HomeMy WebLinkAbout20220412_ADI_ReceivedNORTH CAROLINA MINING
State of North Carolina 1612 Mail Service Center
PERMIT APPLICATION
Department of Environmental Quality Raleigh, NC 27699-1612
y Division of Energy, Mineral, and Land Resources (919) 707-9220
NOTE: It Is recommended that you contact the appropriate Regional Office or the Raleigh Central Office for a PRE -
APPLICATION MEETING to discuss your intentions and address any questions.
1. Name of Mine
Site #2 Mine
County
Currituck River Basin Pasquotank
Latitude (decimal degrees to four
places)
36.150688 N
Longitude (decimal degrees to four
places)
-76.844968 W
2. Name of Applicant
Lee Septic & Land, LLC
Applicant Contact
Roy Lee Etheridge, Jr. Consultant Contact Kenneth Elliott
Applicant Email
lee@septicandland.com Consultant Email ken@kenobx.com
Telephone
252-261-3073 Telephone 252-339-9021
Cell Phone
252-202-8651 Cell Phone 252-339-9021
Permanent Address for Receipt of
3' Official Mail"
3908 Poor Ridge Road, Kitty Hawk, NC 27949
4. Mine Office Address
3908 Poor Ridge Road, Kitty Hawk, NC 27949
5. Mine Manager
Roy Lee Etheridge, Jr.
Mine Manager Email
lee@septicandland.com
Telephone
252-261-3073 . Cell Phone 252-202-8651
I certify that all details contained in this permit application are true and correct to the best of our knowledge. We
fully understand that any willful misrepresentation of facts will be cause for permit revocation.
Signature"" Date — �Q
Print Name Roy Lee Etheridge, Jr.
Title Owner / Operator
'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.
RECEIVE®
Revised September 21, 2021 APR 12 2022 P a g e I i
LAND QUALITY
MINING PROGRAM