ®.
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 structure(s) to the proposed excavation(s) on the mine map and indicate its
approximate distance to the proposed excavation.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ® 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).
Mobile fuel tanks will be used for equipment and all necessary precautions will be taken to avoid
spillage.
_14-

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
location(s) of all permanent channels must be indicated on the reclamation map.
Final reclamation will include final stabilization of all disturbed areas and slopes of basins. Basin will
remain as a lake for recreation.
2. Is an excavated or impounded body of water to be left as a part of the reclamation? Yes ® No ❑.
If yes, illustrate the location of the body(s) of water on the reclamation map and provide a scaled
cross -sections) 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.
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.
N/A
-15-

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.
All areas surrounding the basin will be graded, slightly sloping toward the basin or body of water.
5. a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
All such areas will be graded (see #4 above). All roadways will be left intact.
b. Will any on -site roadways be left as part of the reclamation? Yes ® No ❑.
If yes, identify such roadways on the reclamation map and provide details on permanent road and
ditch line stabilization.
All roadways and existing ditched will be stabilized. (see narrative for stabilization methods)
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 map(s) and reclamation map, along with a list of items to be disposed in said areas.
=111M.

APPLICATION FOR A MINING PERMIT
7. Describe your plan for revegetation or other surface treatment of the affected areas. This plan must
include recommendations for 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 revegetation. Revegetation utilizing only tree
plantings is not acceptable. Recommendations can be sought from:
a. Authorized representatives of the local Soil and Water Conservation District;
b. Authorized representatives of the NC Forest Service, Department of Agriculture and Consumer
Services;
c. Authorized county representatives of the North Carolina Cooperative Extension Service,
specialists and research faculty with the Colleges of Agriculture and Life Sciences and Forest
Resources at North Carolina State University;
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the NC Forest Service, Department of Agriculture and
Consumer Services;
f. N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation;
h. Others as may be approved by the Department.
LIME - RATE OF APPLICATION (tons/acre):
FERTILIZER - ANALYSIS AND RATE OF APPLICATION (pounds/acre):
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Seed Types: Seeding Dates: Seeding Rates:
See Plans and Plan Narrative
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF
ANCHORING:
OTHER VEGETATIVE COVERS - TYPE (S) AND RATE (S) OF APPLICATION
INCLUDING SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Revegetation and/or reforestation plan approved by:
Signature _
Print Name
Title
Agency
-17-
Date

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
The following bond calculation worksheet is to be used to establish an appropriate bond (based upon a
range of $500 to $5,000 per affected acre) for each permitted mine site based upon the acreage approved
by the Department to be affected during the life of the mining permit. Please insert the approximate
acreage, for each aspect of the mining operation, that you intend to affect during the life of this mining
permit (in addition, please insert the appropriate reclamation cost/acre for each cateQory from the
Schedule of Reclamation Costs provided with this application form) OR you can defer to the Department to
r
AFFECTED
RECLAMATION
RECLAMATION
CATEGORY
ACREAGE
COST/ACRE*
COST
Tailings/Sediment Ponds:
0 Ac.
X
$
500
/Ac.
_ $
0
Stockpiles:
0 Ac.
X
$
1800
/Ac.
_ $
0
Wastepiles:
Ac.
X
$
/Ac.
_ $
Processing Area/Haul Roads:
6.63 Ac.
X
$
1800
/Ac.
_ $
11,934
Mine Excavation:
2.90 Ac.
X
$
500
/Ac.
_ $_
1,450
Other: (buffers)
3.00 Ac.
X
$
500
/Ac.
_ $
1,500
TOTAL AFFECTED AC.:
12.53 Ac.
(TOTAL PERMITTED AC.:
12.53 Ac.)
Temporary & Permanent Sedimentation & Erosion Control Measures:
Divide the TOTAL AFFECTED AC. above into the following two categories: a) affected acres that drain into
proposed/existing excavation and/or b) affected acres that will be graded for positive drainage where measures
will be needed to prevent offsite sedimentation and sedimentation to onsite watercourses and wetlands.
a) Internal Drainage 12.53 Ac.
b) Positive Drainage 9.63 Ac. X $1,500.00 = $ 14,445
Inflation Factor: SUBTOTAL COST: $ _ 29.329 ,
0.02 X SUBTOTAL COST: $ 586.58 X Permit Life Provided by Applicant (Life of the Mining
Operation or Life of Lease from Public Entity (in Years)):
INFLATION COST: $ 5866
Total Reclamation Bond Cost: $ 35,195
(round down to the nearest $100.00)
(NOTE: The reclamation bond cannot exceed $1 million per GS 74-54)
-18-

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"
-19-

NOTICE
Pursuant to provisions G.S. 74-50(b1) of The Mining Act of 1971, Notice is hereby given that
has applied on j 0 it - e-/
(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):
0 a new surface mining permit,
El 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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine S4 n9 on 3. ?a acres located
1 (Mineral, Ore) (Number) (Miles) n )
of rlA off/near road S Q/gyp f3
(Direction) Nearest Town) (Number/Name)
in Io County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bI), 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
hours at the above listed address as well as at the appropriate regional office. For information re
at
Mee/Owner of Record's
and Address)
707-9220.
on
Applicable)
-20-
contact
icant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
-21-

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
has applied on ,S =49/,4 —0/
(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):
Va 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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine Ste/ on 37 �� acres located_
(Mineral, Orc) (Dumber) (Miles)
�t+ 5 ofCla4244 off/near road S;Al7bI iQos; �k t'r
(Direction) Nearest Town) (Number/Name)
in County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(b I), 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
comments) 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 re regarding i
s cities the r o ed mtntn acttvit lease contact the a licant at t e followin tele hone numl
For information on the mining permit application review process, please coi
the Mining Program staff at [phone]. Please note that the Department will rnnc;rin� a ., .aa.• ...•
,k§te/Owner of Record's
and Address)
Applicable)
-20-
licant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
—21—

NOTICE
Pursuant to provisions G.S. 74-50(bI) of The Mining Act of 1971, Notice is hereby given that
n
has applied on j a ¢ --z/
(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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine on S• 5?y acres located
(Mineral, Ore) (Number) (Miles)
of r - 11 off/near road SQ/7o f3 �esi t<r
(Direction) Nearest Town) (Number/Name)
in 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 re2ardinp t
on
at [phone].
:ssee/Owner of Record's
and Address)
Applicable)
—20—
contact
licant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
—21—

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
n
L
has applied on S =a ;9 —Z/
(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):
Y- 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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine S'Qyd on S• Va acres located _
(Mineral, Ore) (Number) (Miles)
of < r - 01 off/near road .IA/7p Ao5 0" Ir
(Direction) Nearest Town) (Number/Name)
ni 4?Z40�-d County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(b1), 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 info
ation reeardine t
r.nc ..F H.e - .. ..........__a .__—_—_ _ .. __
19) 707-9220.
(Addressee/Owner of Record's
Name and Address)
[0-I
Applicable)
-20-
licant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
—21—

NOTICE
Pursuant to provisions G.S. 74-50(bI) of The Mining Act of 1971, Notice is hereby given that
n
has applied on z? —Z%
(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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine '$
/r n// on J-1 �v acres located �-
1 (Mineral, Ore) (Number) (Miles)
of r - iJ off/near road : ;P,170 43 Aos r� 1"
in (Direction) County. Nearest Town) (Number/Name)
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bI), 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
filin# 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 rponrdino —o..:a.... ,.r a.. ---- -
on
at [phone].
:ssee/Ownbf of Record's
and Address)
Applicable)
-20-
licant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
—21—

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
n
has applied on S =a /2 —z%
(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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine _ _a ndon I %% acres located _
(Mineral, Ore) (Number)
5 of r - 11 off/near road .5AIxo /eosi t♦r �7
(Direction) Nearest Town) (Number/Name)
inn 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 ]eased 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 rpvardino i
at
Record's
and Address)
707-9220.
on
Applicable)
-20-
review
licant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
-21-

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
n
has applied on s !J ¢ --z/
(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 pennit to add land to the permitted area with no
disturbance
to in the area proposed. Please [tote that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine -SG p/ on Sw c%y acres located
(Mineral, Ore) (Number) (Miles)
E� of A off/near road AS;" 1" Pd
(Direction)) Nearest Town) (Number/Name)
in glve +a 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 reEardine 1
-- --!V_- -V.�--------' - ' - ....
on
at [phone].
:ssee/Owner of Record's
and Address)
Applicable)
-20-
review process, please contact
I consider any relevant written
hout the application review
b {/y m
licant: Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
-21-

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
n
L
has applied on I--,-? /- —Z/
(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):
T 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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine. ;54 o on S- C%y acres located - (Mineral, Ore) (Number) (Miles) les:�w 5 of - r it off/near road S;Q/%O Roz " Ie Pd
(Direction) Nearest Town) (Number/Name)
to gin ka _ County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bI), 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 re¢ardino i
on
at [phone].
(Addressee/Owner of Record's
Name and Address)
Applicable)
-20-
contact
icant:Include Contact Person
& Company Name, if

(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
-21-

NOTICE
Pursuant to provisions G.S. 74-50(b1) of The Mining Act of 1971, Notice is hereby given that
0 .,Sg,1 /� . L/.
icant Name) /
has applied on ;ot `0l
(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
to in the area proposed. Please note that future modification(s) may be submitted by the applicant
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine a tj on ,5-- Fa _
acres located -,;;If
(Mineral, Ore) (Number) (Miles)
of i ,r` — o, off/near road c+5 `066
(Direction) Nearest Town) (Number/Name)
in - cp County.
'SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(b 1), the mine operator is required to make a reasonable effort, satisfactory to the
Department, to notify all owners of record, both public and private, of all tracts of land that are adjoining the
mining permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of
the mine tract, all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of
the mining 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 proposed mining activity. please contact the applicant at the following telephone number:
. For information on the ndning permit application review process, please contact
the Mining Program staff at [phone]. Please note that the Department will consider any relevant written
until a final decision i
cati
to
on review
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if
Applicable)
_20_

APPLICATION FOR A MINING PERMIT
AFFIDAVIT OF NOTIFICATION
I, VW , an applicant, or an agent, or employee of an applicant, for
a new ML4nj Permit, bl 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)
(Attach additional list if necessary)
I do also attest that the following individual is the chief administrative officer of the county or municipality in
which any part of the permitted area is located and that notice of the pending application has been caused to be
mailed, by certified or registered mail, return receipt requested, to said office at the following address:
(Chief Administrative Officer Name) (Address)
[i.e.: City Manager, County Manager, Mayor, etc.]
1111, r&.J.•A nnf „AW AP16A/t/1✓
The above attestation was maJriby 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 permit boundary) and the chief administrative officer of the county or
municipality in which any part of the permitted area is located in compliance with N.C.G.S. 74-50(bl) and 15A
NCAC 5B .0004(d). I understand that it is the responsibility of the applicant to retain the receipts of mailing
showing that the above notices were caused to be mailed and to provide them to the Department upon request.
�u,f5--
nature of Applicant or Agent Date
If person executing
Name of applicant:
Title of
person exec
1, �YiJOdL-
or employee of an applicant, provide the following information:
State of North Carolina, do hereby certify
appeared before me this day and under oat
-22-
a Notary Public of the County of flfw
Commission

APPLICATION FOR A MINING PERMIT
expires:
—23—

Mr. Greg Martin
Bladen County Manager
201 East King St.
Elizabethtown, N.C. 28337
KELLY E. CLARK
132 OUTLAND AVE
BREVARD, N.C. 28712
CARL B. CLARK
894 MCKENZIE ROAD
LAKE HELEN, FL. 32744
BYRDFIELD FARMS LLC
697 EVERETT BYRD RD.
CLARKTON, N.C. 28433
JAMES LEWIS
705 RICHARD SWITCH RD
CURRIE, N.C. 28435
ORRIN W. PERRY
3993 BONNIE WALTERS RD
LAGRANGE, N.C. 28551
AGNES B. PERRY
820 IVANHOE DR.
RALEIGH, N.C. 27615
E2 COMPANIES LLC
PO BOX 682
WHIEVILLE, N.C. 28472

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:
APPLICANT:
Signature: `� `'� ��` '5- C1 C"`< Signature: Z —
Print Name: `� ' 1 `1 nrr F C L' RK
(Title, if applicable)
Company
(If applicable)
Address: I Z 8 a0{o�l
C
c;S3ro +
Telephone: (91 0) ` 1(
Date Signed:
5- 2.L— Zoe (
Print Name: i
Title:
Company: Z,,),.c .¢/�- GL e`.
Mine Name: G G
Telephone: (Q/d } `3 S f!Z
Date Signed: V - Zd z. l _
*Signature must be the same as the individual who signed Page I of this application
One original and five 5 covies of the completed application, sixCM copies of all location maps, mine
mans and reclamation maps, 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
-24-

APPLICATION FOR A MINING PERMIT
[phone].
-25-

APPLICATION FOR A MINING PERMIT
MINING FEE SCHEDULE
A nonrefundable permit application processing fee when filing for a new mining permit, permit modification or transferred permit is
required as follows:
0-25 acres
26+acres
New Permit Applications
$3,750.00
$5,000.00
Permit Modifications
$750.00
$1,000.00
Permit Transfers
$100.00
$100.00
Annual Operating Fee
$400.00
$400.00
Acres for new permits means the total acreage at the site. Acres for modification of permits means that area of land affected by the modification within the permitted
mine area, or any additional land that is to be disturbed and added to an existing permitted area, or both.
- 26 -

APPLICATION FOR A MINING PERMIT
There are seven Division of Energy, Mineral, and Land Resources (DEMLR) Regional Offices. Use the map below to
locate the Regional Office serving your county.
Asheville Regional Office
• Counties: Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey
• Address: 2090 U.S. Highway 70, Swannanoa, NC 28778
• Voice:828.296.4500
• FAX:[phone]
Fayetteville Regional Office
• Counties: Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Richmond, Robeson, Sampson,
Scotland
• Address: 225 Green Street, (Systel Building), Suite 714, Fayetteville, NC 28301-5094
• Voice:910.433.3300
• FAX:[phone]
Mooresville Regional Office
• Counties: Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly,
Union
• Address: 610 East Center Ave., Suite 301, Mooresville, NC 28115
• Voice:704.663.1699
• FAX:[phone]
Raleigh Regional Office
• Counties: Chatham, Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton,
Orange, Person, Vance, Wake, Warren, Wilson
• Address: 1628 Mail Service Center, Raleigh, NC 27699-1628 or 3800 Barrett Drive, Raleigh, NC 27609
• Voice:919.791.4200
• FAX:[phone]
Washington Regional Office
• Counties: Beaufort, Bettie, Camden, Chowan, Craven, Currituck, Dare, Gates, Greene, Hertford, Hyde, Jones,
Lenoir, Martin, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne
• Address: 943 Washington Square Mall, Washington, NC 27889
• Voice:252.946.6481
• FAX:[phone]
27 -

APPLICATION FOR A MINING PERMIT
LAND QUALITY REGIONAL OFFICES (continued)
Wilmington Regional Office
• Counties: Brunswick, Carteret, Columbus, Duplin, New Hanover, Onslow, Pender
• Address: 127 Cardinal Drive Extension, Wilmington, NC 28405
• Voice:910.796.7215
• FAX:[phone]
Winston-Salem Regional Office
• Counties: Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
• Address: 1450 Hanes Mill Road, Suite 300, Winston-Salem, NC 27103
• Voice:336.776.9800
• FAX:[phone]
-28-

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.
-29-

The Godwin Dri-Prime CD150M pump offers
flow rates to 2290 USGPM and has the capability
of handling solids up to 3.0" in diameter.
The CD150M is able to automatically prime to
28' of suction lift from dry. Automatic or manual
starting/stopping available through integral
mounted control panel or optional wireless -
Indefinite dry -running is no problem due to the
unique Godwin liquid bath mechanical seal
design. Solids handling, dry -running, and
portability make the CD150M the perfect choice
for dewatering and bypass applications.
Features and Benefits Specifications
• Simple maintenance normally limited to
checking fluid levels and filters.
• Dri-Prime (continuously operated Venturi air
ejector priming device) requiring no periodic
adjustment. Optional compressor clutch
available.
• Extensive application flexibility handling
sewage, slurries, and liquids with solids up to
3.0" in diameter.
• Dry -running high pressure liquid bath
mechanical seal with high abrasion resistant
solid silicon carbide faces.
• Close -coupled centrifugal pump with Dri-
Prime system coupled to a diesel engine or
electric motor.
• All cast iron construction (stainless steel
construction option available) with cast steel
impeller.
• Also available in a critically silenced unit
which reduces noise levels to less than 70
dBA at 30'.
of Standard engine JCB TCAE-55 (FT4). Also
available with John Deere 404STFC03 (FT4).
%eaumeumthefeo goroe¢efarfunherdemis A t1pice1 picture of the pump a sheen
NI mfermame a app mdmau end for -..I g.Mence .*
Suction connection
6" 150# ANSI B16.5
Delivery connection
6" 150# ANSI 816.5
Max capacity
2290 USGPM t
Max solids handling
3.0"
Max impeller diameter
11.0"
Max operating temp
1760F*
Max working pressure
70 psi
Max suction pressure
58 psi
Max casing pressure
104 psi
Max operating speed
2200 rpm
• Please contact our office for applications in excess of 176eF.
t Larger diameter pipes may be required for maximum flows.
godwin
a xylem brand

160
140
120
1w
eo
i
60
40
z0
Performance Curve
n.w(marhr)
0 50 103 ill 200 250 300 350 400 450 500 55C
00rpm 31%
rmd
54%
59%
bn
59%
55%
41%
31%
50
40
30 e
E
20 i
10
0
0 250 500 750 1000 1250 1500 175D 2000 2250 2500
Flow IUSG PM)
Engine option 1
JCB TCAE-55 (FT4), 74 HP 0 2200 rpm
Impeller diameter 11.0"
Pump speed 2200 rpm
Suction Vr tTable
Total Total Delivery Head (feet)
auction
Head
30 1 46 62 1 81
1 121
(feet)
Out ut(USGPM)
10
2179
2131
2083
1889
1356
15
2058
1937
1816
1574
1162
20
1453
1453
1453
1332
848
25
1259
1217
1114
969
484
Fuel capacity: 60 US Gal
Max fuel consumption 0 2200 rpm: 4.5 US GaVhr
Max fuel consumption 0 1800 rpm: 2.4 US Gal/hr
Weight (Dry): 3,20016s
Weight (Wet): 3,630 Ibs
Dim.: (L)119" x (W) 66•' x (H) 77"
Performance data prodded In cables is based on water tests in a. level and
20'C ambient. All information u approximate and for general guidance only
Please contact the is......Nice far further details.
�n
[1673mm]
16" 17"
[912mm] Ll
I I [424mm]
141
Materials
Pump casing &
Cast iron BS EN 1561 -1997
suction cover
Wearplates
Cast iron BS EN 1561 - 1997
Pump Shaft
Carbon steel BS 970 - 1991
817M40T
Impeller
Cast Steel BS3100 A5 Hardness to
200 HB Brinell
Non -return valve
body
Cast iron BS EN 1561 - 1997
Mechanical seal
Silicon carbide face; Viton
elastomers; Stainless steel body
Engine option 2
John Deere 404STFC03 (Ff4), 74 HP 0 2200 rpm
Impeller diameter 11.0"
Pump speed 2200 rpm
Suction Lift Table
Total
Total Delive Head (feet)
Suction
Head
30 46
62
1 B1
121
(feet)
Out ut(uSGPM)
10
2179
2131
2083
1889
1356
15
2058
1937
1816
1574
1162
20
1453
1453
1,
1332
848
25
1259
1211
111A
969
484
Fuel capacity: 60 US Gal
Max fuel consumption 02200 rpm: 5.2 US Gal/hr
Max fuel consumption 01800 rpm: 2.6 US Gal/hr
Weight (Dry): 3,180lbs
Weight ( Wet): 3,610 Ibs
Dim.: (L) 119" x (W) 66" x (H) 91"
Performance data provided in tables is based on anner Iola at sea level and
2PC ambient All information is approximate and for general guidance only
Please concert the factory or.H¢e far fuller details
9e
(222mm]
C
1191,
xylem ''Bridgeport,
Flo.dgaca Road Reference number . 2000PA0000980
Bnd) 4673360Fax a USA Date of Issue- November2, 2015
Let's Solve Water 1a56)46I]636. Fax [phone] Issue -
www.godwinpumps.com
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or on the front if space permits.
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Hanover Design Services, P.A.
Land Surveyors, Engineers, Land Planners
July 30, 2021
DEMLR-Stormwater Program
Department of Environment Quality
1612 Mail Service Center
127 Cardinal Drive Extension
Raleigh, NC 27699-1612
Re: NCG020000- Rosindale Sand Mine
To whom it may concern:
Attached please find a NCG020000 Notice of Intent for the Rosindale Sand Mine located in
Bladen County, N.C. Included in this package:
• Original Application
• Two copies of the Mine Plan
• $100 NOI Fee
If you have any questions please do not hesitate to contact me.
Sincerely,,
reg A. Wayne, PLS
Hanover Design Services P.A.
[e-mail]
[phone] Office
[phone] Fax
1123 Floral Parkway Wilmington, N.C. 28403 Phone [phone] Fax [phone]
Business Firm License No. C-0597

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