NCG020811_COMPLETE FILE - HISTORICAL_20120430

STORMWATER-0NISION COUINGSHEET -
RESCISSIONS
PERMIT NO.
NL(�
DOC TYPE
'COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
YYYYMMDD

Edgerton, Thom
From: Lowther, Brian
Sent: Monday, April 30, 2012 11 A4 AM
To: Edgerton, Thom
Subject: SW General Permit NCG020811
Attachments: NCG020811_EureSandMine_N01. pdf
Thom,
We've received an NOI from John R. Lane, JR for their site Eure Sand Mine in Gates County for
coverage of their sand mine. I have had the application a little while but had sent them a letter
saying they need an O&M and we will wait for their mining permit to be issued before we issue our
permit. Have you received anything for this permit? The site discharges stormwater to the Chowan
River (B; NSW). The NOI is attached. I have some maps and plans they provided. Would you like
me to forward them to you?
Please let me know if the Washington Regional Office has any concerns about issuing this facility
a COC for this general permit, and are there any potential impacts to wetlands? If we don't
receive any objections, we'll issue the COC in 30 days.
Thanks,
Brian
I

Division of Water Quality 1 Surface Water Protection
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NCDENR' National Pollutant Discharge Elimination System
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NCG020000
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National Pollutant Discharge Elimination System application for coverage under General Permit
NCG020000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code - 14XX Mineral Mining Industry (except as specified below)
The following activities are also included:
• Active or inactive mining operations (including borrow pits ---except for NCOCT borrow pits) that discharge
stonnwater 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 at mining operations;
• Overflow from facilities that recycle process wastewater; and/or PIE
�9 j�W7[R
• Mine dewatering (wastewater) i! tJ ( I
The following activities are specifically excluded from coverage under this General Per@ffC -• 2 2011
• Stormwater discharges associated with peat mining, coal raining, and metal min'ing 0FNR_WAZERQU
• Stormwater discharges from mining operations which are intermixed on site with st�r�Qimindt�l0nI
operations and/or concrete operations;
• Stormwater discharges associated with oil and gas extraction operations; and
• Stormwater dischargos associated with tourist gem mines
• NCDOT borrow pits are covered under 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 (i,e., sand
dredging or dipping operations)
For crew mining sites that require an authorization to construct (AEC) wastewater treatment facilities: This
NOI is also an APPLICATION FOR an ATC for new wastewater treatment facilities. ATC requests must be
submitted at least 90 days prior to construction'.
For existing mining sites that require an Authorization to Operate {ATO) wastewater treatment facilities;
This NOI is also an APPLICATION FOR an ATO for wastewater treatment facilities in place.
Construction, modification, or installation of any new treatment c� omponents at an existing site requires an
ATC. (If the site is already covered by NCG020000, the ATC request may be submitted without an NOI).
Some wastewater treatment facilities used to treat or r_tecyole wastewater at mining sites will require an ATC prior.
to construction per 15A NCAC 2H .0138. Please see the NCG020000 General Permit for details about which
treatment facilities require an ATC (summarized in Table 1 below). The authorization to construct or continue
to operate will be issued at the same time as the Certificate of Coverage (COC) for the N0002 permit. Design of
treatment facilities must cam,aly with requirements of 15A NCAC 21-1 .0138 & .0139.
Construction of wastewater treatment facilities subject to the ATCIATO requirements in the NCG02 permit
at new orexisting mining sites requires submission of three (3) sets of plans and specifications signed
Page 1 of 9
'As per 15A NCAC 2H .0106
'Unless Iroatment facilities are designed, constructed, and put into operation by employees internal to the company who are qualified Icy perform
such work for their respective companies in accordance with General Statutes, 69C-25 (7), plans and upecilications must be signed and sealud
by a P.E.
SWU-NCG02-NOI last revised 06107/2010

NCG020000 N.O.I.
and sealed by a Professional Engineer (P.E.) or qualified staff2 along with this application. A copy of the
design calculations should be included. Please see questions 18 R 19.
Table is Summary of Wastewater Permit Requirements
Quarterly
Monitoring?
Requires
A to C?
Mine Dewatering (MD)
Yes
No
Yes
No
MD Discharges that do not need treatment
other than E&SC to meet permit conditions
✓
MD Discharges that need treatment other than
f&5C to meet permit conditions
Process Wastewater
Other Recycle
✓
✓
Closed Loop Recvcle
r
Any Other Process WW
✓
For questions, please contact the DWO Regional Office for your area. (Seepage 7)
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Owner Name JOHN R t,AN
Owner Contact JOHN R. LANE, JR., KEN ELLIOTT
Street Address 433 GATES SCHOOL ROAD
City GATES State_NC — ZIP Code 27937
Telephone No. 252-357.1279 Fax:
E-mail Address [e-mail], [e-mail]
2) Location of facility producing discharge:
Facility Name SURE SAND MINE
Facilely Contact JOHN R. LANE, JR., KEN ELLIOTT
Street Address FORT ISI-AND ROAD
City _EURF. RT1 State NC ZIP Code
County GLOTi_.S COUNTY
Telephone No. 252_357-11279 252 39-9021 Fax:
Contact E-mail [e-mail] ken @kenobx.com.
3) Physical Location Information:
Please provide a narrative description of haw to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). From intersection} of NC 37 and NC 137 in downtown
GatesvilleLgo west 4.4 miles on NO 137 to intersection of Taylor Mill Road (SR 1118). travel south on Taylor
Mill Road 1.6miles, taking secondaved left onto Fort Island Road (SB 1220), travel south 0.5 mile on Fort
Island Road to dirt road entrance on the right.
4) Latitude 36°23'58.28" _ Longitude-78°50-54.25" (degrees, minutes, seconds)
Page 2 of 9
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NCG020000 N.O.I.
Permits:
5) This NPDES Permit Application applies to which of the following:
J New or Proposed Facility Date operation is to begin J_ A_N_ UARY, 2012
❑ Existing
❑ New Permit not applicable — ATC request only. NPDES Permit Number
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 1442
7) Provide a narrative description of the types of minerals mined at this facility:
SAND & TOPSOIL
B) Is this mine an inactive mine site?
No
❑ Yes If yes, do you posses an "Inactive Renewal' from DLR and notified the DWO Regional Office or
have you certified to the DWO that the site has been stabilized? ❑ No ❑ Yes
9) Does this facility already have a valid Mining Permit from the Division of Land Resources (DLR)?
No If No, please indicate the status of the Mining Permit application: SUBMITTED OCTOBER 2011
❑ Yes If yes, please provide the Mining Permit nurnber: Please also provide a
copy of your DLR Mining Permit with this DWO application.
Note_ DWO cannot issue a COC for the NCGO20000 General Permit until a Mining Permit is issued or
renewed by the Division of Land Resources (DLR).
10) Does this facility have any other NPDES permits?
❑ No
Yes If yes, list the permit numbers for all current NPDES permits for this facility: _STORMWATER
SUBMITTED NOVEMBER 2011
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does total area of this mine site include ready -mix and asphalt areas?
No
❑ Yes If yes, do they have DWO stormwater permits (if owned by the same company)? ❑ No ❑ Yes
(provide permit number._ __ )
If not owned by the same company, who is the owner?
13) Will this mining operation precede development activities at this site?
No
❑ Yes
14) Is this mine located within one of the 20 Coastal Counties and will it add more than 10,000 ftx of impervious
surface?
Wage 3 of 9
SWU-NCO02-NOI last ruvisud 6/7/2010

NCG020000, N.O.I.
❑ No
Yes If yes, you may be required to apply for an additional state stormwater permit. Check with your
local Regional Office. See contact information and checklist below.
15) Is this mine located the Neuse, Tar -Pamlico, or Catawba River Basin, or the Randfeman or Jordan
Water supply Watersheds?
Nd
❑ Yes If yes, what size stream buffers are included on site? . ft. Please show buffers in site plans.
Discharge Points, Receiving Waters & Wetlands:
16) 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 end up in? CHOWAN RIVER
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer),.
Receiving water classification (if known): B, NSW
Note: Discharge of process wastewater to receiving waters classified as WS-11 to WS-V or SA must be
approved by the N.C. Dept. of Environmental Health. If DEH does not approve, coverage under
NCG020000 cannot be granted. 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 the NCG02 General Permit.
17) If your facility has wastewater discharges and they are to HWQ, PNA waters (Primary Nursery Areas) waters,
what is the flow rate? _ (See hitp://www.ncdmf.tiottmaps/PNA maps/index himl, for map)
18) Discharge Points:
Number of discharge points (ditches, pipes, channels, etc, that convey discharges from the property):
gnsite: Stormwater: _.1------- Mine dewatering; Process Wastewater Overflow:
Offsite: Stormwater: Mine dewatering: _ Process Wastewater Overflow:
Discharge points should be clearly marked on the submitted site plan.
Please provide short narrative description of discharges:
25 year stormwater overflow discharge only. Rainwater will drain hack into excavation dodnQ nori a
operations_' Q_eg low_will-be sheet -flow rate across flat-top_erryr through not(±ej spillway lied wish ri rap_._
a) Is your mine dewatering and discharging? (Answer only if you are dewatering)
%/ No
❑ Yes If yes, where to? — Surface Waters and/or Wetlands (on -site or off -site)
Other (on -site or off -site) Describe:
b) Are you dewatering but not discharging? (Answer only if you are dewato iog)
No
❑ Yes If Yes, please explain how you are dewatering, and where that water will be directed:
Page 4 of 9
SWU-N0G02-N01 Last rovisud 6/7/2010

NCG020000 N.O.Q.
19) Will mining operations require dewatering near wetlands or impact any stream, groundwater, or wetlands?
No
❑ Yes
Note: 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 (O&M) Plan that has been approved by the
Division.
For sites that may drain wetlands— ;pprovaf of a Pumping_O&M_plan maybe " cjprio to
coverage under this general ep rmit. The Pumping O&M Plan should be submitted to the
appropriate Regional Office and must 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 end of document. Contact your local Regional Office for questions specific to your mine.
20) If you are dewatering, are there wetlands or -surface waters within 400' of the mine pit perimeter?
V No, but wetlands are within 400' of mine pit, no dewatering
❑ Yes If yes, what distance are they from the mine pit perimeter? feet.
21) Have you been required to obtain a 404f401 Certification permits?
❑ No
-\/ Yes if yes, please briefly describe below (include information such a required mitigation, BMPs, setbacks,
amber O&M plans for on or off -site wetlands or other pertinent information). Attach other shoots as necessary:
attached
22) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ No V Yes It yes, please attach to application submission.
Stormwater BMPs:
23) Does this facility employ any best management practices for Stormwater control?
C] No V Yes If yes, please briefly describe: attached
24) Does this facility have a Stormwater Pollution Prevention Plan?
No n Yes
If yes, when was it implemented?
25) Will vehicle maintenance activities occur at this -facility?
J No ❑ Yes
Page 5 of 9
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NCG020000 N.O.I.
Wastewater Treatment Facilities:
26) Will mine dewatering discharges occur? (An ATCIATO is required for wastewater treatment facilities'
dewatering discharges where E&SC devices alone will not meet effluent limits andlor protect water quality
standards).
No
❑ Yes
27) Will discharges of overflows from process wastewater treatment systems occur? (ATC or ATO required,
unless closed -loop recycle system)
�,/ No
❑ Yes
If yes, answer the following questions for each wastewater treatment system:
Please describe the type of process used to treat and/or recycle the process wastewater. Give
design specifics (i.e. design volume, relention time, surface area, etc.). Existing treatment facilities
should be described in detail, and design criteria or operational data should be provided (including
calculations) to ensure that the facility can comply with requirements of the General Permit. [Use
separate sheet(s)]
b, Does this facility employ chemical additives to flocculate suspended solids? ❑ No ❑ Yes
If yes, please state the name, manufacturer and the quantity of average daily usage of the
chemical additive
Note: Please see our websile for a list of evaluated polyacrylarnide (DAMS) products for use in North Carolina,
G. Does this facility overflow only during rainfall events exceeding the 10-yr, 24-hr rainfall event?
❑ No V Yes, possibly
28) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
1/ No
❑ Yes If so, include information to demonstrate protection from flooding, (Minimum design requirements for
treatment works include protection from the 100-year flood, per 15A NCAC 2H .0219.)
Other:
29) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
-,/ No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
No ❑ Yes
c) is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
-,/ No ❑ Yes
d) If you answered yes to questions b, or c., please provide the following information:
Type(s) of waste:
Page 6 of 9
SWU-NOG02-NOI Last revised 6/7/2010

NCG020000 N.O.I.
How is material stored. -
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:_
Vendor address:
30) Are you applying for a mining permit in the same location as a previously permitted mine?
❑ No
\/ Yes If yes, specify permit number and name if known: Eure Sand Mine, appi submitted Oct 2011, pendin
31) Does your site have an active landfill within the mining permit boundary?
V No
❑ Yes If yes, specify type: ❑ l-CID ❑ Other:
32) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? See permit
text online for secondary containment requirements.
V No
❑ Yes
Final Checklist:
This app icat'o 'li be re u ned as 9ncom fete unless all of the followi ite s have been included and
initialed for. Please show that the following required information has been included by initialing in each
space below.
Fee of $100 made payable to NCD,ENR
Completed application and all supporting documents
Copy of the valid approved mining permit (MP) for the facility or indication of MP application status
Copy of a county map or other general location reap that shows the mining site and nearest major roads
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.
2 copies of large-scale site plan with topographical lines with all outfails, applicable buffers and wetlands
clearly delineated
A copy of your DLR mining permit
A copy of your US Army Corps -approved wetland delineation if you marred "yes" to question 22 above.
If mine site is in one of the 20 Coastal Counties,
• Applicant has checked with the appropriate regional office to verity the need for a Coastal State
Stormwater permit. Regional Office -Contact:
• Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas and total drainage area.
If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the following and contact your jocpI re nai off ice about a Pumping O&M Plan (see below
for contact Information). You may.te required to_proylde an a ed Pumping O&M_plan.prior to
NCG02 issuance.
.�. 2 copies of detailed Full Size plans delineating was on the fans and listirig_acreag.., (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).
Well information (design, depths, maintenance)
Physical monitoring for the wetlands areas
5eifling pond sizing information, it applicable
Page 7 of 9
SWIJ•NCO02-NOI Last revised 6/712010

NCG020000 N.0.1.
W
bevel spreader design, # applicable
Details about dewatering method
Cone of influence calculations
Description of measures to prevent erosion and flooding
Description & inforwation about 401/404 permits that have been obtained
Copy of US Army Corps of Engineers wetland delineations or approved wetland delineation (if
applicable)
l have contacted my local regional office about a Pumping 0&M Plan.
Regional Office Contact: Date contacted:
I will not any impact nearby wetlands, surface waters or groundwater by dewatering.
If an ATC or ATO is required, three (3) sets of plans, specifications, and design calculations, signed, sealed,
and dated by a P.E. ATC and ATO requirements in NCG02000 are summarized in Table 1 on Page 2 of
this NOI (see the permit text for more details), Pians shall show all pertinent design features, including the
location of the outfall(s). If stormwater is flowing off -site, the plan must show that stormwater will not be
mixed with wastewater.
Certification: North Carolina General Statute 143.215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document fiiesl or requirod to be maintained under this Artidt, or a rulo implementine7 this Articie; or who kmmw ngy y makes a false
statement of a material fact in a rulemakfng procoe,rling or coniosted case under this Article; or who lalsWos, tampers with, or knowingly
renders inaccurate any rocording or monitoring device or method required to he oparnted or maintained under :his Article or rule-9 of the
fEnvironmental Managemenl) Commission implemonting this Article shall ho guilty of a Class 2 misdomoanor which may include a line not to
exceed tun thousand dollars ($$10,000).
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 raining 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
protection 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.
Page 8 of 9
8WL1-NCG02-Nbl Last revised Sr12010

NCG020000 N.O.i.
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 l 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:_JDhn R. Lane, Jr.
Title: _A_ pp]icantLOwner
cure of
NQ,vember 8, aOl1_
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100,00 made payable to NCDENR.
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
The submission of this document does not guarantee the issuance of an NPDE"S permit.
For questions, please contact the DWQ Regional Office for your area.
DWQ Regional Office Contact Inform o : .
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)
807-6300
Page 9 of 9
swlt-HC002•14Of Last revisod 617/2010

Central Files: APS SWP
04/04/12
Permit Number NCG020811
Permit Tracking Slip
Program Category
Status Project Type
NPDES SW
In review New Project
Permit Type
Version Permit Classification
Mining Activities Stormwater Discharge COC
COC
Primary Reviewer
Permit Contact Affiliation
brian.iowther
Coastal SW Rule
Permitted Flow
Facili
Facility Name
-Eure'Sarid Mine
Location Address
Fort Island Rd
Gates NC 27937
Owner
Owner Name
John R Lane
Dates/Events
Major/Minor Region
Minor Washington
County
Gates
Facility Contact Affiliation
#4 -C -eS �-o LL e C L ae-. S I -Is k S
Owner Type �Ae r�
Individual
Owner Affiliation
John R. Lane Jr. 4-0 + t
433 Gates School Rd
Gates NC 27937
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective
12/02/ 11
Regulated Activities Requested/Received Events
RO staff report received
RO staff report requested
Outfall 001
Expiration
Waterbody Name Stream Index Number Current Class Subbasin
CHOWAN RIVER 25 B;NSW 03-01-01

Page 1
36.3995221 -76.848406

6i
NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. John R. Lane, Jr.
433 Gates School Road
Gates, NC 27937
Dear Mr. Lane:
Division of Water Qualily
Coleen H, Sullins
Director
December 13, 2011
Subject: General Permit No. NCG020000
Eure Sand Mine, NCG020811
Gates County
Dee Freeman
Secretary
The Division of Water Quality's Stormwater Permitting Unit received a National Pollutant Discharge
Elimination System (NPDES) permit application for Eure Sand Mine on December 2, 2011. The application
included a copy of an associated application for a mining permit submitted to the Division of Land Resources
(DLR). Please be aware that the issuance of an NPDES permit is contingent upon the issuance of an
associated mining permit from DLR. Our office will process your stormwater permit application once a
DLR mining permit has been issued for your project.
Please also be aware that if your project is located near wetlands, your NPDES permit will require
dewatering operations without wetland impacts. The specific requirements for mine dewatering at facilities
near wetlands can be found in the text of the general NPDES mining permit number NCG 020000 available
on our website, http:l/portal.ncdenr.org/web/wq/ws/su/npdessw. See Part III, Section E of the permit. An
approved Operation and Monitoring Plan is required for NPDES-permitted mining facilities and may be
required prior to permit issuance. Discharging mine dewatering wastewater without Plan approval will be
subject to enforceriment action. A Plan for your facility must be submitted to the Washington Regional Office
within 60 days of your receipt of an NPDES permit. We encourage you to contact Thorn Edgerton at the
Washington Regional Office at [phone] to address any wetland concerns for your facility in order to
ensure a successful NPDES application review.
If you have any questions concerning the NPDES permit approval process, please contact me at telephone
number [phone].
Sincerely,
Brian Lowther
Environmental Engineer
cc: Washington Regional Office, Thom Edgerton
Central Files
Stormwater Permitting Unit Files
1617 Mai! Service Center, Ralegh, North Carolina 27699.1617
Location: 512 N. Salisbury St. Ralegh, North Carolina 27604
Phone: [phone] L FAX: [phone] Customer Service: 1-877-623.6748
Internet: www.ncwaterqualit .org
An Equal Opporlunity 1 Affirmative Action Employer
RECEIVED
DEC 2 1 2011
D WQ' 1l YARO
NonrthCarolina
Aatura!!y

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Marine Fisheries
Beverly Eaves Perdue
Governor
TO: Judy Wenner
THROUGH: Anne Deaton
FROM: Kevin Hart
Dr, Louis B, Daniel III
Director
DATE: October 20, 2011
SUBJECT: Division of Land Quality, CEiJre'Sand'Mft e-1
Dee Freeman
Secretary
The following comments by the North Carolina Division of Marine Fisheries (NCDMF) on the subject project
are offered pursuant to G.S. 113-131. The applicant is proposing to mine sand at a location in Gates County in
the Chowan River Basin. According to site maps this area is densely covered with wetlands and is less than a
mile from Buckhorn Creek and just over a mile to the Chowan River an Anadromous Fish Spawning Area. The
site is 322.6 acres and the expected mine will be 20' deep maximum (15' average). In the application there is no
information provided saying how many acres of the 322.6 acres will be mined. If the entire 322.6 acres were to
be mined the NCDMF would have serious concerns due to the adverse impacts that would arise from this
activity.
The NCDMF is concerned that a project of this size would have major adverse impacts by mining through the
wetlands on this project site. The NCDMF would need more information as to the total amount of wetlands that are
impacted as well as avoidance and minimization would have to be demonstrated. The NCDMF would also have
concerns of potential discharges if water was to be discharged from the mine into surface waters or adjacent
wetlands. Information would have to be provided as to how much water would be discharged and into what
location.
I was not provided an entire application so with the information provided, the NCDMF would have objected to the
subject project. I spoke with other agencies to obtain more information on the project and was informed that only
18 acres would be mined and there would be no discharges (NPDES permit) into wetlands or surface waters for this
project. The NCDMF is concerned that this applicant may come back for future modifications to add additional
acreage to the project. At that time the NCDMF may have further comments as to impacts.
If you have any comments or questions, please call me at [phone] or email me at Kevin. Hartnncdenr gov .

Edgerton, Thom
From:
Scheller, Roberto
Sent:
Monday, October 24, 2011 11:09 AM
To:
Edgerton, Thom
Subject:
FW: Eure Sand Mine
Attachments:
Eure_Sand_Mine_Oct_20-2011.pdf
From: Hart, Kevin
Sent: Thursday, October 20, 2011 3:23 PM
To: Wehner, Judy; Dunn, Maria T.; Scheller, Roberto
Cc: Mcclain, Pat; Deaton, Anne
Subject: Eure Sand Mine
Ms. Wehner,
Please see attached comments regarding the Eure Sand Mine.
Thanks,
Kevin Hart
Kevin Hart
Marine Biologist
Habitat Section
North Carolina Division of Marine Fisheries
943 Washington Square Mall
Washington, NC 27889
252-948-3878
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties unless the content is exempt by statute or other regulation.

Fl p
NORTH CAROLINA
MINING PERMIT APPLICATION
State of North Carolina
Department of Environment
and Natural Resources
Division of Land Resources
Land (duality Section
1612 Mad Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: January 30, 2008

ELLIOTT CONSUhTING
September. 22, 2011
10 Whom It May Concern:
This mine permit application is for a new 18.82-acre sand mine excavation (Eurc Sand
Mine) constructed by John R. L.ane, Jr., on leased property off Fort Island Road (SR 1220),
Rt. 1, Eure, NC 27944, in Gates County. The requested permit area encompasses 2 parcels
of land totaling 322.6 acres, both of which are owned or partially owned by Mr. Lane's
family. Of the 322.6 acres, the property consists of 173.04 acres of pocosin wetlands,
delineated in 2010. These wetlands arc scattered about the property, leaving some areas of
slightly higher sandy land in non -wetland areas which are suitable for excavation.
At this time, Mr. Lane plans to excavate 6 small ponds totaling 18.82 acres, as follows:
Pond #5 — 0.49 acres, Pond #6 — 3.44 acres, Pond #7 - 8.10 acres, Pond #8 — 4.75 acres,
Pond #9 - 0.38 acres, Pond #10 -- 1.68 acres. Ponds #1-4 (phase 2) in the north of the
permit area and a third area (phase 3) inside the western end of the permit area will be
excavated near the completion of the previous ponds, and will be requested to be permitted
by modification of the current permit at that time.
To reach the excavation areas it will be necessary to cross six areas of wetlands on a 15-ft
wide sand access road. These roads are mostly pre-existing and are shown on the current
USACE delineation map. Total length of these roads is 1403 feet and will impact 0.483
acres of wetland. All roads through the wetlands will have silt fence installed along their
perimeters and will have any other sediment and erosion controls required by USACE. A
Pre -Construction Notice for a Nationwide 14 Permit (Linear Construction across Wetlands)
is being submitted to USACE and DWQ at this time.
Mr. Lane is also required to apply for a Special Use Permit and a Zoning Compliance
Permit with Gates County, which is being done at this time.
All ponds are being located a minimum of 75 feet from delineated wetland boundaries.
Each pond will have a 50-ft undisturbed buffer around excavation areas and processing
areas, and each pond will have a 25-ft unexcavated buffer around the excavation area
containing roads & berms. There will be an 8'x3' sand berm established and maintained
along the outer edge of all unexcavated buffers and processing areas to prevent offsitc
erosion into adjacent wetlands.
The excavation area is located geographically 0.4 mile from the nearest dwelling and 0.4
mile from the nearest public highway in a lightly populated area, and is accessible only by a
private, gated access road. Distance from highways and dwellings along with wooded areas
and fields on all sides of the excavation area provide adequate screening of the mining
operation, and the site is not visible from the closest highway. Access to the permit area is
limited by private property, and private road access.
Upon receipt of the approved permits from NCDENR Land Quality and USACE, Mr.
Lane plans to excavate the sand pits to an average depth of 15 feet below* natural ground
level, and will include construction of proper cut slopes on all sides of the excavated area, as
required in the permit. Reclamation of the mine area will include grading, leveling, and

— 2 — September 22, 2011
grassing of all affected areas. Mr. Lane plans to seed all sloped areas with ground cover to
provide good erosion control.
All adjacent landowners have been contacted and have been made aware of the
proposed mining and dewatering operation. The Gates County Manager has been contacted
regarding this application and land entry agreements have been obtained. The mine area will
be well marked with warning and keep out signs to prevent inadvertent public access.
Mr. Lane does hereby request approval for this mining permit application, and asks that
it be expedited as soon as possible. Mr. Lane appreciates your consideration of this permit
application and looks forward working with NCDENR in coming years.
Sincerely,
Ken Elliott
for John R. Lane, Jr.
622 ROCKY HOCK CREEK ROAD • EDENTON, NORTH C.AROLINA • 27432
11110NV: 252-482-8846 • FAX: [phone]

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
Name of Mine Eure Sand Mine County Gates
River Basin Chowan
Latitude (decimal degrees to four places) 36.3972
Longitude (decimal degrees to four places) —-76.8594
2. Name of Applicant*
Permanent address for receipt of official mail** 43 3 Gates School Road Gates NC 27937
Telephone [phone] Alternate No. ( 252 ) 398-7708
4. Mine Office Address 433 Gates School Road, Gates NC 27937
Telephone ( 252 ) 398-7708
Mine Manager. John R. Lane, Jr.
We hereby 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 -/j"! Date September 16. 2011
...-.�...�
Print Nance John R, Lane, Jr,
Title _ 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 Land Quality Section must be notified of any changes in the permanent address or telephone number.
*** Si mature of company officer re aired.
G.S. 74-51 provides that the Department shall grant or deny an application for a permit within 60 days of receipt ofa
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 slieets as needed.

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 mustt be clearly conveyed on a corresponding, detailed mine map.
A. GENERAL CHARACTERISTICS OF THE MINE
1. Answer all of the following that apply:
® If this is an application for a NEW permit, indicate the total acreage at the site to be covered by the
permit (this is the acreage that the "new permit" fee will be based upon): 322.6 acres
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: 322.6 acres Property owner if leased: — J. Roger Lane (father), Rita H. Lane
(mother), George Mac Miller, Charles T. Hofler, Jr. (partners)
❑ If this is an application for RENEWAL 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 (this is the acreage that the "renewal" fee will be based upon):
❑ If this is an application for a MODIFICATION to a mining permit, indicate the mining permit
number and the total (overall) acreage covered by the existing permit.
Mining Permit No.: _ Total permitted acreage:
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 ❑ NoFT 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
Dragline & Truck
®Front-end Loader & Truck ❑ Shovel & Truck
Self -loading Scraper
Other (explain): Excavator
4. a. Expected maximum depth of mine (feet) _
Depth is relative to what benchmark? (e.g.,
b. Expected average depth of mine (feet) _ 15 feet
level, mean sea level, road elevation, etc.
-2-

APPLICATION FOR A MINING PERMIT
5. Has any area(s) at this site been mined in the past? Yes ❑
If yes, when and by whom was this activity conducted?
6. Number of years for which the permit is requested (10 years maximum): 10 years
B. MAPS
Clearly mark and label the location of your mining operation on six (6) conies of a 7.5-minute quadrangle
and a county highway map. These maps, in addition to six (6) conies 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:
1612 Mail Service Center OR
Raleigh, North Carolina 27699-1612
[phone]
www.geolo .eY tir.state.nc_us/
Physical Address:
512 North Salisbury Street, 5�h Floor
Raleigh, North Carolina 27604
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]
www.nedot.org/it/p,isContact/defaul_t.htmi
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. As a reminder, mining permits can
only be issued for up to 10 years; thus, all mine and reclamation maps must only 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 casements 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 fcw 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.
I. 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.
-3-

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 = 100 feet
200+ Acres
1 inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)
WE

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 areafhaul 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
Access Roads
199 acres
Processing Areas
1.79 acres
Mine Excavation
18.82 acres
Unexcavated Buffers (roads, berms)
7.64 acres
Total Disturbed Acreage
30.24 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.
-5-

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.
1. Acquire proper permits from NC Department of Environment and Natural Resources, US
Army Corps of Engineers, & CAMA.
2. Acquire Zoning Compliance Permit & Special Use Permit from Gates County Dept of
Planning & Development.
3. 2-parcel tract totaling 322.6" acres will be permitted. Tracts contain total 173.0 acres wetland
pocosin (delineated 2010).
4. Phase 1 of project will be construction of 6 excavations totaling 18.82 acres, as follows:
Pond 5 (0.49 acres), Pond 6 (3.44 acres), Pond 7 (8.10 acres), Pond 8 (4.75 acres), Pond 9
(0.36 acres), Pond 10 (1.68 acres).
5. Phase 2 of project will encompass modification to permit construction of Ponds 1 thru 4
inside of permit area at later time.
6. Phase 3 of project will encompass modification to permit construction of Pond 11 inside of
permit area at later time.
7. All ponds will be laid out on high land inside the permit area, and will have a minimum 25-ft
unexcavated buffer and a 50-ft undisturbed buffer between the excavation and adjacent
wetlands.
8. Operator will construct a 8-ft wide by 3-ft high sand berm around each excavation area along
the outside perimeter of the; unexcavated buffer to prevent offsite sedimentation.
9. Operator will install silt fence along existing access roads through wetlands. Operator will
install silt fence along any new access roads through wetlands per instruction from USACE.
10. Starting with Pond 10, each excavation area will in turn first have topsoil removed down to
2,5 feet below natural ground level and stockpiled, and then sand will be dug from
excavation area by excavator down to average 15 feet below existing natural ground level,
and stockpiled for later removal from premises.
11. At this time there are no plans to dewater any of these excavations.
12. Minimum 2:1 graded slopes will be established around edges of pond area below
groundwater level.
13. Minimum 3:1 graded slopes will be established around edges of pond area above
groundwater level.
14. After excavation and edge sloping is completed, a low 1 ft x 8ft berm will be established
around the entire perimeter of the excavated pond, with outside slope graded down to natural
ground level.
15. All slopes above water level will be fertilized and seeded with ground cover per guidelines
from NC Agricultural Extension Service.
16. Internal haul roads and processing areas of main permit area will be leveled and graded to
natural ground level; to be returned to natural field state; any trash or debris cleaned up and
removed.. A 1 Oft wide field path will remain around the entire perimeter of the excavated
pond for owner access.
17. Access roads & field paths to Fort Island Road will be graded, leveled, and returned to pre-
existing state.
18. Entire affected area inside of main permit area will be fertilized and seeded with groundcover
and will be allowed to return to its pre-existing field state.
19. All silt fence erosion controls will be removed.
20. At end of permit period, affected area returns to pre-existing, natural state.
-6-

APPLICATION FOR A MINING PERMIT
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.
Operator will construct Sft wide x 3ft tall temporary sand berm along the outside perimeter of the
unexcavated buffer of each excavation area to prevent offsite erosion. Berm will be grassed and
stabilized, and will be inspected weekly and repaired as needed.
Operator will establish silt fence erosion control along perimeter of all access roads passing through
wetlands prior to land disturbing activities. Silt fence will either be constructed of standard strength
filter fabric with wire or polymer backing and steel posts set 8 feet apart, or extra strength filter
fabric between steel posts 6 feet apart. Silt fence will be inspected weekly and repaired as needed.
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 chemicals to be used.
Not applicable.
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 ❑ No �J. Ifyes, briefly describe the nature ofthe discharge and locate
all proposed discharge points (along with their method ofstabilization) on your mine map(s).
Not applicable.
-7-

APPLICATION FOR A MINING PERMIT
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 Z.
If yes, what impact, if any, will mine dewatering have on neighboring wells? Estimated withdrawal rate
in gallons per day: _. 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.
Not applicable.
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
Division of Water Quality, Water Quality Section. In addition, the applicant is required to register water
use with the Division of Water Resources if the operation withdraws more than 10,000 gallons per day
and needs a capacity use permit from the Division of Water Resources if the operation lies in a capacity
use area and withdraws more than 100,000 gallons per day.
Not applicable.
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 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?
Spraying water from water supply trucks on haul roads and process areas, or hauled & spread by
bucket on excavators will control dust. Stockpiles will also be sprayed with water weekly if
necessary to control dust. Speed limit on access roads will be maintained at I Omph maximum
-8.

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. Shaw all buffer locations and widths on the mine
map(s).
A 25-ft wide unexcavated buffer will be maintained around the excavation of each pond,
adjacent to an undisturbed. buffer. This buffer will contain erosion & sediment control
berms, roadways, processing areas, and stockpiles.
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).
A 50ft undisturbed buffer will be established around the excavation of each pond, and will be
located between the 25-ft wide unexcavated buffer of each excavation and wetland pocosin.
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.
Landslide or slope instability adjacent to adjoining permit boundaries will be prevented by
construction of graded cut slopes during mining activities. Slopes will have a minimum of 3
horizontal to I vertical gradient.
-9.

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 ofany benches
and/or slope drains (with supporting design information) if needed, and the method of final
stabilization.
Fill slope cross-section of temporary erosion control berms attached to reclamation and mine
maps and will have minimum 2:1 side slope gradient. Final reclamation fill slope will be
established at edge of cut during reclamation of mine, and will have 4:1 side slope gradient.
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).
Not applicable.
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.
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.
Not applicable. Closest dwelling is 0.4 mile from excavation (direct line across wooded wetland);
closest road is 0.4 mile from excavation (direct line across wooded wetland).
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 exist in this permit area.
Caution signs, warning signs, no trespassing, and/or keep out signs will be installed at only entrance
to permit area and every 500 feet on permit boundary along Fort Island Road. Excavation area is
located 0.4 mile from nearest public road (Fort Island Road) and is only accessible from single gated
access road.

APPLICATION FOR A MINING PERMIT
9. Are acid producing minerals or soils present? Yes ❑ No U.
If yes, how will acid water pollution from the excavation, stockpiles and waste areas be controlled?
Not applicable.
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 ofall visual screening on the mine map(s) and provide cross -sections
through all proposed berms or proposed spacing, sizes and species for tree plantings.
Existing natural growth of pine trees, fields and wooded pocosin wetland around perimeter
of permit area will screen operation from public view. No additional screening planned.
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?
Mine permit area located on private -owned farmland, logged -over woodland and wetland
pocosin. Chowan Swamp Game Lands are located south of permit area but will be separated
by 250 feet of forest & wetlands from any mining activities. There are no anticipated adverse
effects to these Gamelands. One access road to Chowan Swamp Game Lands runs through
this permit area and will be maintained as such by mine operator.
11. Will explosives be used? Yes ❑ No �;I.
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.
Not applicable.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ❑ No ®.
Ifyes, describe these materials, how they will be stored and method ofcontainment in case ofspill. Indicate
the location(s) of all storage facilities on the mine map(s).
Not applicable.

APPLICATION FOR A MINING PERMIT
D. RECLAMATION PLAN
I . 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.
I . Excavated body of water will be left as part of reclamation of each excavation for recreational use by
landowner, minimum 4 feet deep.
2. After mine excavation and removal of sand and topsoil stockpiles, all disturbed land, affected areas
and access and service roads inside the permit area will be leveled and graded away from edge of
excavated mine pit 8 feet until graded area reaches natural level. This will create a low berm located
at the edge of the pit I ft high and will extend 8 feet wide away from the pit (see attached cross-
section).
3. All erosion control silt fences along access roads will be removed.
4. Other access roads to excavation area and haul roads will be graded, and returned to original
condition used as farm field access path. Processing areas will be graded and allowed to return to
natural state.
5. Graded land and all affected area will be fertilized and sown with grass seed by mine operator as per
recommendation by County Agriculture Extension Agent (attached). Ultimately all reclaimed land
from 8ft out from excavation will be returned to pasture, field and farm path.
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 bodv(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 Z.
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.
Not applicable. No excavation in rock.
-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.
No mine site waste areas will exist; topsoil and sand stockpiles only.
5. a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
No processing facilities exist.
Stockpiles will be totally removed from processing areas; sedimentation berms adjacent to excavated
area are to be removed and will be filled, graded and sloped away from edge of excavated mine pit 8
feet until graded area reaches natural land level. Stockpile areas will be graded and leveled to flat
natural ground level. All stockpile areas will be fertilized and seeded with grass by mine operator at
end of mining operation. Stockpile and affected areas will be returned to agricultural use by
landowner.
All onsite haul roads in immediate vicinity of excavation will be graded and leveled to flat natural
ground level, and then fertilized and seeded with ground cover by the owner. A I Oft wide field path
will remain around perimeter of finished pond for owner access
b. Will any on -site roadways be left as part of the reclamation? Yes ❑ No Z.
Ifyes, identify such roadways on the reclamation map andprovide details on permanent road and ditch
line stabilization.
Pre-existing access road (2565-ft single lane soil path) from Fort Island Road to main mine site area
will be returned to pre-existing standard during reclamation. The access roads will be constantly
maintained during mining operations, and will be reclaimed by grading, leveling, and repairing
potholes as necessary. Pre-existing ditches will be maintained and repaired as' necessary, and
returned to pre-existing standard during reclamation. A IOft wide field path will remain around
perimeter of finished ponds for owner 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 Briar written approval
from the NC Department of Environrnent and Natural Resources, Land Quality Section 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.
Any and all scrap metal, junk, cables or other such non -original waste materials will be removed
from mine premises by mine operator and disposed of properly at Gates County Landfill, Hobbsville,
NC. All topsoil or sand excavated by mining operation will be removed from premises before
reclamation. No off -site generated waste will be disposed of on -site.
-13-
( ,

APPLICATION FOR A MINING PERMIT
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 rtvegetation. Revegetation utilizing only tree plantings is not
acceptable. Recommendations can be sought from:
a. Authorized representatives of the local Soil and Water Conservation District;
b. Authorized representatives of the Division of Forest Resources, Department of Environment and
Natural Resources;
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University;
d. North Carolina licensed landscape architects;
e, Private consulting foresters referred by the Division of Forest Resources, Department of Environment
and Natural Resources;
f N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation,
h. Others as may be approved by the Department.
.LIME - RATE OF APPLICATION (tons/acre):
0.5 ton / acre upon soil test
FERTILIZER - ANALYSIS AND RATE, OF APPLICATION (pounds/acre):
10:10:10 fertilizer, 430 lbs / acre, Spring, Summer & Fall
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Seed Types: Seeding Dates: Seeding Rates:
Kentucky Fescue April 250 lbs / acre
Rye Grass November 150 lbs / acre
Bermuda Grass May 85 lbs. ! acre
NIULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANCHORING:
Not applicable.
OTHER VEGETATIVE COVERS -- TYPE (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Not applicable.
Revegetation and/or reforestation plan approved by:
Signature _
Print Name
Title
Agency
wfl
Date September 7 2011
-14-

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
The fallowing bond calculation worksheet is io be used to establish an appropriate bond (based upon a range
of $500 to $5, 000 per affected acre) for each permitted mine site based upon the acreage approved by the
Department to be affected during the life of the miningpermit. Please insert the approximate acreage, for each
aspect of the miningoperation, that you intend to affect during the life ofthis mining permit (in addition, please
insert the appropriate reclamation cost/acre for each category from the _Schedule of Reclamation Costs
provided with this application,forml OR you can defer to the Department to calculate your bond for you based
upon your mates and standard reclamation casts:
AFFECTED RECLAMATION RECLAMATION
CATEGORY ACREAGE COST/ACRE* COST
Tailings/Sediment Ponds:
Ac.
X
$
/Ac. _
$
Stockpiles:
Ac.
X
$
/Ac. _
$
Access Roads:
l .99 Ac.
X
$
1800
/Ac. W
$
3582
Processing Area:
1.79_ Ac.
X
$
1800
/Ac. —
$
3222
Mine Excavation:
18.82 Ac.
X
$
500
/Ae. —
$
9410
Unexcavated Buffers (roads, berms):
7.64 _ Ac.
X
$
1800
/Ac. _
$
13,752
TOTAL AFFECTED AC.:
30.2.1 Ac.
(TOTAL PERMITTED AC.:
322.ii Ac.)
Temporajy & 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 30.24 Ac.
b) Positive Drainage Ac. X $1,500.00 = $
SUBTOTAL COST: $ 29,966
Inflation Factor:
0.02 X SUBTOTAL COST: $ 599.32 X Permit Life (I to 10 years): 10
INFLATION COST: $ 5993.20
TOTAL COST = SUBTOTAL COST + INFLATION COST = $ 35,959.20
Total Reclamation Bond Cost: $ 35,900
(round down to the nearest S100.00)
- 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, creel(, 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 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(b1).
SEE THE NEXT TWO PAGES FOR THE "NOTICE" FORM AND THE "AFFIDAVIT OF
NOTIFICATION"
-16-

NOTICE
Pursuant to provisions G.S. 74-50(bI) of The Mining Act of 1971, Notice is hereby given that
John R. Lane, Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 & topsail on 18.82 acres located 2,1 miles
(Mineral, are) (Number) (Miles)
south of Eure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates 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) clays 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 nronosed mining activity, please contact the annlicant 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 anX
relevant written comments/documentation within the provisions of the Mining Act of 1971 throughout the
annlication review process until a final decision is made on the annlication.
Thomas C. & Nan L. Coxe
613 Court Street, Gatesville, NC 27938 _
(Addressee/Owner of Record's
Name and Address)
September 7 2011
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
John R. Lane, Jr.
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
_ 433 Gates School Road, Gates, NC 27937
(Address of Applicant)
-17-

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
John R. Lane Jr.
(Applicant Name)
has applied on September 2011
(Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 i:'uture 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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of Eure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates 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 proposed minine activity, please contact the applicant at the following telephone number:
(2521398-7708 . 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 Mining Act of 1971 throu hg_out the
annlication review nrocess until a final decision is made on the annlication.
NC Wildlife Resources Commission
Div. of Wildlife Management, CIO Isaac Harrold
1722_Mail Service Center, Raleigh, NC 27699-1722 John R. Lane, Jr._
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7, 2011 433 Gates School Road, Gates, NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
- 18-

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of Eure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates 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 information regarding 1
[phone] . P'or intormation on the mining permit application review process,
please contact the Mining Program staff at [phone]. Please note that the Department will consider anx
relevant written comments/documentation within.lhe provisions of the Mining Act of 1971 throughout the
application review process until a final decision is made on the application.
Nature Conservancy
4705 University Dr.,. Ste 290 , Durham, NC 27707 John R. Lane Jr.
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7, 2011 _ _ _ 433 Gates School Road Gates NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
Applicant Name)
has applied on September 2011
(Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Care) (Number) (Miles)
south of Eure. NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates _ 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 rep-arding the
snecifics of the nronosed mining activity. please contact the annlicant at the following telenhone number:
t LnL) JV5- / Iu6 . ror inrormai
please contact the Mining Program staff at [phone].
relevant written comments/documentation within 1he provi:
application review process until a final decision is made on
Toby Chappell, Gates County Manager
PO Box 148.200 Court St.. Gatesville. NC 27938
(Addressee/Owner of Record's
Name and Address)
_ September 7, 2011
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
7
on the mining permit application review process,
TWO
John R. Lane Jr.
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
433 Gates School Road, Gates, NC 27937
(Address of Applicant)
-20-

APPLICATION FOR A MINING PERMIT
AFFIDAVIT OF NOTIFICATION
I, Kenneth C. Elliott , an applicant, or an agent, or employee of an applicant, for a new
Mining Permit, or a modification of ail existing Pinning Permit to add land to the permitted area, from the N.C.
Department of Environment and Natural Resources, 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)
Thomas C & Nan L. Coxe
(Address)
613 Court Street. Gatesville NC 27038
NC Wildlife Resources Div. of Wildlife M mt. J 1722 Mail Service Ctr., Raleigh, NC 27699-1722
Nature ConservancyT 4705 University Dr, Ste 290 Durham, NC 27707
(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.]
Tom Chappell, County Manager
(Address)
PO Box 148, 200-Court St., Gatesville, NC 27938
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 minin-,permit boundary (including, where an adjoining tract is owned or leased by the applicant
or is owned by the lessor o 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 o� the county or municipality in which any
part of the permitted area is located in compliance with N.C.G.S. 74-50(b ]) 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.
i
September 8 2011
Signat e of Applicant or Agent Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: __John R. Lane, Jr. _
Title of person executing Affidavit Agent for Jahn R. Lane Jr.
1, .- heL 1 (1 0 • `&SS _ a Notary Public of the County of ;A_n
State of North Carolina, do hereby certify that_LV4_r)eth (", _ k I I ; o`
appeared before me this day and under oath acknowledged that the above Affidavit was
Witness my hand and notarial seal, this _day of 20j.
Notary:�,� my Commission expires:
-21-

r
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Deliveryis desired.
= Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to'.
Toby Chappell
Gates County Manager
PO Box 148
200 Court Street
Gatesville, NC 27938
2. Adida Number
f7hvwer from sorvlce label)
Ps Form 3811, February 2004
A. Signature 4
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❑ Agent
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❑ Addressee
B. Received by( nted Name)
C. Date of D livery
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D. Is delivery address different from Item 1?
13 Yds
If YES, enter delivery address below:
❑ No
3. Service Type
❑ Certttled Mail ❑ Express MaU
❑ Registered ❑ Return Receipt for Merchandise
❑ insured Mail ❑ C.O.D.
4. Restricted Deflvety? (Exam Fee)
❑ yes
7009 0820 0001 9576 8378
Domestic Return Receipt 102595-02-nit-1540
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Toby Chappell_
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Gatesville, NC 27938
■ Complete items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
d Print your name and address on the reverse
so that we can return the card to you.
* Attach this card to the back of the mailpiece,
or on the front if space permits,
1. Article Addressed to:
Thomas C. & Nan L. Coxe
613 Court Street
Gatesville, NC 27938
MU.S. Postal Servicerr,
CERTIFIED MAII_Fr, RECEIPT
(Domestic Marl Onfy; No Insurance Coverage Provided)
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I0I110,14L7lk�o 1AUL USE
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, 'l Postage $
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certified! Fee $2.85 13
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11 enrTo Thomas C. & Nan L Coxe'�
srreer,A 813Court Street
arf'OSc Gatesville, NC 27938
City Stni
A. Signature
X C ❑ Agent
L uvL:%' ❑ Addressee
6. Received by (Anted Name) C. Date of Delivery
D. Is delivery address different from Item 17 ❑ Yes
If YES, enter detivery address below: ❑ No
3. Service Type
© Certified Mait 0 Express Mail
❑ Registered ❑ Return Receipt for Merchandise
0 Insured Mail ❑ C.O.D.
4, Restricted Delivery? (Extra Fee) ❑ Yes
2. Ardcle Number w _ �7009 0820 0001 9576 8385
(Transfer from service label)
PS Form 3811, February 20134 Domestic Return Receipt 102555 o2-tvt-154o

■ Complete items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mallpiece,
or on the front If space permits.
1. Article Addressed to:
T e Nature Conservancy
4705 University Drive
Suite 290
Durham, NC 27707
A nature '"" r
��II +'�( ,� ❑ Agent
X l_+l 1 V PMAW �✓ 0 Addressee .
B.,Beceived by_(JOrfnted Name) I C. Datp of pelivery
D. Is delivery address different from item '1? U Ye!
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mall ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑ C-o.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
z. Article Number 7 0 0 9 0820 0001 9576 8 2 6 2
(rrarlsfer horn service labs!]
PS Form 3811, February 2004 Domestic Return Receipt
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A Complete Items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mallplece,
or on the front if space permits.
1. Article Addressed to:
NC Wiidlite Resources Commission
Division of Wildlife Management
c/o Mr. Isaac Harrold
1,722 Mail Service Center
Raleigh, NC 27699-1722
1025ss-02-M-1540
U.S. Postal[SP.rVICelu'race
CERTIFIED MAI,RECEIP!Provided)
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city, sire., 1722 Mail Service Center
Raleigh, NC 27699-1722
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8. Recely ! },C C. Date of Delivery
Is delivery address. Is delivery address different from ft% P yes
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SEP 0 8 2011
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❑ Registered ❑ Return Recel t for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? OZ&a Fee) ❑ Yes
2. Article Number
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PS Form 3811, February 2004 Domestic Return Receipt 102595-02-W1540 '

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:
Signature:
Print Name:._ J. Roger & Rita H. Lane
(Title, if applicable)-
Company
(If applicable)
Address: PO Box 485
Gatesville, NC 27938
Telephone: (
Date Signed: !9- _ I ('� �10 t I
APPLICANT:
Signature:* i
:Print Name: John R. Lane. Jr.
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: ( 252 ) 398-7708 _
Date Signed: g- I Co - a u i 1_
*Signature must be the same as the individual who signed Page 1 of this application
One ordinal and five_(5) copies of the completed application, six (6) copies of all location mans, mine maps and
reclamation maps, and the appropriate rocessin fee (see next page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
- 25 -

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:
Signature: /`�'� z�
Print Name: Charles T. Hofler, Jr.
(Title, if applicable)
Company
(If applicable)
Address: 181 NC 37 South
Gatesville, NC 27938
Telephone: (
Date Signed: q- i Le- -)o I I
APPLICANT:
Signature:*
—X�d W;/,
Print Name: John R. Lane Jr.
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: [phone]
Date Signed: - f Co - rD- C. I
*Signature must be the same as the individual who signed Page I of this application.
One orilZinal and five 5 coRies of the completed ipplication, six 6 co ies of all location maps, mine maps and
reclamation mal2s, and the appropriate rocessin fee (see next page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Qualitv Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
-26-

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. 74756.
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
Signature. ' 7
Print Name: George .Mac Miller
(Title, if applicable)
Company
(If applicable)
Address: 310 NQ HvLnLI37
Gatesville NC 27938_
Telephone: (
Date Signed: q - 1 (0 - a-o t I
APPLICANT:
>ignature:*
Print Name: John R. Lane Jr.
Title: Operator _
Company:
Mine Name: Eure Sand Mine
Telephone: [phone]
Date Signed: qt . ( U - 1 1
*Signature must be the same as the individual who signed Page I of this application.
on,ainal and five (5) conics of the comnleted smnlication. six (6) conies of all location mans. mine mans and
reclamation maps, and the appropriate processing, fee (see next page for fee schedule) in the forma check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.

APPLICATION FOR A MINING PERMIT
MINING FEE SCHEDULE
A nonrefundable permit application processing fee when filing for a new mining permit, a major permit modification or a renewal permit is
required as follows:
0-25 acres 26+acres
New Permit Applications $3,750.00 $5,000.00
Permit Modifications $750.00 $15000.00
Permit Renewals $750.00 $100.00
Transfers/Minor Modifications* $100.00 $100.00
* A nonrefundable T100.00 permit application processing fee is required for minor permit modifications. Minor permit modifications include ownership transfers, name
changes, bond substitutions and permit renewals where the mine is inactive sod fully stabilized. A minor permit modification also includes lands added to a permitted area,
outside of the minimum permit buffer zone requirements. where no plans for mining related disturbance of the added lands have been approved. All other changes are
considered major permit modifications.
Acres for new permits and renewal permits means the total acreage at thesite. Acres for major 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.
- 25 -

APPLICATION FOR A MINING PERMIT
SCHEDULE OF RECLAMATION COSTS
(Based upon ranize of $500 - $5,000 ner 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
TIS Ponds
S.piles
W.piles
P.area/H.R.
Mine Excay.
SG, GS,
$5001ac.(L)
$1800/ar.
$20001ac.
$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 sideslohes
(Fl) = reclamation by filling in and revegetating
(PD) = reclamation by grading for positive drainage & revegetating
AS PER NCAC 15A 5B.0003, IF YOU DISAGMEE 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, Land Quality Section, 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 STI'E IN QUESTION
YOU WILL BE NOTIFIED AS SOON AS POSSIBLE OF THE DIRECTOR'S FINAL BOND DETERMINATION.

44
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{X
STATE CF NORTH CAPO_INA
(NC WIL -IFE RESOURCES CU-AlfCSSiON)
fry STAB
wrT C1 or t
U4 Ear
EURE SAND MINE
PONDS # 5 -10
OVERVIEW MAP
SCALE 1" w 500'
JOHN R. LANE, JR.
EURE, NC
GATES COUNTY
SEPT 21, 2011
KEN ELLIOTT. CONSULTING
SITE INFORMATION
TOTAL PERMIT AREA- 322.60 AC
TOTAL UNDISTURBED - 292.35 AC
TOTAL WETLANDS - 173.04 AC
PROCESSING AREAS - 1,79AC
ACCESS ROADS (OUTSIDE OF EXCAV AREAS) - 1.99 AC
UNEXCAVATED BUFFERS (WITH ROADS) - 7.64AC
EXCAVATION - 18.82 AC
IJ,'F
STATE CF NOPT:-I Cz,'�O'-Pt:l
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VV? W'ET AJAD CROSSING
435 (SILTFBICE INSTI
1&4 wETLAPU CROSSpJ0
45' (SILT FENCE tNST)
W5 V,FrLA^JD CROSSING
36' (SILT FENCE ILtST(
• ��r_
J.ROGEiR LANE
RITA H. LANE
GEOPGE rAkC MLLER
CFIARLES I FO=LEA, JR.
ll-E NATIJRE CONSERVMrCY '
N

EURE SAND MINE
PONDS #5&6
MINING MAP
SCALE 1" = 150'
JOHN R. LANE, JR.
EURE, NC
GATES COUNTY
SEPT 22, 2011
KEN ELLIOTT, CONSULTING
SITE INFORMATION
TOTAL PERMIT AREA- 322-60 AC
TOTAL UNDISTURBED - 292.35AC
TOTAL WETLANDS - 173,04 AC
TOTAL PROCESSING AREAS - 1.79AC
TOTAL ADD'L ACCESS ROADS - 1.99AC
UNEXCAVATED BUFFERS - 7.64AC
TOTAL EXCAVATION AREA-18.82AC
TOTALAFFECTED AREA- 30.25 AC
3
SX3 SAND BERM DETAIL
POND 7 `
8.10AC ••
•: �/IRGINIA POWER
.• OVERHEAD LINES,**
NON -WETLANDS :VIRGINIA POWER
• � '• OVERHEAD LINES "
•
•
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•
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3.44 AC :
• tfa~ ns WETLANDS
IoMR g4�
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BUFFER
WETLANDS
LEGEND
PERMIT BOUNDARY
WETLANDS BOUNDARY
PROPERTY LANE ---.
EXCAVAT[ON EDGE
INTERIOR SLOPE
UNEXCAVATED BUFFER
UNDISTURBED BUFFER
ACCESS I HAUL ROAD
SALT FENCE
PROCESSING AREA
POWER LINE • • • .
BAND BERM
WETLANDS
�H7 �
6� ��
p. rall�
o POND S
0,40 AC
245,
� So prWj�C���R I
d.
ins
:
•
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WETLANDS
e :
i
:
NON -WETLANDS
N
WETLANDS
4AC "'' �Q- NON -WETLANDS
3.44POND
AC
WETLANDS
Z
r8O YL_i NON -WETLANDS
WETLANDS
• 4m
• S
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I
•
t
•
NON-WEFUANDS '
•

LEGEND
""" BOUNDARY caen
WETLANDS BOUNDARY
PROPERTY LINE —•—
EJ}ON EDGE
INTERIOR
=
INTERIOR SLOPE
NUNEXCAYATED BUFFER
1 UNDISTURBED BUFFER
ACCESSlHAULROAD
SILT FENCE
PROCESSING AREA
POWER LINE •••••
SAND BERM
sago ear,}:
3
8X3 SAND BERM DETAIL
993, TO
of SO/V 4 R w
NON -WETLANDS
•
NON-WSTLANOS
EURE SAND MINE
POND # l
MINING MAP
SCALE 1" = ISO'
JOHN R. LANE, JR.
EURE, NC
GATES COUNTY
SEPT 22.2011
KEN ELLIOTT, CONSULTING
SITE INFORMATION
TOTAL PERMITAREA- 322.60AC
TOTAL UNDISTURBED — 292.35 AG
TOTAL WETLANDS — 173.04AC
PROCESSING AREAS - 1.79AC
ROADS (INCL THRU WETLANDS) - 1.99 AC
UNEXCAVATED BUFFERS — 7.64AC
EXCAVATION —18.82 AC
NET ANDS
•
: VIRGINIA POWER .•
•�: OVERHEAD LINES♦.'�
NON•WMANDS
s e NE
3.

w•
v3aagy
• .
%�
.
•
WETLANDS /
w
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•
•
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-"`n:
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-
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i
A pI5UARY
WEP-ND.
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• PROPERTY CSNE
EXCAVATION EPOE
.�
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3�
INTERIOR SLOPE
• UNEXCAVATED BUFFER
PONDS
• �
, UACCESRBEOBUFFER
ACCESS/HAUL ROAD •�
'
` 4.75AC
9p
i
r�,
°
NON -WETLANDS.
SILT FENCE
' PROGEPOWER RNA .
POWER
.'VIRGINIAPOWER
' OVERHEAD LINES.
` �,
Bg
• SAND BERM
�# 130'
''N4 u�
'
�
ryh
•
WETLANDSEr
1
65'
_ 55'
O.
NON -WETLANDS
POND 7 `
ss
&1DAC
POND 8
0
•
4.75 AC
>S•
-yd
NON-WE.TL-ANDS
WETLANDS
140
1
W 8'
WETLANDS
SILT E
�d
NON-WETLANDS
j�
yq0'
NON -WETLANDS
m
9
rND
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ti
e0.
•
yo
WETLANDS
•
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i
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bA'f}
RED
10.9
&1F4
EURE SAND MINE
`)o.
75-
a
PONDS # S, 9 & 10
yE(LANDS
45' Apr
MINING MAP
2so.
SCALE 1" = 150'
c,TF iNFORMAT101V
TOTAL PERMiTAREA - 322.60 AC
JOHN R. LANE, JR'
TOTAL UNDISTURBED - 292.38 AC
WETLANDS-173.oaAC
.3
�'"
NON -WETLANDS
EURE, NC
TOTAL
8X3 SAND BERM DETAIL
GATES COUNT`
PROCESSING AREAS - 1.79AC
WETLANDS) 1 99AC
ROADS (INCLTHRU
UNEXCAVATED FERS - C AC
SEPT 22, 2011
EXCAVATIONF 18 82 AC
KEN ELLIOTT. CONSULTING

NORTH CAROLING
MINING PERMIT APPLICATION
State of North Carolina
Department of Environment
and Natural Resources
Division of Land Resources
Land Quality Section RECEIVED
NOV 3 O 2011
pWQ-WARD
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: January 30, 2008

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
Name of Mine Eilre Sand Mine County Gates
River Basin Chowan
Latitude (decimal degrees to four places) 36.3972
Longitude (decimal degrees to four places)-76,8594
2. Name of Applicant* John R
Permanent address for receipt of official mail** 433 Gates School Road, Gates NC 27937
Telephone ( 252 ) 357-1279 Alternate No._(- 252) 398-7108
4. Mine Office Address 433 Gates School Road, Gates NC 27937
Telephone (252 ) 398-7708
Mine Manager John R.
We hereby 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
Print Name John R. Lane Jr.
Title Operator
Date September 16, 2011
* This will be the narne that the mining permit will be issued to and the name that must be indicated on the
reclamation bond securit that corresponds to this site.
** The Land Quality Section must be notified of any changes in the permanent address or telephone number.
*** Si Jnature 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 ofa
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.

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:
® 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): 322.E acres
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: 322.6 acres Property owner if leased: J. Roger Lane (father), Rita H. Lane
(mother), George Mac Miller, Charles T. Hofler, Jr. (partners)
❑ If this is an application for RENEWAL 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 (this is the acreage that the "renewal" fee will be based upon):
❑ If this is an application for a MODIFICATION to a mining permit, indicate the mining permit
number and the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
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 ❑, 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:
HHydraulic Dredge Front-end Loader & Truck ❑ Shovel & Truck
Dragline & Truck ® Self -loading Scraper
Other (explain): Excavator
4. a. Expected maximum depth of mine (feet) 20 feet
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation, etc.)_
Natural 7round level
b. Expected average depth of mine (feet) IS feet
-2-

APPLICATION FOR A MINING PERMIT
Has any area(s) at this site been mined in the past? Yes ❑
If yes, when and by whom was this activity conducted?
W
6. Number of years for which the permit is requested (10 years maximum): 10 years
B. MAPS
Clearly mark and label the location ofyour 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:
Mailin` Address:
1612 Mail Service Center OR
Raleigh, North Carolina 27699-1612
[phone]
Physical Address:
512 North Salisbury Street, 5"' Floor
Raleigh, North Carolina 27604
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:
NC.DOT GIS Unit
3401 Carl Sandburg Court
Raleigh, North Carolina 2 76 10
[phone]
1V%V W.II(A 0t.0 rrlt i-,iSCoIII CUde'l;itIIt.htl)ll
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
snaps along with their corresponding (approximate) acreage. As a rescinder, mining permits can
only be issued for up to 10 years; thus, all mine and reclamation maps must only 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, it 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 ofall settling and/or processing wastewater ponds.
k, Location and acreage of all planned and existing access roads and on -site haul roads.
I. 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.

APPLICATION FOR A MINING PERMIT
p. Narnes 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. I fan 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 urine 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:
I. 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
I inch = 100 feet
200+ Acres
I inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)
-4-

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/Sedirnent Ponds
Stockpiles
Access Roads
1.99 acres
Processing Areas
1.79 acres
Mine Excavation
18.82 acres
Unexcavated Bui ers (roads, berms)
7.64 acres
Total Disturbed Acreage
30.24 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 {PI EASE NOTE THE ITALICIZED QUESTIONS/STAT,EAIENTS
THROUGHOUT THE FORM). THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS.
- 5 -

APPLICATION FOR A I1'IfNING PERMIT
C. PROTECTION OF NATURAL RESOURCES
Describe in detail the sequence of events for the development and operation of the mine and referetice the
sequence to the ramie map(s). Attach additional sheets as needed.
1. Acquire proper permits from NC Department of Environment and Natural Resources, US
Army Corps of Engineers, & CAM.A.
2. Acquire Zoning Compliance .Permit & Special Use Permit from Gates County Dept of
Planning & Development,
3. 2-parcel tract totaling 322.6 acres will be permitted. Tracts contain total 173.0 acres wetland
pocosin (delineated 2010).
4, Phase 1 of project will be construction of 6 excavations totaling 18.82 acres, as follows: Pond
5 (0.49 acres), Pond 6 (3.44 acres), Pond 7 (8.10 acres), Pond 8 (4.75 acres), Pond 9 (0.36
acres), Pond 10 (1.68 acres).
5. Phase 2 of project will encompass modification to permit construction of Ponds 1 thru 4
inside of permit area at later time.
6. Phase 3 of project will encompass modification to permit construction of Pond 11 inside of
permit area at later time.
7. All ponds will be laid out on high land inside the permit area, and will have a minimum 25-ft
unexcavated buffer and a 50-.ft undisturbed buffer between the excavation and adjacent
wetlands.
8. Operator will construct a 8-ft wide by 3-if high sand berm around each excavation area along
the outside perimeter of the unexcavated buffer to prevent offsite sedimentation.
9. Operator will install silt fence along existing access roads through wetlands. Operator will
install silt fence along any new access roads through wetlands per instruction from USACE.
10. Starting with Pond 10, each excavation area will in turn first have topsoil removed down to
2.5 feet below natural ground level and stockpiled, and then sand will be dug from excavation
area by excavator down to average 15 feet below existing natural ground level, and stockpiled
for later removal from premises.
11. At this time there are no plans to dewater any of these excavations.
12. Minimum 2:1 graded slopes will be established around edges of pond area below groundwater
level,
13. Minimum 3.1 graded slopes will be established around edges of pond area above groundwater
level.
14. After excavation and edge sloping is completed, a low I ft x Bit berm will be established
around the entire perimeter of the excavated pond, with outside slope graded down to natural
ground level.
15. All slopes above water level will be fertilized and seeded with ground cover per guidelines
from NC Agricultural Extension Service,
16. Internal haul roads and processing areas of main permit area will be leveled and graded to
natural ground level, to be returned to natural field state, any trash or debris cleaned up and
removed.. A 101E wide field path will remain around the entire perimeter of the excavated
pond for owner access.
17. Access roads & field paths to Fort Island Road will be graded, leveled, and returned to pre-
existing state.
18, Entire affected area inside of main permit area will be fertilized and seeded with groundcover
and will be allowed to return to its pre-existing field state.
19. All silt fence erosion controls will be removed.
20. At end of permit period, affected area returns to pre-existing, natural state.
-6-

APPLICATION FOR A MINING PERMIT
2. Describe specific erosion control measures to be installed prior to land disturbing activities and during
mining to prevent offsite sedimentation (illclrc(le . l)ecl fie p1(1i1.5' fol' .Yedin?et11 crud erosion control for mille
ex -car cationN, iva.SYe piles, accessl'mine roads- and process areas), and give a detailed sequence of
installation and schedule for maintenance of the measures. Locale crud label all sediment and eravion
control meayul-e.v on the inane inal)(S) anti provide tyl)ical croSv-S-G'CliOIISIC011.VII'llCllOn deklitV of each
weasul-e. Engineering designs and calculations are required to justify the adequacy of any proposed
measures.
Operator will construct 8fi wide x 3ft tall temporary sand berm along the outside perimeter of the
unexcavated buffer of each excavation area to prevent offsite erosion. Berm will be grassed and
stabilized, and will be inspected weekly and repaired as needed.
Operator will establish silt fence erosion control along perimeter of all access roads passing through
wetlands prior to land disturbing activities. Silt fence will either be constructed of standard strength
filter fabric with wire or polymer backing and steel posts set 8 feet apart, or extra strength filter fabric
between steel posts 6 feet apart. Silt fence will be inspected weekly and repaired as needed.
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 waste water from the mine or plant as a point discharge to
the waters of the State? Yes ❑ No Z. If}%es, briefly describe the nature lI f the discharge and locale
c111 proposed dischai-ge poinls (along tiviih their method of .stabilization) on your inane maj)(5).
Not applicable.
-7-

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 N.
If yes, what impact, if any, will mine dewatering have on neighboring wells? Estimated withdrawal rate in
gallons per day: Locate all existing ivelty on the niiiiei wj)(s) that lice i0thin
S(If1 feel of thc• proposed erccrsjatia�r area. Provide data to support any conclusions or staternents 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.
Not applicable. rl o "z'
7
d. If you answered yes to any of the above questions, provide evidence that you have applied for or obtained
the appropriate water duality permit(s) (i.e., non -discharge, N'P.DES, Stormwater, etc.) from the Division
of Water Quality, Water Quality Section. In addition, the applicant is required to register water use with
the Division of Water Resources if the operation withdraws more than 10,000 gallons per day and needs a
capacity use permit from the Division of Water Resources if the operation lies in a capacity use area and
withdraws more than 100,000 gallons per day.
Not applicable.
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No 0.
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?
Spraying water from water supply trucks on haul roads and process areas, or hauled & spread by
bucket on excavators will control dust. Stockpiles will also be sprayed with water weekly ifs
necessary to control dust. Speed limit on access roads will be maintained at 1 Oniph maximum
-8-

APPLICATION FOR A MINING PERMIT
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. Shory all buffer locatio».c at'id widths oti the mWe mal)(S).
A 25-ft wide unexcavated buffer will be maintained around the excavation of each pond,
adjacent to an undisturbed buffer. This buffer will contain erosion & sediment control berms,
roadways, processing areas, and stockpiles.
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 ]and disturbing activities within the
mining permit boundaries and any natural watercourses and wetlands at this site? Show all buffer
locations and ii-ic%ths oll the niiiie maj)(�).
A 50ft undisturbed buffer will be established around the excavation of each pond, and will be
located between the 25-fl wide unexcavated buffer of each excavation and wetland pocosin.
5. a. Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries
during mining. Minimum 2 horizontal to 1 vertical slopes or Batter 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.
Landslide or slope instability adjacent to adjoining permit boundaries will be prevented by
construction of graded cut slopes during mining activities. Slopes will have a rninimum of 3
horizontal to 1 vertical gradient.
-9-

APPLICATION FOR A MINING PERMIT
b. Provide a cross-section nn the mine maj)(s) .for all fill slopes (berms, ivastepiles, overbla'dell
di.sC)osal areas, etc.), clearly indicating the illtellded side .slope gradient, iti.viallation of airy benches
a11di01' slope Gl!'ai11.4 (Vt�lth S'l!!)I)ortlllg de.5'ifr11 it fol7natioll) if needed, and the method offinal
stabilization.
Fill slope cross-section of temporary erosion control berms attached to reclamation and mine
maps and will have minimum 2:1 side slope gradient. Final reclamation fill slope will be
established at edge of cut during reclamation of mine, and will have 4:1 side slope gradient.
c. In excavation(s) of unconsolidated (non -rock) materials, specify the angle of all cut slopes including
specifications for benching and sloping. Cros.1'-sections far all cut .slopes !mist be provided on the
111111e maj)(s).
Not applicable.
d. In hardrock excavations, specify proposed bench widths and heights in feet. Provide cross -sections
of the !nine excavalion clearly noting the angles of the cw slopes, widths of all.safety henche.s and
mine benches', and the eay)ected maximum depth af'the excavation.
Not applicable.
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwellin
house, public road, public, commercial or industrial building from any mine excavation. Locate all Me
.strnaures o11 the urine nlcrp if they are within 300 feet of any proposes! excavallon.
Not applicable. Closest dwelling is 0.4 mile from excavation (direct line across wooded wetland); closest
road is 0.4 mile from excavation (direct line across wooded wetland).
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 couvrllction detail/cross-section and location of each type of
barrlcaCle to he used must be indicated on the !nine nlap(s).
No high wall areas exist in this permit area.
Caution signs, warning signs, no trespassing, and/or keep out signs will be installed at only entrance
to permit area and every 500 feet on permit boundary along Fort Island Road. Excavation area is
located 0.4 mile from nearest public road (Fort Island Road) and is only accessible from single gated
access road.
- 10-

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?
Not applicable.
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 localioii of all visual screening on the innie inap(s) anciprovide cross-seclioils
through all proposed herms oi• proposed .si)acirrg, sizes aitd ,si,7ecies. for free plantings.
Existing natural growth of pine trees, fields and wooded pocosin wetland around' perimeter
of permit area will screen operation from public view. No additional screening planned.
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?
]tine permit area located on private -owned farmland, log ed-over woodland and wetland
pocosin. Chowan Swamp Game Lands are located south o permit area but will be separated
by 250 feet of forest & wetlands from any mining activities. There are no anticipated adverse
effects to these Gamelands. One access road to Chowan Swamp Game Lands runs through
this permit area and will be maintained as such by mine operator.
11, 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 offsile occupied
str ucttire(s) to the proposed exem,atiorr(s) oil the niirre map and indicate its approximale distance to file
proposed excavalioir.
Not applicable
12, Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ❑ No ®,
1 f yes, describe these materials, haw they ivill he stored and method ref cowainmerlt in case af.vl)i1L Indicate
the locafion(s) of all storage facilities oit the inhie map(s).
Not applicable.

APPLICATION FOR A MINING PERMIT
D. RECLAMATION PLAN
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
illforrllalioil musl he ilhlstraled on a reclamalion map and nlrlst corresl)olyd zhi-eclly with the iiTforrnalion
I)1'011dE'Gl ()Il the li0le illal)(5), In addlllOil, dG'.5lg!! !!!f()i'I?TCTlloil, including typical cross-seciioil,s, Of'crny
perlllanew channels to be constructed as part (?f the reclaniatioit plan will the locatimn(.$) of all permanent
channels must be imlicated o!! the 1-eclanialion illal).
I . Excavated body of water will be left as part of reclamation of each excavation for recreational use by
landowner, minimum 4 feet deep.
2. After mine excavation and removal of sand and topsoil stockpiles, all disturbed land, affected areas
and access and service roads inside the permit area will be leveled and graded away from edge of
excavated mine pit 8 feet until graded area reaches natural level. This will create a low berm located
at the edge of the pit I ft high and will extend 8 feet wide away from the pit (see attached cross-
section).
3. All erosion control silt fences along access roads will be removed.
4. Other access roads to excavation area and haul roads will be graded, and returned to original
condition used as farm field access path. Processing areas will be graded and allowed to return to
natural state.
5. Graded land and all affected area will be fertilized and sown with grass seed by mine operator as per
recommendation by County Agriculture Extension Agent (attached). Ultimately all reclaimed land
from 8ft out from excavation will be returned to pasture, field and Farm path.
2. Is an excavated or impounded body of water to be left as a part of the reclamation? Yes ® No ❑.
If yes, ill!lstirale the location of the hod),(s) of ivalel- on the reelanlatioti real) aml provide a .scaled
cross-section(s) through the proposed body(~) 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 alld locations of all permanent
barricades must be shoivn on the rec1ainatimi nicy).
Not applicable. No excavation in rock.
-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
ctreas musl he provided ot1 the recicrnlation nrap.
No urine site waste areas will exist; topsoil and sand stockpiles only.
5. a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
No processing facilities exist.
Stockpiles will be totally removed from processing areas; sedimentation berms adjacent to excavated
area are to be removed and will be frilled, graded and sloped away from edge of excavated mine pit S
feet until graded area reaches natural land level. Stockpile areas will be graded and leveled to flat
natural ground level. All stockpile areas will be fertilized and seeded with grass by mine operator at
end of mining operation. Stockpile and affected areas will be returned to agricultural use by
landowner.
All onsite haul roads in immediate vicinity of excavation will be graded and leveled to flat natural
ground level, and then fertilized and seeded with ground cover by the owner. A 1 Oft wide field path
will remain around perimeter of finished pond for owner access
b. Will any on -site roadways be left as part of the reclamation? Yes ❑ No ®.
if3-cis, iderttify such r-oad�r-ays• orr the i-eclarttcrIion ntap crird fi or ide 4lelei iIs ott perntaneii/ road artd ditch
line sicrililizatiom
Pre-existing access road (2565-ft single lane soil path) from Fort Island Road to main mine site area
will be returned to pre-existing standard during reclamation. The access roads will be constantly
maintained during mining operations, and will be reclaimed by grading, leveling, and repairing
potholes as necessary. Pre-existing ditches will be maintained and repaired as necessary, arid returned
to pre-existing standard during reclamation. A 1Oft wide field path will remain around perimeter of
finished ponds for owner 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 n1ju written approval
from the NC Department of Environment and Natural Resources, Land Quality Section and either
the Division of Waste Management (DWM.) or local governing body. If a disposal permit lt:ts been
issued by DWM for the site, a copy of said permit must be attached to this application. All
lenworctry and permanew refuse disposal areas mast be clearly delineated on the mine ntap(s) crud
rec antcrlioyt trap, along rritli cr A5,/ of'itelia to he di.sh(.),%vd in said ctrecrs.
Any and all scrap metal, junk, cables or other such non -original waste materials will be removed from
mine premises by mine operator and disposed of properly at Gates County Landfill, Nobbsville, NC.
All topsoil or sand excavated by minim operation will be removed from premises before reclamation.
No oti•-site generated waste will be disposed of on -site.
- 13 -

APPLICATION FOR A MINING PERMIT
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, time 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 C-om:
a. Authorized representatives of the local Soil and Water Conservation District,
b. Authorized representatives of the Division of Forest Resources, Department of Environment and
Natural Resources;
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University;
d. North Carolina licensed landscape architects,
e. Private consulting foresters referred by the Division of Forest .Resources, Department ofEnvironment
and Natural Resources;
f N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation;
h. Others as may be approved by the Department.
.LENT E - RATE OF APP.LICAT.ION (tons/acre):
0.5 ton / acre upon soil test
FERTILIZER - ANALYSIS AND RATE OF APPLICATION (pounds/acre):
10. ] 0.10 fertilizer, 430 lbs / acre, Spring, Summer & Fall
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING VEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Seed Types: Seeding Dates: Seeding Rates:
Kentucky Fescue April 250 lbs / acre
Rye Grass November 150 lbs / acre
Bermuda Grass May 85 lbs. / acre
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANCHORING:
Not applicable.
OTHER VEGETATIVE COVERS — TYPE (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Not applicable.
Revegetation and/or reforestation plan approved by:
Signature
Print Name
Title
Agency North Carolina Cooperative Extension Service
Date September 7, 2011

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
117e folloii,ing bond calculL7lion worksheel is to he used to establish all aI)Irl'Oprlcae bond (based upon (I1"all re
of S OU to S5, UUU per cfffecled acre) for each permilleti mine site based upon the cfcr•eage approved by the
DepC7rtlllelTt to be affected during the life of the milling perw t. I'lease insert the C7))ro.yiw47te acre�, for each
av)ect of the 171irWIV ovel-Cf11011. 1hca you lntencl to affect durint, the life of this wininf, vertnii (in ciddllio)i.
please insert the aa)ro )r1ale reclonicition cosilacre for ellch ccllegory froln the Schedule O f Recklnl(llion Costs
vroviclecl ii4th this aon icolivn form) OR you eclN clefer to the DeUcn•lrnelrt to ecllelllate vole• bond for von hclseci
AFFEC'CED
.RECLAMATION
RECLAMATION
CATEGORY
ACREAGE
COST/ACRE*
COST
Tailings/Sediment Ponds:
Ac,
X
$
/Ac.
_ $
Stockpiles:
Ac.
X
$
/Ac.
_ $
Access Roads:
1.99 Ac.
x
$
1800 /Ac.
_ $
3582
Processing Area:
1.79 Ac.
X
$
1800 /Ac.
— $
3222
Mine Excavation:
18.82 Ac.
X
$
500 /Ac.
— $
9410
Unexcavated Buffers (roads, berms):
7.64 Ac.
X
$
1800 /Ac.
_ $
13,752
TOTAL AFFECTED AC.:
30.24 Ac.
(TOTAL PERMITTED AC.:
322.6 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 10,24 Ac.
b) Positive Drainage Ac. X $1,500.00 = $
Inflation Factor:
SUBTOTAL COST: $ 29,966
.
0.02 X SUBTOTAL COST: $ 599.32 X Permit Life (1 to 10 years): 10
INFLATION COST: $ 5993.20
TOTAL COST = SUBTOTAL COST + INFLATION COST = $ 35 959.20
Total Reclamation Bond Cost: $
(round down to the nearest $100.00)
- 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) (fie chiefadrninistrative 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 raining 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 naap(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 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 NIINING PERMITS
AND ALL MODIFICATIONS OF A MINING PERM IT 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"

NOTICE
Pursuant to provisions G.S. 74-50(b I ) of Tile Mining Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one)-
0
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 niodification(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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Sure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates 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 cornment(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-zard the
specifics of the proposed niinin2 activity, please contact the applicant at the followin-2 telephone number:
252 398-7708 . For information on the mining permit application review process,
please contact the Mining Program staff at [phone]. Please note that the Department will consider anx
relevant written comments/documentation within the provisions of the Minim Act of 1971 throughout the
application review process until a final decision is made on the application.
Thomas C. & Nan L. Coxe
613 Court Street, Gatesville, NC 27938 John R. Lane, Jr. _
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7, 2011 _ 433 Gates School Road Gates NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
- 17 -

NOTICE
Pursuant to provisions G.S. 74-50(bI ) of The Mining Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 niodification(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 R topsoil _ _ _._ on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Eure. NC _ off/near road Port Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAVIES 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, ifan 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
snecifics of the oronosed mining activity, please contact the apnlicant at the following telephone number:
[phone] . For rntormation 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 vrovisions of the Mining Act of 1971 throughout the
application review process until a final decision is made on the application.
NC Wildlife Resources Commission
Div. of Wildlife Management, CIO Isaac Harrold
1722 N4ail Service Center, Raleigh, NC 2769.9-1722 John R. Lane, Jr.
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7 2011 _ _ 433 Gates School Road, Gates, NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
- 18-

NOTICE
Pursuant to provisions G. S. 74-50(bl) of The Mining Act of 1971, :Notice is hereby given that
John R, Lane Jr. has applied on Se tember 2011
(Applicant Name) (Date)
to the Land Quality Section, .Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Eure. NC otf'Inear road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACFIED 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 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 regardinp, the
specifics of the nronosed minims activity, please contact the applicant 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
Nature Conservancy
4705 University Dr. Ste 290 Durham NC 27707
(Addressee/Owner of Record's
Name and Address)
September 7, 2011
(Date of Issuance of this Notice/
.Mailed to Addressee/Owner of Record)
John R. Lane, Jr.
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
433 Gates School Road Gates NC 27937
(Address of Applicant)
- 19-

NOTICE
Pursuant to provisions G.S. 74-50(b 1) of The Mining Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 & to soil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Eure NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAN ES AND LOCATIONS*
In accordance with G.S. 74-50(b]), 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 oror)osed minim activity, please contact the applicant at the following telephone number:
252 398-7708 For information on the mining permit application review process,
please contact the Mining Program staff at [phone]. _Ple_ase note that the Department will consider any
relevant written commentsldocumentation within the nrovisions of the Minim Act of 1971 throtmhow the
Toby Chappell, Gates County Manager
PO Box 148, 200 Court St., Gatesville, NC 27938
(Addressee/Owner of Record's
Name and Address)
September 7, 2011
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
John R. Lane, Jr.
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
433 Gates School Road, Gates, NC 27937
(Address of Applicant)
-20-

APPLICATION'I:OR A MINING PERMIT
AFFIDAVIT OF NOTIFICATION
1, Kenneth C. 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 Environment and Natural Resources, 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)
Thomas C & .Nan L. Coxe
NC Wildlife Resources, Div. of Wildlife Mgmt.
Nature Conservancy-
(Address)
613 Court Street, Gatesville, NC 27038
1722 Mail Service Ctr., Raleigh, NC 27699-1722
4705 University Dr, Ste 290, Durham, NC 27707
(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.]
Toby Chappell, County Manager
(Address)
PO Box 148 200 Court St. Gatesviile NC 27938
The above attestation was made by ine 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 ad''olning 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(b1) and 15A NCAC 5B .0004(d). 1
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.
Signature of Applicant or Agent
__. September 8, 2011 _...._..
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: John R. Lane Jr.
Title of person executing Affidavit Agent for John R Lane, Jr.
a Notary Public of the County of
State of North Carolina, do hereby certify that
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 day of 20
Notary: my Commission expires:
21-

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:
Signature
Print Name: J. Rog
er & Rita H, Lane
(Title, if -applicable)
Company
(If applicable)
Address: PO Box 485
Gatesville, NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name: John R, Lane, Jr,
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: (_252_)_398-7708
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
One original and five {Stcopies of the completed apnlicationzsi {G) copies of all lotation maps, mine mats and
reclamation maps, and the anpropriateprocessing fee (see next page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
_22_

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:
Signature:
Print Name: Charles T, H_ofler, Jr.
(Title, if applicable)
Company
(If applicable
Address: 181 NC_' South
Gatesville. NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name: John R. Lane, Jr.
Title: Operator _
Company:
Mine Name: Eure Sand Mine
Telephone: (.252 ) 398-7708
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
One original and five (5) cor)jes of the completed application, six (6) copies of all location maps, mine maps and
reclamation maps, and theappropriate processing fee (see next page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment. and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
-2.>-

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:
Signature
Print Name: George_ Mac Miller
(Title, if applicable)
Company
(If applica
Address: 310 NC Hwy 137
Gatesv,ille NC 27938
Telephone: ( )
Date Signed:
APPLICANT:
Signature:*
Print Name: John R. Lane, Jr.
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: ( 252 ) 398-7708 __._...
Date Signed:
*Signature must be the same as the individual who signed rage 1 of this application,
riginal and five (51 co
conics of all
BUIRT
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 Environment and Natural Resources must be sent to the Land
uality Section Central Office at the address listed ore the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
- 24 -

APPLICATION FOR A MINING PERMIT
MINING FEE SCHEDULE
A nonrefundable permit application processing fee when tiling for it ne►►' mining permit, a major permit modification or a rent►►'af permit is
required as follows:
0-25 acres 25+acres
New Permit Applications $3,750.00 $5,000.00
Permit Modifications $750.00 $1,000.00
Permit Renewals $750.00 $1,000.00
Transfers/Minor Modifications* $100.00 $100.00
A nonrefiindable S100.611 permit applicatiolr processing fee is required for minor permit modificalfoils. Minor permit nwdifications include o"'ucrship transfers, name
chmiges, bond suhstitutions mid permit renewals where the nlille is hlactive :aid ftdlr stabilized. A minor permit urodillcatlon also Im'ImIeS lands added to a permitted area,
outside of the minimum pernifT buffer Zone requirements, lrhere no plans for nlinlng related disturbance of the added farms have been npprotied. AIf other changes are
emisidered major perinit modifications.
Acres for new pennits and renewal permits means the Iota acreage at the site. Acres for major madillcatiou orpennils nrealls that area orlarul affecied by the modification
r+ilhin the permitted Mine ar•ca, or• any' addilfunal laud that is to be disturbed and added to an existing permitted area, or both.
-25-

APPLICATION FOR A MINING PERMIT
There are seven Land Quality Section (LQS) 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
• F'AX:828.299.7043
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: 910.486,0707
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:919.571,4718
`Vashington Regional Office
• Counties: Beaufort, Bertie, 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]
-26-

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. 585 Wauglitown Street, Winston-Salem, NC 27107
Voice: 336.771.5000
• FAK 336.771.4631
-27-

APPLICATION FOR A MINING PERMIT
SCHEDULE OF RECLAMATION COSTS
(Based upon range of $500 - $5,000 uer affected acre)
COMMODITY CODES: SG = Sand and/or Gravel, GS = Gemstone, Borrow = Borrow/fill dirt, CS = Crushed Stone,
DS = Dimension Stone, PS = Feldspar, M I = Mica, L1 = Lithium, PF = Pyrophyllite, OL = Olivine,
KY = Kyanite/Sillinianite/Andalusite, PH = Phosphate, CL = Clay/Shale, PE = Peat, AU = Gold, T[ =Titanium, and OT =
Other
Type
TIS Ponds
S.piles _ -
Wailes _
Pmrea/H.R.
Mine Excay.
SG, GS,
$5001ac.(L)
$1800/ac.
$20001ac.
$18001ac.
$5001ac.(L)
Borrow
1500(FI)
$2000(PD)
CS, DS,
500(L)
I S00
2000
2000
500(L)
FS, MI,
1500(FI)
2500(PD)
L.I, 13F, OL, KY
PH
I000(L)
2500
5000
5000
2000(L)
2500(FI)
5000(PD)
CL
1000(L)
2500
5000
5000
2000(L)
2500(FI)
3700(PD)
PE, AU,
I000(L)
2500
3000
3500
2000(L)
T1, 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 513.0003, IF YOU DISAGREE WITH THE BOND AMOUNT DETERMINED BY THE
BOND CALCULATION WORKSHEET, YOU MAY SUBATIT AN ESTIMATE OF RECLAMATION COSTS
FROM A THIRD PARTY CONTRACTOR. SAID ESTIMATE MUST BE PROVIDED WITHIN 30 DAYS TO
TI=1E FOLLOWING ADDRESS: Mining Program, Land Quality Section, 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 R.ECLAMATTON COSTS NECESSARY TO COMPLY WITH THE APPROVED
RECLAMATION PLAN FOR THE SITE IN QUESTION
YOU WELL BE NOTIFIED AS SOON AS POSSIBLE OF THE DIRECTOR'S FINAL BOND DETERMINATION.
-28-

Division of Water Quality / Surface Water Protection
NCRL%)'ENRK'6National Pollutant .Discharge Elimination System
Ncxrtri :.w:wr.Dwn+r,e+r w
_urir+cu r,Hi •+n Nul/K :. NF:YUIIUCf:f
NCG020000
NOTICE OF INTENT
FOR AGE:NC Y USF. ONLY
Dole Received
Year
kinnth
Deg'
Ccrtlrlc3lc n Coverage
NIOGW12
Check ,4
Am wrtt
Yermit Acmgncd to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG020000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code - 14XX Mineral Mining industry (except as specified below)
The following activities are also 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 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 PerC"EIVED
Stormwater discharges associated with peat mining, coal mining, and metal min 1-, -
Stormwater discharges from mining operations which are intermixed on site with stormwater from asphalt
operations and/or concrete operations; NOV 3 0 2011
• Stormwater discharges associated with oil and gas extraction operations; and
Stormwater discharges associated with tourist gem mines
NCDOT borrow pits are covered under NCS000150
-WARO
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 (i.e., sand
dredging or dipping operations)
For new mining sites that require an authorization to construct (ATC) wastewater treatment facilities: This
NOI is also an APPLICATION FOR an ATC for new wastewater treatment facilities. ATC requests must be
submitted at least 90 days prior to construction'.
For existing mining sites that require an Authorization to Operate (ATO) wastewater treatment facilities:
This NOI is also an APPLICATION FOR an ATO for wastewater treatment facilities in place.
Construction, modification, or installation of any new treatment components at an existing site requires an
ATC. (if the site is already covered by NCG020000, the ATC request may be submitted without an NOI).
Some wastewater treatment facilities used to treat or recycle wastewater at mining sites will require an ATC prLor
to construction per 15A NCAC 2H .0138. Please seethe NCG020000 General Permit for details about which
treatment facilities require an ATC (summarized in Table 1 below). The authorization to construct or continue
to operate will be issued at the same time as the Certificate of Coverage (COC) for the NCG02 permit. Design of
treatment facilities must comply with requirements of 15A NCAC 2H .0138 & .0139.
Construction of wastewater treatment facilities subject to the ATC/ATO requirements in the NCG02 permit
at new orexisting mining sites requires submission of three (3) sets of plans and specifications signed
Page 1 of 9
'As per 15A NCAC 2H .0106
Unless treatment facilities are designed, constructed, and put into operation by employees internal to the company who are qualified to perform
such work for their respective companies in accordance with General Statutes, 89C-25 (7), plans and specifications must be signed and sealed
by a P.E.
SWU-NCG02-NOI Last revised 06/07/2010

NCG020000 N.O.I.
and sealed by a Professional Engineer (P.E.) or qualified state along with this application. A copy of the
design calculations should be included. Please see questions 18 & 19,
Table 1: Summary of Wastewater Permit Requirements
Quarterly
Monitoring?
Requires
A to C?
Mine Dewatering (MD)
Yes
No
Yes
No
MD Discharges that do not need treatment
other than E&SC to meet permit conditions
✓
✓
MD Discharges that need treatment other than
E&SC to meet permit conditions
✓
✓
Process Wastewater
Other Recycle
✓
✓
Closed Loop Recycle
✓
✓
Any Other Process WW
✓
✓
�EFor questions, please contact the DWO Regional Office for your area. (See page 7)
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailedl:
Owner Name JOHN R. LANE. JR.
Owner Contact _ JOHN R. LANE_, JR._, KEN ELLIOTT
Street Address 433 GATES SCHOOL ROAD
City GATES State —NC _ ZIP Code 27937
Telephone No. 252-357-1279 Fax:
E-mail Address _r3talane.C?embarcfrna0.corn. [e-mail]
2) Location of facility producing discharge:
Facility Name EURE SAND MINE
Facility Contact JOHN R. LANE, JR., KEN ELLIOTT
Street Address FORT ISLAND ROAD
City EURE RT1 State NC ZIP Code
County GATES COUNTY
Telephone No. 252-357-1279, 252-339-9021 Fax:
Contact E-mail _ritallaneCOONTil)<Ircl_r7 ail.com ken@kenobx.c.,)m
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). From intersection of NC 37 and NC 137 in downtown
Gatesville, go west 4.4 miles on NC 137 to„intersection of Taylor Mill Road (SR 11181 travel south on Taylor
Mill Road 1.6 miles taking second paved left onto Fort Island Road SR 1220 travel south 0.5 mile on Fort
Island. Road to dirt road entrance on the right. _
4) Latitude 36-23-58.28" Longitude-76`50"54.26" (degrees, minutes, seconds)
3�-.319 Szz
Page 2 of 9
SWU-NCG02-NOI Last revised 6l7/2010

NCG020000 N.0.1.
Permits:
5) This NPDES Permit Application applies to which of the following:
V New or Proposed Facility Date operation is to begin JANUARY, 2012
❑ Existing
❑ New Permit not applicable -- ATC request only. NPDES Permit Number
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 1442
7) Provide a narrative description of the types of minerals mined at this facility:
SAND & TOPSOIL
8) Is this mine an inactive mine site?
No
❑ Yes If yes, do you posses an "Inactive Renewal" from DLR and notified the DWQ Regional Office or
have you certified to the DWQ that the site has been stabilized? ❑ No ❑ Yes
9) Does this facility already have a valid Mining Permit from the Division of Land Resources (DLR)?
No If No, please indicate the status of the Mining Permit application: SUBMITTED OCTOBER 2011
❑ Yes if yes, please provide the Mining Permit number: Please also provide a
copy of your DLR Mining Permit with this DWQ application.
Note: DWQ cannot issue a COC for the NCGO20000 General Permit until a Mining Permit is issued or
renewed by the Division of Land Resources (DLR).
10) Does this facility have any other NPDES permits?
❑ No
V Yes If yes, list the permit numbers for all current NPDES permits for this facility: _STORMWATER
SUBMITTED NOVEMBER 2011
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
No
❑ Yes It yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does total area of this mine site include ready -mix and asphalt areas?
V No
❑ Yes If yes, de they have DWQ stormwaler permits (if owned by the same company)? ❑ No ❑ Yes
(provide permit number )
If not owned by the same company, who is the owner?
13) Will this mining operation precede development activities at this site?
v No
❑ Yes
14) Is this mine located within one of the 20 Coastal Counties and will it add more than 10,000 ft2 of impervious
surface?
Page 3 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N.O.I.
❑ No
Yes If yes, you may be required to apply for an additional state stormwater permit. Check with your
local Regional Office. See contact information and checklist below.
15) Is this mine located the Neuse, Tar -Pamlico, or Catawba River Basin, or the Randleman or Jordan
Water supply Watersheds?
No
❑ Yes If yes, what size stream buffers are included on site? ft. Please show buffers in site plans.
Discharge Points, Receiving Waters & Wetlands:
16) Receiving wafers:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges end up in? CHOWAN RIVER
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
Receiving water classification (if known): B. NSW___
Note: Discharge of process wastewater to receiving waters classified as WS-11 to WS-V or SA must be
approved by the N.C. Dept. of Environmental Health. If DEH does not approve, coverage under
NCG020000 cannot be granted. No new discharges of wastewater are permitted in receiving
waters classified as WS-1 or freshwater ORW. Wastewater discharges to Saltwater ORW witl
not be approved under the NCG02 General Permit.
17) If your facility has wastewater discharges and they are to HWQ, PNA waters (Primary Nursery Areas) waters,
what is the flow rate? _ (See i�ttf�:/fwww ncclsr�f.net/r�napsl)_f A_tri�3psi'tncfex_htrjjj, for map)
18) Discharge Points:
Number of discharge points (ditches, pipes, channels, etc. that convey discharges from the property):
Onsfte: Stormwater: _1 Mine dewatering: Process Wastewater Overflow:
Offsite: Stormwater: Mine dewatering: Process Wastewater Overflow:
Discharge points should be clearly marked on the submitted site plan.
Please provide short narrative description of discharges:
25 year stormwater overflow discharge only. Rainwater will drain back into excavation during normal
operations. Overflow will be sheet -flow rate across flat -top berm, or through notched spillway lied with riprap,
a) Is your mine dewatering and discharging? (Answer only if you are dewatering)
V No
❑ Yes If yes, where to? Surface Waters and/or Wetlands (on -site or off -site)
Other (on -site or off -site) Describe:
b) Are you dewatering but not discharging? (Answeroniy if you are dewatering)
No
❑ Yes if Yes, please explain how you are dewatering, and where that water will be directed:
Page 4 0# 9
5WU-NCG02-NOI Last revised 6l712010

NCG020000 N.0.1.
19) Will mining operations require dewatering near wetlands or impact any stream, groundwater, or wetlands?
v No
❑ Yes
Note: 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 (O&M) Plan that has been approved by the
Division.
For sites that may drain wetlands — approval of a Pumping O&M plan maybe required prior to
coverage under this general ep rmit, The Pumping O&M flan should be submitted to the
appropriate Regional Office and must 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 end of document. Contact your local Regional Office for questions specific to your mine.
20) If you are dewatering, are there wetlands or surface waters within 400' of the mine pit perimeter?
V No, but wetlands are within 400' of mine pit, no dewatering
❑ Yes If yes, what distance are they from the mine pit perimeter? feet.
21) Have you been required to obtain a 404/401 Certification permits?
❑ 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:
attached
22) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ No V Yes If yes, please attach to application submission.
Stormwater BMPs:
23) Does this facility employ any best management practices for stormwater control?
❑ No V Yes If yes, please briefly describe: attached
24) Does this facility have a Stormwater Pollution Prevention Plan?
V No ❑ Yes
If yes, when was it implemented?
25) Will vehicle maintenance activities occur at this facility?
-\ No ❑ Yes
Page 5 of 9
SWU-NCG02-NOI Last revised 6/7/2b10

NCG020000 N.O.I.
Wastewater Treatment Facilities:
26) Will mine dewatering discharges occur? (An ATC/ATO is required for wastewater treatment facilities'
dewatering discharges where E&SC devices alone will not meet effluent limits and/or protect water quality
standards).
-, No r rc�.�, � � : 3 c. Xe_y-5-CS La.n (Q & 14P��-j
El Yes +�u� , �„4.� a) "I
E-a 1 (?.4A t'L
27) Will discharges of overflows from process wastewater treatment systems occur? (ATC or ATO required,
unless closed -loop recycle system) ` L
V No J �r A�� V_)QLSL h�M) o� Yv�G.0
❑ Yes i � a S � 0)r-a-.►:. T,7 A,'. lL .c.r4-+c t- a-C4,xe- i
If yes, answer the following questions for each wastewater treatment system:
a. Please describe the type of process used to treat and/or recycle the process wastewater. Give
design specifics (i.e. design volume, retention time, surface area, etc.). Existing treatment facilities
should be described in detail, and design criteria or operational data should be provided (including
calculations) to ensure that the facility can comply with requirements of the General Permit. [Use
separate sheet(s)]
b. Does this facility employ chemical additives to flocculate suspended solids? ❑ No ❑ Yes
It yes, please state the name, manufacturer and the quantity of average daily usage of the
chemical additive
Note: Please see our website for a fist of evaluated potyacryfamide (DAMS) products for use in North Carolina.
C. Does this facility overflow only during rainfall events exceeding the 0-y11r, 24-hr rainfall event?
❑ No Yes, possibly 4-5 0) a-s
28) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
No
❑ Yes If so, include information to demonstrate protection from flooding. (Minimum design requirements for
treatment works include protection from the 100-year flood, per 15A NCAC 2H .0219.)
Other:
29) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg, of hazardous waste generated per month) of
hazardous waste?
v No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
-\/ No ❑ Yes
A If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
Page 6 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N.0.1.
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:_
Vendor address:
30) Are you applying for a mining permit in the same location as a previously permitted mine?
❑ No I/V* ( I -t- L Q 19Rx trn L � O - � ;r,q .
Yes If yes, specify permit number and name if known: Eure Sand Mine, appi submitted Oct.2011, pending
31) noes your site have an active landfill within the mining permit boundary?
No
❑ Yes If yes, specify type: ❑ LCID ❑ Other:
32) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? See permit
text online for secondary containment requirements.
No
❑ Yes
Final Checklist:
This application_ will be returned as incomplete unless all of the following items have been included and
initialed for. Please show that the following required information has been included by initialing in each
space below.
Fee of $100 made payable to NCDENR
Completed application and all supporting documents
Copy of the valid approved mining permit (MP) for the facility or indication of MP application status
Copy of a county map or other general location map that shows the mining site and nearest major roads
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.
2 copies of large-scale site plan with topographical lines with all outfalls, applicable buffers and wetlands
clearly delineated
A copy of your DLR mining permit
A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 22 above.
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 State
Stormwater permit. Regional Office Contact:
Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas and total drainage area.
If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the following and contact your local regional office about a Pumping O&M Plan (see below
for contact information). You may be required to provide an approved Pumping OEM plan priorto
NCG02 issuance.
2 copies of detailed Full Size Plans delineating areas on the plans and fistigg acrea a (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),
Well information (design, depths, maintenance)
Physical monitoring for the wetlands areas
Settling pond sizing information, if applicable
Page 7 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N-0.1.
Level spreader design, if applicable
Details about dewatering method
Cone of influence calculations
Description of measures to prevent erosion and flooding
Description & information about 401/404 permits that have been obtained
Copy of US Army Corps of Engineers wetland delineations or approved wetland delineation (if
applicable)
—1 have contacted my local regional office about a Pumping O&M Plan.
Regional Office Contact: . Date contacted:
I will not any impact nearby wetlands, surface waters or groundwater by dewatering.
If an ATC or ATO is required, three (3) sets of plans, specifications, and design calculations, signed, seated,
and dated by a P.E. ATC and ATO requirements in NCG02000 are summarized in Table 1 on Page 2 of
this NOl (see the permit text for more details). Plans shall show all pertinent design features, including the
location of the outfall(s). If stormwater is flowing off -site, the plan must show that stormwater will not be
mixed with wastewater.
Certification: North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document tiled or required to he maintained under this Article or a rule implementing this Article; or who knowingly makes a lalso
statement of a material tact in a rulemaking 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 tine not to
exceed ten thousand dollars ($10,000).
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
protection 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.
Page 8 of 9
SWU-NCG02-NO) Last revised 6/7/2010

NCG020000 N.O.I.
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: John R. Lane, Jr.
Title: Aoollcant / Owner
of
November 8 2011
(Date Signed)
Notice of intent must be accompanied by a check or money order for $100.00 made payable to NCDENR.
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office
.,. [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office
... [phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 9 of 9
SWU-NCG02-NOI Last revised 6/7/2010

s„j`T�t��13
IGa,,
OPERATION AND MAINTENANCE PLAN
SAND MINE EXCAVATION — EMERGENCY OVERFLOW P P [ _ P I 0
Operator: John R. Lane, Jr., 433 Gates School Road, Gates, NC 27937
Job Location: Eure Sand Mine, Fort Island Road (SR 1120), Rt. 1, Eure, NC NOV 3 0 2011
County: Gates County
Prepared by: Ken Elliott, consultant DWQ—� /, ►ARO
Date: November 17, 2011 {/ �/
This plan defines responsibilities for operating the Eure Sand Mine safely, and that overflow wastewater
will not degrade or negatively impact any wetlands or waters of the state.
Description and Operation of the Eure Sand Mine:
Eure Sand Mine will be a group of 6 new excavations totaling 18.82 acres located 2.1 miles south of
Eure, NC on high sandy land adjacent to pocosin wetland. At this time Mr. Lane is filing an application
with DLR for a new permit for this excavation, along with a Nationwide 14 permit from the US Army
Corps of Engineers and a Stormwater Permit from NCDENR.
Because of adjacent wetlands on the tract Mr. Lane will be required to maintain a 50ft wide undisturbed
buffer (no mining activity) and a 25ft wide unexcavated buffer (may contain berms & roads) between
any excavation and the adjacent pocosin wetlands. The excavation areas and buffers will be carefully
marked to prevent mining activity from occurring outside of designated areas. Mr. Lane will be
constructing a sand berm around the perimeter of all unexcavated buffers so that all rainfall inside the
mining activity areas will drain back into the excavated pit instead of into the adjacent wetlands.
Sedimentation and Erosion Control
Temporary sand berm around perimeter of excavation area will be constructed with 3:1 slope on inside
and 2:1 slope on outside, with 2ft - 4ft flat top. Slopes will be sowed with ground cover after
construction for coverage within 7 days.
Berms & Rainfall Overflow Protection
During normal operation, rainfall on processing areas and interior roads will drain back into the
excavated pit. During times of excess rainfall causing larger than designed peak flows, 2 types of
overflow protection will be used.
1. A level topped vegetated berm crest will be constructed on the entire berm system around each
excavation area. This provides a very flat berm top so that water will overflow along the berm
length in a thin layer so as not to create erosion problems.
2. A notched spillway will be located at the lowest end of each berm system and will be lined with
rock riprap and vegetation. This emergency spillway will be designed so that it will safely carry
the maximum expected flow from a 25-year storm.
N11

Maintaining the Berm System
Inspections and maintenance are required to obtain the intended function of the berm system, and to
maintain the life of any adjacent wetlands or waters of the State. Items to inspect and maintain during
the 10 year life of the mine permit are:
• 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 spillway structures in berms regularly, replace dislodged rock as necessary.
Monitoring the Process and Effects of Dewatering
Analytical and qualitative monitoring of overflow mine wastewater will be in accordance with the
NCG020000 permit, as follows:
• All ponds in the Eure Sand 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 following
significant (1/2-inch) rainfall events for damages, and all structures will be repaired immediately.
• Special inspections will be conducted immediately following severe storms, vandalism, and
other significant events.
• Overflow of mining wastewater after severe storms will be monitored bi-annually at three
stream sites on the property, located inside the wetland areas. Water samples (grab samples)
will be tested for pH, 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.
Records
Data will be collected as follows:
• Data will be collected from samples taken from wetland sampling sites after severe storm
events causing overflow from the excavation areas.
• Elliott Consulting will maintain the following records in a permanent file at the Elliott Consulting
office at 622 Rocky Hock Creek Road, Edenton, NC 27932, 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 excavating Eure Sand Mine
will not degrade or negatively impact any wetlands or waters of the State.
Signed,
Ken Elliott
for John R. Lane, Jr.
November 17, 2011

Sand Berm with Overflow Rock Baffle / Weir
Practice Standards and Specifications 6.87 -- Check Dam with Weir
Eure Sand Mine
Rt. 1, Eure, NC
Gates County
3FF X BfT
SANDIER■
IFTSANO 1ERE
3"XO T
SAND {ERE
Definition: Small stone dam structure with a weir outlet with sediment storage area on the upper side, installed in
sand berm.
Purpose: To reduce erosion in overflow drainage outlet during major rainstorms by reducing velocity of flow, and
provide sediment control.
Siting: To be placed at lower end of sand mine disturbed area perimeter berm (8ft x 3ft sand berm).
Aggregate Size: NC DOT Class B stone lined with NC DOT ##5 or ##57 stone on upper side.
Construction Specifications: Keep center stone section 6 inches below top of sand berm. Place sediment control stone
minimum 1ft thick on upstream side of berm at weir. Provide 9ft long stone apron on lower side of berm to flush with
surrounding grade.
Maintenance: Inspect check dams weekly and after significant rainfall and repair immediately if needed. Clean out
limbs, sediment and other debris that could clog the weir. Add stones to check dam to maintain correct height.
Maintain vegetative ground cover on berm, repair berm erosion as needed.
Ken Elliott, consulting
November 17, 2011
k:

North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue, Governor
Date November 8, 2011
Name of Property Owner Applying for Permit:
John R. Lane. Jr.
Mailing Address:
433 Gates School Road
Gates NC 27937
Dee Fryman, Secretary
1 certify that 1 have authorized (agent) Ken Elliott to act on my
behalf, for the purpose ol'applying !or and obtaining all 1)%VQ / USACE Permits to
install or construct (activity) excavate and mine sand and topsoil
at (any property located at) Fort Island Road, Rt 1, Eure NC in Gates County
This certification is valid thru (date) November 8, 2021
Date

p4. wnrR
�o` pG Office Use Only:
r Corps action ID no.
i , �, r o DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: ®Section 404 Permit U Section 10 Permit
1 b, Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? Z Yes ❑ No
14 Type(s) of approval sought from the DWQ (check all that apply):
S 401 Water Quality Certification -- Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. is this notification solely for the record
For the record only for DWQ 401
For the record only for Corps Permit:
because written approval is not required?
Certification:
❑ Yes ❑ No
❑ Yes
❑ No
If. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
❑ Yes
® No
of impacts? It so, attach the acceptance letter from mitigation bank or in -lieu
fee program,
i g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
® Yes
❑ No
below.
1 In. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑Yes
® No
12. Project Information
2a. Name of project:
Eure Sand Mine
2b, County:
Gates
2c. Nearest municipality 1 town:
Eure, NC
2d. Subdivision name:
rvur 1)
2e. NCDOT only, T.I.P. or state
project no:
1 A
3a.
Name(s) on Recorded Deed:
J. Roger & Rita Lane, George Mac Miller, Charles T. Honer
3b.
Deed Book and Page No.
00 263 PG 640, DS 284 PG 246
3c. Responsible Party (for LLC if
applicable):
3d.
Street address:
PO Box 485
3e.
City, state, zips
Galesville, NC 27938
3f.
Telephone no.:�
3g.
Fax no.:
3h.
Email address:
ritalaneZembargmaii.com
Page 1 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent El Other, specify: Son
John R. Lane, Jr.
4b. Name:
4c.
Business name
(if applicable):
Lane Farms
4d. Street address:
_
433 Gates SchoolRoad
4e.
City, state, zip:
Gatesville, NC 27938
4f.
Telephone no.:
[phone], [phone]
4g.
Fax no.:
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Ken Elliott
5b.
Business name
(if applicable):
Elliott Consulting
5c.
Street address:
622 Rocky Hock Creek Road
5d.
City, state, zip:
Edenton, NC 27932
5e.
Telephone no.:
[phone], [phone]
5f.
Fax no.:
5g. Email address: T
ken [e-mail]
Page 2 of 10
PCN Form — Version 1.3 December 10, 2008 Version

B. Project information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel iD):
0200505, 0200252
Latitude: 36.3972 Longitude: - 76.8594
1 b. Site coordinates (in decimal degrees):
(DD.DDDDDD) (-DD.DDDDDD)
1 c Property size:
322.6 acres (total 2 parcels) acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Chowan River
proposed project:
2b. Water Quality Classification of nearest receiving water:
B; NSW
2c. River basin:
Chowan
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
High sandy land interspersed with pocosin wetland, mostly logged over woodland with some full growth woodland
remaining.
3b. List the total estimated acreage of all existing wetlands on the property:
173,0 acres (total 2 parcels)
3c. List the total estimated linear feet of all existing streams'(intermittent and perennial) on the property:
None
3d. Explain the purpose of the proposed project.
Sand mine excavation, 6 ponds to be excavated at this tune for sand & topsoil
3e. Describe the overall project in detail, including the type of equipment to be used:
Attached
4. Jurisdictional Determinations
4a, Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property !
ED Yes ONO ❑ Unknown
project (including ai( prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
❑Preliminary ®Final
of determination was made.
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: True Line Surveying, PC
Name (if known): Curk T. Lane
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
August 13, 2010
S. Project History
5a. Have permits or certifications been requested or obtained for EY
® Nathis ❑Unknown
project (including all prior phases) in the past?
5b, If yes, explain In detail according to "help file" instructions.
Mining permit application submitted to NCDLR in Sept 2011
6. Future Project Plans
6a. is this a phased project?
®Yes ❑ No
6b. If yes, explain.
Phase 1:18.82-acres excavation proposed start immediately; Phase 2- approximately 16-acres excavation planned after
completion Phase 1; Phase 3: approx 7-acres excavation planned after Phase 2.
Page 3 of 10
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
2 Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.—
Wetland impact
Type of jurisdiction
number --
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non-404, other)
(acres)
Temporary T
W1 ®P ❑ T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.046
W2 ®P ❑ T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.139
W3 M P 0 T
Direct
Pocosin
❑ Yes
® No
© Corps
® DWQ
0,242
W4 ®P ❑ T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.015
W5 ®P ❑ T
Direct
Pocosin
® YVos
® Corps
0.012
W5 ❑ P ❑ T
❑ No
E) Corps
❑ DWQ
0A28
2g. Total wetland impacts
0,482
2h. Comments; All impacts are linear - access 7 haul roads for mining equipment.
3. Stream Impacts
if there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e,
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non-404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑P❑T
❑PER
❑Corps
❑ 1NT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
$4 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h, Total stream and tributary impacts
3i. Comments:
Page 4 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4. Open Water Impacts
It there are proposed impacts to takes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b. 4c,
4d.
4e,
Open water
Name of waterbody
irapact number—
{if applicable) Type of impact
Waterbody type
Area of impact (acres)
ermanent (P) or
�emporary
TT
01❑P[1T
—02 ❑P❑T
---
03 ❑P❑T
04 ❑P❑T
=if. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d,
5e:
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments;
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i, Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWO)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. It anv irnaacts require miticlation, then you MUST tilt out Section D of this form.
6a,
Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico
❑ Catawba ❑ Randleman
❑ Other:
6b. 6c. 6d. 6e. 6f, 6g.
Buffer impact
number — Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
j Temporary (T} impact required?
B.t ❑ P ❑ T
❑ Yes
❑ No
62 ❑P❑T
❑Yes
❑ No
63 ❑ P ❑ T
❑ Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 5 of 10
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize theproposed._.._...n _ sig
p y impacts in designing project.
Sand road crossing wetlands at narrowest points, using pre-existing roads; access roads will level flow -across roads with
culverts
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Install heavy duty silt fence along perimeter of roads crossing wetlands, install 12in culverts every 200ft through wetlands.
2. Compensatory Mitigation for Impacts to Waters of the U,S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
® Yes ❑ No
21). 1i' yes, mitigation is required by (check all that apply):
❑ DWQ ® Corps
2c. If yes, which mitigation option will be used for this
projects
❑ Mitigation bank
❑ Payment to in -lieu fee program
® Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) hype Quantity
3c, Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. if using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d, Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland rnitrg€ ddon requested; �
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a, if using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Owner will be requesting USAGE Wilmington District to hold conservation easement of 5.0 acres for the site.
Conservation declaration will be added to property deed and attached to this application.
Page 6of10
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) -- required by DWO
6a. Will the project result in an impact within a protected riparian buffer that requires ❑ Yes ®No
buffer mitigation?
6b. ff yes, then identify the square feet of impact to each zone of (fie riparian buffer that requires mitigation. Cafcu(ate the
amount of mitigation required.
6c.
6d.
6e.
Zone Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
-- --
---- t.3 — ---- - —
6f. Total buffer mitigation required:
6g, if buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee Fund).
6h. Comments' _I
Page 7 of 10
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse flow Plan (required by DWQ)
1. Diffuse flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
❑Yes EJ No
within one of the NC Riparian Suffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? if no, explain why.
❑Yes No ❑
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
3.54°% incl unexcavated buffers %
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. if this project DOES NOT require a Stormwater Management Plan, explain why: Low percentage impervious surface
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
® DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Govemment Stormwater Review
3a. In which local government's jurisdiction is this project? Gates County, North Carolina
❑ Phase 11
❑ NSW
3b. Which of the following locally -implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
® Other: LAMA Core Use Land
Program
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4, DWQ Stormwater Program Review
® Coastal counties
❑ HOW
4a, Which of the tollowing state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
®'yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
[] Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.3 December -10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWO Requirement)
1 a.
Does the project involve an expenditure of public (fed erallstate/local) funds or the
❑ Yes
® No
use of public (federal/state) land?
1 b.
If you answered "yes' to the above, does the project require preparation of an
environmgntal document pursuant to the requirements of the National or State
❑ Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
if you answered "yes' to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
j
❑ Yes
❑ No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
if you answered `yes` to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. if you answered "no," provide a short narrative description.
4.
Sewage Disposal (DWQ Requirement)
4a.
Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater
generated from
the proposed project, or available capacity of the subject facility.
No sewage disposal on property.
Page 9 of 10
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ® Yes ❑ No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ® Yes No
impacts? ❑
® 5c. If yes, indicate the USFWS Field Office you have contacted. Raleigh
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS Species Report for North Carolina
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes 1Z No
6b. What data sources did yeu use to determine whether your site would impact Essential Fish Habitat?
NOAA Essential Fish Habitat Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ❑ Yes No
status (e.g., National Historic 'Crust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Trust for Historic Preservation, NC Dept of Cultural Resources, NC Office of State Archaeology
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FE MA -designated 100-year floodplain? To Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: Berms around excavations, stormwater & wastewater plans riled
8c. What source(s) did you use to make the floodplain determination? Floodplain Mapping Information System
John R. Lane, Jr.
Nov. 8, 2011
ApplicantlAgent's Printed Name
Date
Applic VAge ignature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
_J
Page 10 of 10
RCN Form — Version 1.3 December 10, 2008 Version

This certifies that there are no delinquent ad valorem
real estate taxes, which the Gates County Tax Collector
is charged with collecting, that are a lien on PIN 02-00505.
This is not a certification that the PIN # matches the
deed description.
Date c T Col le)frax Clerk
Record:
$17.00
Stamps:
$1,100.00
Return:
Godwin & Godwin
NO OPINION ON TITLE IS RENDERED BY
GODWIN & GODWIN WITHOUT A SEPARATE
WRITTEN OPINION ON TITLE FROM
GODWIN & GODWIN
STATE OF NORTH CAROLINA
GATES COUNTY
FILM in GATES Cows NC
on Nov 07 2007 of 0410:52 PM
by: swim G. F1AFiliE1 to
PEGISTER OF I
t 263 PAGE fi40
Prepared by: Philip P. Godwin, Jr.
Attorney at Law
P. O. Box 44
Gatesville, NC 27938
TEL: r252j 357-0438
F.6 K (252) 357-D01 ?.
lecued Nuv 'u7 2007
0 IJ00.00
.a Slot$ of GATES
al Norfh Car-oli:rm cowry
Real Estate Exdeo Tax
WARRANTY DEED
THIS DEED, Made and entered into this 7th day of November, 2007, by and
between EUGENE N. JORDAN, INC., Grantor, with its principal office and place of
business at 402 Sign Pine Road, Tyner, North Carolina 27980 to J. ROGER LANE
AND RITA H. LANE, TRUSTEES FOR J. ROGER LANE DECLARATION OF
TRUST AND J. ROGER LANE AND RITA H. LANE, TRUSTEES FOR RITA H.
LANE DECLARATION OF TRUST, Grantees, P. O. Box 187, Gates, North Carolina
27937.
W-I-T-N-E-S-S-E-T-H
That the grantor for a valuable consideration paid by the grantee, the receipt
of which is hereby acknowledged, has and oy these presents does grant, bargain,
sell and convey unto the grantee in fee simple, all that certain lot or parcel of land
situated in the Hall Township, Gates County, North Carolina, and more particularly
described as follows:
Bounded and described according to a survey made thereof by T. J.
Jessup on October 28, 1970, generally as follows. -
Lying to the westward of and abutting NCSR 1120 which leads from
NCSR 1118, the Eure's Christian Church Road to Raye's Beach;
bounded on the North by the lands of Mrs. W_ J. Foreman; bounded on
the West by Union Camp Corporation', bounded on the Soufh by Union
Camp Corporation; Mrs. Mary Horton and the D. C. Eure Estate;
bounded on the East by the aforesaid NCSR 1120. 'The said tract of
land contains 274.8 acres according to said survey.
The above -described tract or parcel of land is the same which was
conveyed to Eugene N. Jordan by deed of Kenneth C. Brack et als,
dated July 20, 1971, and recorded in the Office of the Register of
Deeds of Gates County in Book 110, Rage 70. Reference is also made
to deed from Jamie K. Eure et ais, dated May 3, '1971, recorded in the
Office of the aforesaid Register of Deeds and plat entitied "l), R. Eure
Estate, Fort Island Tract''.
RECEIVED
NOV 3 0 2011
DWQ-WARD
Book 263 Page 640

8" 263 PAGE 641
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges
and appurtenances thereto belonging to the grantee in fee simple absolute.
And the grantor covenants with the grantee, that grantor is seized of the
premises in fee simple, has the right to convey the same in fee simple, that title is
marketable and free and clear of all encumbrances, except restrictions, covenants,
conditions, and easements of record, and that grantor will warrant and defend the
title against the lawful claims of all persons whomsoever.
IN WITNESS WHEREOF, EUGEIvE W JORDAN, INC., ha" caus d-this deed
to be signed by its duly authorized officer by authority of its Board of Directors and
with the specific intent that this deed is executed as an instrument under seal, the
day and year first above written.
EUGENE N. JORDAN, INC.
By: - '�- Cf_ ' `
___(SEAL)
PRESIDENI� �
NORTH CAROLINA, GATES COUNTY
I, Fleda P. Eure, a Notary Public of the County and State aforesaid, certify that
EUGENE N. JORDAN, JR. personaliy came before me this day and acknowledged
that he is President of EUGENE N. JORDAN, INCO., P, corporation, and that he, as
President, being quthor�zed to do so, executed the foregoing on behalf of the
corporation.
WITNESS my hand and official seal or stamp, this 7th day of November, 2007
My commission expires: 3/25/11
I
NOTARY PUBLIC
Book 263 Page 641

Filed: 04/09/2010 11:52:10 AM
SHARON G. HARRELL, Register of Deeds
Gates County. NC
asp b • �A
Excise Tax: $250.00
Return: Godwin & Godwin
This certifies that there are no delinquent ad valorem real
estate taxes, which the Gates County Tax Collector is
charged with collecting, that area lien on:
PIN# Get - 0 J a 5�
Gates County Tax Department. This is not a
certification that the PIN# matches the deed description.
Date Tax CollecN/Tax Clerk
e orc 28a PAGE 246 (3)
Record: $25.00
Excise Tax: $250.00
Prepared by: PHILIP P. GODWIN, JR.
a licensed North Carolina attorney
Attorney at Law
110 Court Street
Gatesville, NC 27938
TEL: [phone]
FAX:[phone]
NO OPINION ON TITLE IS RENDERED BY GODWIN & GODWIN
WITHOUT A SEPARATE WRITTEN OPINION ON TITLE FROM
GODWIN & GODWIN
NORTH CAROLINA
WARRANTY DEED
GATES COUNTY
THIS DEED, Made and entered into this I day April, 2010 by and between
IRMA HORTON GRANT et Ar BOBBY GRANT,1400 NC 137, Eure, North Carolina
27935; LESSIE HORTON PERNELL et vir JIMMY 0. PERNELL., 1349 NC 137,
Eure, North Carolina 27935; BESSIE HORTON FUTRELL et vir WAYNE
FUTRELL, 9651 US Hwy 258, Murfreesboro, North Carolina 2.7855, and CATHY
HORTON, Unmarried, Taylor Mill Road, Eure, North Carolina 27935, Grantors, and
CHARLES THOMAS iHOFL.ER, .IR. 181 NIC 37 South, Gatesville, North Carolina
27938; J. ROGER. L.AiNE AND RITA H. LANE, TRUSTEES FOR J. ROGER LANE
DECLARATION OF TRIJ I�T AND J. ROGER LANE AND RITA H. LANE,
TRUSTEES FOR RITA K. LANE:. DECLARATION OF TRUST, D. 0.. Box 187,
Gates, North Carolina 27937; and GEORG'E MAC MILLER, 310 NO 137, Gatesville,
North Carolina 27938, Grantees, a one-third undivided interest each.
W-1-T-N--E-S-S-E-T-H
That th,? cm --tors fora valuable consideration paid by the grantees, the receipt
of . which is hereby ackrm6-Idged , have and by these presents do grant, bargain,
sell, and convey unto. the Grantees in fee sirnple, all that certain lot or parcel of land
Book 284 Page 246

BK 284 PG 247 DOC#301632
situated in the Hall Township, Gates County, North Carolina and more particularly
described as follows:
It being the same tract or parcel as conveyed by deed of gift dated July
30, 1975 from Mary E. Horton to her children, Irma H. Grant, Lessie H.
Pernell, Catherine Horton, and Bessie H. Futrell as shown in Book 114,
Page 270 of the Gates County Registry and described therein as
follows: Lying to the westard of NCSR 1112, which leads from Eure's
Christian Church to Ray's Beach. Said tract or land is bounded on the
North oy`the lands of J. H. Eure; bounded on the East by the lands of
T. E. Eure;; bounded on the South by the lands of 0. R. Eure, D. C.
Eure and others, and bounded on the West by the lands of J. H. Eure.
For further chain of title, reference is made to Book 87, Page 264, deed
from John R. Eure and wife, Annie Eure to Lester L. Horton and wife,
Mary E. Horton. Reference is made to Book 100, Page 543, Book 43,
Page 345. and Book 50, Page 455.
The grantees, J. Roger Lane and Rita H. Lane, Trustees for J. Roger
Lane Declaration of Trust and J. Roger Lane and Rita 11. Lane,
Trustees for Rita H. Lane Declaration of Trust, have a right-of-way as
shown in Plat Cabinet 2, Slide 191, Plat 1 which is a non-exclusive
right-of-way which will serve as access to all grantees for the purpose
of ingress and egress to and from the subject parcel.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges
and appurtenances thereto belonging to t,ha grantees in fee simple absolute.
And the grantors covenant with the grantees, that grantors are seized of the
premises in fe:,= simple, f-.,ave the right to convey tne: same in fee wimple, that title is
marketable and free and clear of all encurnbrances, except restrictions, covenants,
conditions, and easements of record or evidenced by an on -the -ground inspection,
and that granters wilt warrant and defend. the tif.le against the lawful claims of all
persons whomsoever.
IN WITNESS WHEREOF, the ,grantors have hereunto set their hands and
seals, the day and year first above written.
X--9-v L —.4EAL)
IRMA HOR'roN GRANT 4
ZL
(S EAL)
BOBBY GRANT
(SEAL)
LESSIE HORTON P�NELL
(3 EAL)
JOMY 0-16ERNELL.
_(SEAL)
FIG;�SIE HORTON FUTRELL
Book 284 Page 247

BIB. 284 PG 248 DOC#301632
(SEAL)
V1,'AY E F•U ftRt_ LL
(SEAL)
CATHY KORTON
STATE OF NORTH CAROLINA, GATES COUNTY
I, Fleda P. Eure, a Notary Public for said Count., and St ate, do hereby certify
that IRMA HORTON GRANT et vir BOBEAY GRANT•, LESSIE HORTON PERNELL
et vir JIMMY 0. PERNELL; BESSIE HORTON FUTRE I._ et vir WAYNE FUTRELL;
and CATHY HORTON, Unmarried, Grantors, personally appeared before me this
day and acknowledged the execution of the foregoing instrument. Witness my nand
and official starnp or sea!, this 9th day of April, 2010. My commission expires:
3125/11
NOTARY PUBLIC
��pVaLtiC..
00
Book 284 Page 248

NORTH CAROLING
MINING PERMIT APPLICATION
State of North Carolina
Department of Environment
and Natural Resources
Division of Land Resources
Land Quality Section
RECEIVED
NOV 3 0 2011
pWQ-WARO
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: Januaii- 30, 2008

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
Name of Mine Eure Sand Mine County
River Basin Chowan
Latitude (decimal degrees to four places) 36,3972
Longitude (decimal degrees to four places)-76.8594
2. Name of Applicant* John R. Lane, Jr.
Permanent address for receipt of official mail** 433 Gates School Road, Gates NC 27937
Telephone ( 252 ) 357-1279 Alternate No. ( 252 ) 398-7708
4. Mine Office Address 433 Gates School Road, Gates NC 27937
Telephone ( 252 ) 398-7708
5, Mine Manager John R. Lane, Jr.
We hereby 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
Print Name John R. Lane, Jr.
Title -- - --- Operator _
Date September 16 2011
This will be the name that the mining permit will be issued to and the name that must be indicated oil the
reclamation bond (security). that corresponds to this site.
** The Land Quality Section must be notified of any changes in the permanent address or telephone number.
*** Signature of company officer required.
G. S. 74-5 l provides that the Department shall grant or deny an application for a permit within 60 days of receipt of
complete application or, if a public Bearing is held, within 30 days following the hearing and the fling 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.

APPLICATION FOR A NI INING 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 urine snap.
A. GENERAL CHARACTERISTICS OF THE MINE
1. Answer all of the following that apply:
® If this is an application for a NEW permit, indicate the total acreage at the site to be covered by the
permit (this is the acreage that the "new permit" fee will be based upon): 322.6 acres
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: 322.6 acres Property owner if leased: J. Roger Lane father Rita H. Lane
(mother), George Mac Miller, Charles T. Hotler, Jr, (partners)
❑ if this is an application for RENEWAL 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 (this is the acreage that the "renewal" fee will be based upon):
❑ If this is an application for a MODIFICATION to a mining permit, indicate the mining permit
number and the total (overall) acreage covered by the existing permit.
Muting Permit No.: Total permitted acreage:
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 ❑. 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:
HHydraulic Dredge ® Front-end Loader & Truck ❑ Shovel & Truck
Dragline & Truck Self -loading Scraper
Oilier (explain): Excavator
4. a. Expected maximum depth of mine (feet) 20 feet
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation, etc.)_
Natural ground.level
b. Expected average depth of mine (feet) 15
-2-

APPLICATION FOR A MINING PERMIT
Has any area(s) at this site been mined in the past? Yes ❑
If yes, when and by whom was this activity conducted?
. /1
6. Number of years for which the permit is requested (10 years maximum): 10 years
13. M A PS
Clearly mark and label the location of your minim operation on six (0) conies of a 7.5-minute quadrangle
and a county highway map. These maps, in addition to six (0) 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, 5"' Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
1V'ww.'_'eolouv. C-11r. c'mle. tic uy
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 G.lS Unit
3401 Carl Sandburg Court
Raleigh, North Carolina 27610
[phone]
1i•'11'�b.11C:Ci('iI.OI't_'i�ltr''!,15��(7nlriCtr`C1C.'lilllll.l7tn11
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. As a reminder, mining permits can
only be issued for up to 10 years; thus, all mine and reclamation maps must only denote those
activities that are intended to be conducted during the life of the mining permit. All maps must be
of a scale sufricient (see minimum requirements listed below) to clearly illustrate the following, at a
In in fin1IIn:
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 ruining
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 l ,000 feet of
the mining permit boundary, must be provided on the mine map.

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.
cl. Map legend:
. 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)
-4-

APPLICATION FOR A MINING PERMIT
A table./chart must be provided on the mine map that clearly fists 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
Access Roads
1.99 acres
Processing Areas
1.79 acres
Mine Excavation
18.82 acres
Unexcavated Bufllers (roads, berms)
7.64 acres
Total Disturbed Acreage
30.24 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
T[IIS APPLICATION FORM (PLEA,VE NOTE THE ITALICIZED QUESTION&STATEMENTS
THROUGHOUT THE FORS. THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS.
- 5 -

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 refer"e►►ce the
sequence to the mine Attach additional sheets as needed.
I . Acquire proper permits from NC Department of Environment and Natural Resources, US
Army Corps of Engineers, & CAMA.
2, Acquire Zoning Compliance .Permit & Special Use Permit from Gates County Dept of
Planning & Development.
3. 2-parcel tract totaling 322.E acres will be permitted. Tracts contain total 173.0 acres wetland
pocosin (delineated 2010).
4. Phase l of project will be construction of 6 excavations totaling 18.82 acres, as follows: Pond
5 (0.49 acres), fond 6 (3.44 acres), Pond 7 (8.10 acres), Pond 8 (4.75 acres), Pond 9 (0.36
acres), Pond 10 (1.68 acres).
5. Phase 2 of project will encompass modification to permit construction of Ponds 1 thru 4
inside of permit area at later time.
6. Phase 3 of project will encompass modification to permit construction of Pond 1 l inside of
permit area at later time.
7. All ponds will be laid out on high land inside the permit area, and will have a minimum 25-ft
unexcavated buffer and a 50-ft undisturbed buffer between the excavation and adjacent
wetlands.
8. Operator will construct a 8-ft wide by 3-ft high sand berm around each excavation area along
the outside perimeter of the unexcavated buffer to prevent offsite sedimentation.
9. Operator will install silt fence along existing access roads through wetlands. Operator will
install silt fence along any new access roads through wetlands per instruction from USACE.
10. Starting with Pond 10, each excavation area will in turn first have topsoil removed down to
2,5 feet below natural ground level and stockpiled, and then sand will be dug from excavation
area by excavator down to average 15 feet below existing natural ground level, and stockpiled
for later removal from premises.
11. At this time there are no plans to dewater any of these excavations.
12. Minimum 2:1 graded slopes will be established around edges of pond area below groundwater
level.
13. Minimum 3 : I graded slopes will be established around edges of pond area above groundwater
level.
14. After excavation and edge sloping is completed, a low In x 8ft berm will be established
around the entire perimeter of the excavated pond, with outside slope graded down to natural
ground level.
15. All slopes above water level will be fertilized and seeded with ground cover per guidelines
fi"om NC Agricultural Extension Service,
16. Internal haul roads and processing areas of main permit area will be leveled and graded to
natural ground level, to be returned to natural field state; any trash or debris cleaned up and
removed.. A 10ft wide field path will remain around the entire perimeter of the excavated
pond for owner access.
17. Access roads & field paths to Fort Island Road will be graded, leveled, and returned to pre-
existing state.
18. Entire affected area inside of main permit area will be fertilized and seeded with groundcover
and will be allowed to return to its pre-existing field state.
19. All silt fence erosion controls will be removed.
20. At end of permit period, affected area returns to pre-existing, natural state.
-6-

APPLICATION FOR A MINING .PERMIT
2, Describe specific erosion control measures to be installed prior to land disturbing activities and during
mining to prevent offsite sedimentation (iiiclndc' ,vl)eci f c plates foi" Sedinieiil and erosimi control for ninie
exccwwion(s), waste piles, accessirnine roads cried process curets), aril give a detailed sequence of
installation and schedule for maintenance of the measures, Locale crud 1cibel all.sednneiil cued c:rosiori
conlrol measures on the whie inap(s) crud proi,icle typical cross-.vectioit. lconsli,itelioti details of each
inea.suire. Engineering designs and calculations are required to justify the adequacy of any proposed
measures.
Operator will construct 8ft wide x 3ft tall temporary sand berm along the outside perimeter of the
unexcavated buffer of each excavation area to prevent oflisite erosion. Berm will be grassed and
stabilized, and will be inspected weekly and repaired as needed.
Operator will establish silt fence erosion control along perimeter ofa]I access roads passing through
wetlands prior to land disturbing activities. Silt fence will either be constructed of standard strength
filter fabric with wire or polymer backing and steel posts set 8 feet apart, or extra strength filter fabric
between steel posts G feet apart. Silt fence will be inspected weekly and repaired as needed.
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes ❑ No®. 1f yes, briefly describe all such processes including any chemicals to be used.
Not applicable.
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 ❑ No Z. Ifj%es•, briefl describe the ncrtiue vTthe disehargeandloccrte
all proposed discharge points (along with their method of stab ilizcilion) on your inhie nicrp(.$).
Not applicable.
- 7 -

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 Z.
If yes, what impact, if any, will mine dewatering have on neighboring wells? Estimated withdrawal rate in
gallons per day: . Locale all existing ►wlls on the mine map(.$) that lice within
500. fret of the pr•ol)osed excavation urea. 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.
Not applicable.
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, NP.DES, Stormwater, etc.) from the Division
of Water Quality, Water Quality Section. In addition, the applicant is required to register water use with
the Division of Water Resources if the operation withdraws more than 10,000 gallons per day and needs a
capacity use permit from the Division of Water Resources if the operation lies in a capacity use area and
withdraws more than 100,000 gallons per day.
Not applicable.
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No 0.
Ifyes, indicate evidence that you have applied for or obtained an air duality 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?
Spraying water from water supply trucks on haul roads and process areas, or hauled & spread by
bucket on excavators will control dust. Stockpiles will also be sprayed with water weekly if
necessary to control dust. Speed limit on access roads will be maintained at I Omph maximum
-8-

APPLICATION FOR A MINING PERMIT
S. 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
Chat 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. Shore all buffer localions and widths on the mine mal)(s).
A 2541 wide unexcavated buffer will be maintained around the excavation of each pond,
adjacent to an undisturbed buffer. This buffer will contain erosion & sediment control berms,
roadways, processing areas, and stockpiles.
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 justif ed. Depending on site conditions, a buffer wider than 50 feet maybe
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 oll buffer
locations and ividihs on the iniiiG
A 50ft undisturbed buffer will be established around the excavation of each pond, and will be
located between the 2541 wide unexcavated buffer of each excavation and wetland pocosin.
6. a. Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries
during mining, Minimum 2 horizontal to I 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.
Landslide or slope instability adjacent to adjoining permit boundaries will be prevented by
construction of graded cut slopes during mining activities. Slopes will have a minimum of 3
horizontal to I vertical gradient.
-9-

APPLICATION FOR A MINING PERMIT
b. Provide a cross-section on the Mille n7crp(s) .for' all fill slopes (berms, ivastepiles, overburderl
disposal areas, ele.), clearly indicating the inlerrded side .slope gradient, installaliorl of any benches
andior .vlol)e dl'ains (wilh suj)1)orinng design it fOl'malron) if needed, and the Method of final
stabilization.
Fill slope cross-section of temporary erosion control berms attached to reclamation and mine
maps and will have minimum 2:1 side slope gradient. Final reclamation fill slope will be
established at edge of cut during reclamation of mine, and will have 4: l side slope gradient.
c. In excavation(s) of unconsolidated (non -rock) materials, specify the angle of all cut slopes including
specifications for benching and sloping. Cross-sectiolr.s for all crrt .slopes nw.st he provided on lire
mine map(S).
Not applicable.
d. In hardrock excavations, specify proposed bench widths and heights in feet. Provide clro.ss-Secllons
of the mine excavation clearly noting the angles of the cul .slopes, +viclths of all safety henches alyd
aline benches, cmd the eaj_�ecled maxinium deplh of the excavation.
Not applicable.
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwellingb)
house, public road, public, commercial or industrial building from any mine excavation. Locale all srrc{r
str7lelrlres on the wine oral) if they are rWfhrn 300 feet of any proposed excavation.
Not applicable. Closest dwelling is 0.4 mile from excavation (direct line across wooded wetland); closest
road is 0.4 mile from excavation (direct line across wooded wetland).
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/cros.s-.s'ection and location of each type of
barricacle to he rtsed Inusl he indicated on the mine
No high wall areas exist in this permit area.
Caution signs, warning signs, no trespassing, and/or keep out signs will be installed at only entrance
to permit area and every 500 feet on permit boundary along Fort Island Road. Excavation area is
located 0.4 mile from nearest public road (Fort Island Road) and is only accessible from single gated
access road.
- ]0-

APPLICATION FOR A MINING PERMIT
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. 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 orr the inhie maps) ar7d provide cross -sections
through all proposed berms or proposed spacing, sizes and .species for tree plan ing.5.
Existing natural growth of pine trees, fields and wooded pocosin wetland around perimeter
of permit area will screen operation from public view. No additional screening planned.
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?
Mine permit area located on private -owned farmland, logged -over woodland and wetland
pocosin. Chowan Swamp Game Lands are located south of permit area but will be separated
by 250 feet of forest & wetlands from any mining activities. There are no anticipated adverse
effects to these Gamelands. One access road to Chowan Swamp Game Lands runs through
this permit area and will be maintained as such by mine operator.
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). Locale the nearest offsite occupied
str7rclure(.r) to the proposed excavation(s) orr the mine map wid indicate its approxh7rate distance to the
proposed excavation.
Not applicable.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ❑ No Z.
If yes, describe these materials, how they will he stored and method of containment in cave of shill. Indicate
the loccrtiorr(s) of all storage facilities on the mine map(s).
Not applicable.

APPLICATION FOR A MiNING PERMIT
D. RECLAMATION PLAN
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 he illustrated on a i'eclaniatioii niap aird must correspond directly ►rich the iinforinnalionn
provided on the niite inap(s). lit addition, design itfornnation, hichidilig typical crass-section.s, of any
permauent channels to he constructed Cis pawl Uf the reclainatioit plait aitd the locafiott(s) f f all pel'maiieni
chamiels must be indicated on the 1'eclanicition slap.
i. Excavated body of water will be left as part of reclamation of each excavation for recreational use by
landowner, minimum 4 feet deep.
2. After mine excavation and removal of sand and topsoil stockpiles, all disturbed land, affected areas
and access and service roads inside the permit area will be leveled and graded away from edge of
excavated mine pit 8 feet until graded area reaches natural level. This will create a low berm located
at the edge of the pit lft high and will extend 8 feet wide away from the pit (see attached cross-
section).
3. All erosion control silt fences along access roads will be removed.
4. Other access roads to excavation area and haul roads will be graded, and returned to original
condition used as farm field access path. Processing areas will be graded and allowed to return to
natural state.
5. Graded land and all affected area will be fertilized and sown with grass seed by rnine operator as per
recommendation by County Agriculture Extension Agent (attached). Ultimately all reclaimed land
from 8ft out from excavation will be returned to pasture, field and farm path.
2. is an excavated or impounded body of water to be left as a part of the reclamation? Yes ® No ❑.
if yes, illustrate the locatioii of the body(v) of �iwler on the reclanlatioit map and provide a scaled
cross -sections) through the proposed hody(s) of ►eater. 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 acid locations of all permanent
barricades must he shown oit the 1'eclamation map.
Not applicable. No excavation in rock.
-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 loccrliorls for such
areas must be provided on the recicunation reap.
No mine site waste areas will exist, topsoil and sand stockpiles only.
a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
No processing facilities exist.
Stockpiles will be totally removed from processing areas; sedimentation berms adjacent to excavated
area are to be removed and will be filled, graded and sloped away from edge of excavated mine pit 8
feet until graded area reaches natural land level. Stockpile areas will be graded and leveled to flat
natural ground level. All stockpile areas will be fertilized and seeded with grass by mine operator at
end of mining operation. Stockpile and affected areas will be returned to agricultural use by
landowner.
All onsite haul roads in immediate vicinity of excavation will be graded and leveled to flat natural
ground level, and then fertilized and seeded with ground cover by the owner. A 1 Oft wide field path
will remain around perimeter of finished pond for owner access
b. Will any on -site roadways be left as part of the reclamation? Yes ❑ No E.
1 f f-es, identify .vrch rocrdiccry s, on the i-eclarrrcrtion mat and pr'o► icle details orrhernranent road arrd dilc]r
line sterhilizcrtion.
Pre-existing access road (2565-ft single lane soil path) from fort Island .Road to main mine site area
will be returned to pre-existing standard during reclamation. The access roads will be constantly
maintained during mining operations, and will be reclaimed by grading, leveling, and repairing
potholes as necessary. Pre-existing ditches will be maintained and repaired as necessary, and returned
to pre-existing standard during reclamation. A 1 Oft wide field path will remain around perimeter of
finished ponds for owner 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 Environment and Natural Resources, Land Quality Section and either
the Division of Waste Management (DWM) or local governing body. If a disposal permit bas been
issued by DWM for the site, a copy of said permit must be attached to this application. All
Ielll��OraYV an[l 11L'1'lllcllle'.11l 1'e'ff,4e disljoSal are'a.�' !]lust he clearly delineerle'd on the Millie map(.$) Cltnd
rec'lcrntcltivn neap, along Ivitlr "r list of helms to be disposed in said areas.
Any and all scrap metal, junk, cables or other such non -original waste materials will be removed from
mine premises by mine operator and disposed of properly at Gates County Landfill, Hobbsville, NC.
All topsoil or sand excavated by minim operation will be removed fi-om premises before reclamation.
No off -site generated waste will be disposed of on -site.
_13_

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 Division of Forest Resources, Department of Environment and
Natural Resources;
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University;
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the Division of Forest Resources, Department of Environment
and Natural Resources,
f N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation;
h. Others as may be approved by the Department.
.LIME - RATE OF APPLICATION (tons/acre):
0,5 ton / acre upon soil test
F'ERTILUZER - ANALYSIS AND RATE OF APPLICATION (pounds/acre).
10.10:10 fertilizer, 430 ibs / acre, Spring, Summer & Fall
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Sees! Types: Seeding Dates: Seeding Kates_
Kentucky Fescue April 250 lbs / acre
Rye Grass November 150 lbs / acre
Bermuda Grass May 85 lbs. / acre
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANCHORING:
Not applicable.
OTH ER VEGETATIVE COVERS — TYPE (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Not applicable.
Revegetation and/or reforestation plan approved by:
Signature _
Print Name
Title
Date September 7 201 1
Agency North Carolina Cooperative Extension Service •_•.,�
_14_

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
I he following bond calculation ivorksheet is to he used to establish an appropriate holed (based llpon cr range
of .5500 to S3,1100 per crffecled acre) for each permitted mine site based 7lpon the acreage approved by the
Depcirtn7enr to he aff(�ctecl duriir�;r die life of the Cmlling permit. I le(7se insert the approxiniale crci jfg for each
a1f)ecl of the initihig operation, ih(y you intend to afect during the life of this niiiling permit (in addition,
please inserl the aU )1•o )rlale reclal77allon costicicre or each cclte oi• rom the Schedule o Reclanualion Costs
provided with this ape) ic•alion form) OR y m eerie defer to the De�)arltnenl to ecdculate your holed for, �cl u hcised
u—pon .your rngr)s and standard recicnnation costs:
AFFECTED RECLAMATION RECLAMA"PION
CATEGORY ACREAGE COST/ACRE* COST
Tailings/Sediment Ponds:
Ac.
X
$
/Ac. _
$
Stockpiles:
Ac.
X
$
/Ac. _
$
Access Roads:
1.99 Ac.
X
$
1800
/Ac. _
$
3582
Processing Area:
.1.79 Ac.
X
$
1800
lAc. _
$
3222
Mine Excavation:
18.82 Ac.
X
$
500
lAc. —
$
9410
Unexcavated Buffers (roads, berms):
7.64 Ac.
X
$
1800
lAc. _
$ _-
13,752
TOTAL AFFECTED AC.:
30.24 Ac.
(TOTAL PERMITTED AC.:
322.6 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 30.24 Ac.
b) Positive Drainage Ac. X $1,500.00 = $
Inflation Factor;
SUBTOTAL COST: $ 29,966
.
0.02 X SUBTOTAL COST: $ 599.32 X Permit Life( I to 10 years): 10
INFLATION COST: S 5993.20
TOTAL COST = SUBTOTAL COST + INFLATION COST = $ 35 959.20
Total Reclamation Bond Cost: S _ 35,900 _
(round down to the nearest $100.00) _
-15-

APPLICATION FOR A MINING PERMIT
F. NOT]FICATION 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 adrriirristrative officer ofeaclr county and municipality in which any part oftlre 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 (lie 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 raining permit boundary) as indicated on the mine nrrp(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 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 13E COMPLETED FOR ALL APPLICATIONS FOR NEW MINING PERMITS
AND ALL MODIFICATIONS OF A MINING PERM IT TO ADD LAND TO THE PERMITTED AREA, AS
REQUIRED BY NCGS 74-50(b1).
SEE THE NEXT TWO PAGES FOR THE "NOTICE" FORM AND THE "AFFIDAVIT OF
NOTIFICATION"

NuriCE
Pursuant to provisions G.S. 74-50(bI) of The Mining Act of 1971, Notice is hereby given that
John R, Lane, Jr. has applied on September 2011
(Applicant Narne) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 m Hication 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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of Eure. NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in _ Gates County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDAWES AND CORRESPONDING
ADJOINING LANDOWNER NAVIES 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
soccifics of the proposed minim activity, please contact the applicant at the following telephone number:
252 398-7708 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
Thomas C. & Nan L. Coxe
613 Court Street, Gatesville, NC 27938
(Addressee/Owner of Record's
Name and Address)
September 7, 2011
(:Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
_John R. Lane, Jr.
(Narne of Applicant: Include Contact Person
& Company Name, if Applicable)
433 Gates SchoolRoad; Gates, NC 27937
(Address of Applicant)
-17-

NOTICE
Pursuant to provisions G. S. 74-50(b ) ) of The Mining Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on _ September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 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 niodification(s) niay be sabnnitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine sand & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of Eure. NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED AIAP .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 arding the
specifics of the vrovosed mininp- activity, olease contact tite applicant at the following telmhone 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- an
NC Wildlife Resources Commission
Div. of Wildlife Management, CIO Isaac Harrold
1722 !Hail Service Center. RaI60i, NC 27699-1722
(Addressee/Owner of Record's
Name and Address)
September 7 2011
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
John R. Lane. Jr.
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
433 Gates School Road Gates NC 27937
(Address of Applicant)
-18-

NOTICE
Pursuant to provisions G.S. 74-50(b1) of The Minim Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-161.2, 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 & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of _ Eure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCAT.tONS*
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 ofland 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 not'
tied (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
soecifics of the proposed mining activity, please contact the applicant at the followiiw 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 an
relevant_ written comments/docilmentation within thurovisions of the Mining Act of 1971 throu,ghout the
application review process until a final decision is made on the application.
Nature Conservancy
4705 University Dr., Ste 290 , Durham, NC 27707 John R. Lane, Jr.
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7, 2011 _ 433 Gates School Road, Gates, NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
- 19-

NOTICE
Pursuant to provisions G.S. 74-50(b I ) of The Mining Act of 1971, Notice is hereby given that
John R. Lane Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land .Resources, North Carolina Department of Environment
and Natural Resources, 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 & topsoil on 18,82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of Eure NC off/near road Fort Island Road
(Direction) (Nearest Town) (NumberlName)
in Gates 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 nronosed mining activity, please contact the annlicant at the followine telenhone number:
252 398-7708 . For information on the mining permit application review process,
please contact the Mining Program staff at [phone]. Please note that the Department will consider anv
relevant written comtnents/documentation within the provisions of the Mining Act of 1971 thrOUghout thethe
application review process until a final decision is made on the application.
Toby Chappell, Gates County Manager
PO Box 148, 200 Court St., Gatesville. NC 27938 John R, Lane, Jr.
(Address ee/0 wner of Record's (Nanie of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7,201 f 433 Gates School Road, Gates, NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
-20-

APPLICATION FOR A MINING PERMIT
AFFIDAVIT OF NOTIFICATION
1, Kenneth C. 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 Environment and Natural Resources, 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 ]eased 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)
Thomas C & Nan L. Coxe
NC Wildlife Resources, Div. of Wildlife Mgmt.___
Nature Conservancy
(Address)
613 Court Street, Gatesville, NC 27038 _
1722 Mail Service Ctr., Raleigh, NC 27699-1722
4705 University Dr, Ste 290, Durham, NC 27707
(Attach additional list if necessary)
1 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.]
Toby Chappell, County Manager PO Box 148 200 Court St. Gatesville NC 27938
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 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(b1) 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.
Signature of Applicant or Agent
Se tember 8 2011
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: John R. Lane, Jr.
Title of person executing Affidavit Agent for John R. Lane, Jr.
a Notary.Public of the County of
State of North Carolina, do hereby certify that
appeared before me this day and under oath acknowledged that the above Affidavit was made by himllter.
Witness my hand and notarial seal, this day of 20
Notary: my Commission expires:
-21 -

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:
Signature
Print Name: J. Roger R Rita I -I, Lane
(Title, if applicable)
Company _
(If applicable
Address: PO Box 485
Gatesville, NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name: John R. Lane, Jr.
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone. ( 252 ) 398-7.708
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
i2inal and
ion, six (61 Conies of all I
reclamal loll ma ms and the appropriate rocessin fee (see next page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Quality Section Central Office at the address fisted on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
-22-

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:
Signature:
Print Name: Charles T. Hofler, Jr.
{Title, if applicable)
Company
(if applicable
Address: 18 f NC 37 South
Gatesville NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name'. John R. Lane, Jr:
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: ( 252 ) 398-7708�
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
One original and five 5 copies of the com leted apl2lication, six G copies of all location ma s mine ma s 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 Environment and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
- 23 -

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
reasonabl}, 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:
Signature
Print Name: George Mac Miller
(Title, if applicable)
Company
(If applica
Address: 310 NC Hwy 13.7 T
Gatesville NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name: John R. Lane, Jr.
Title: Operator -
Company;
Mine Name: Eure Sand Mine
Telephone: [phone]
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
One on-2inal an
leted
a I I
ine m
reclamation ma ps anti 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.Environnient and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of tills application should be directed to the Mining Program staff at (919) 733-
4574.
-24-

APPLICATION FOR A MINING PERMIT
MINING FEE SCHEDULE
A nonretuntlabfe permit application processing; foe when ailing for a new minim; permit. it major permit modification or a renerwal permit is
requires) as follows:
0-25 acres 26+acres
New Permit Applications $3,750.00 $5,000.00
Permit Modifications $750.00 $1,000.00
Permit Renewals $750.00 $1,000,00
Transfers/Minor Modifications* $100.00 $100.00
A nonrefundable S I Ifli.00 pemlit applicalloll processing rce is required for lit Inor permit modifications. 1linor permit modifications include ownership transfem, name
changes, bond sulist Itutious and Imt'nlit reuVW.IIS wilere the mule is inactive mid fully stabiQzed. A mina,• permit modification also I11CllldeS lands added to a permitted area,
outside of the mininnlmn permit bufYt•r zone requirements, where nu pL•111% fin' mining related mstur'bame orate added tends have been approved. All ofher changes arc
considered major permit modifications.
Acres for neiv pennits and renewal permits means file total acreage at the site. Acres for major modificatiol of per7111ts meatus that al•ea of land afrected by the modification
rviltuu tale permitted mine area, orally additional baud that is to be disturbed and added tit ;lit esfsting pel'utitted at•ca, ur both.
-25-

APPLICATION FOR A MINING PERMIT
There are seven Land Quality Section (LQS) 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,
Alacon, Madison, .McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey
• Address: 2090 U.S. Highway 70, Swannanoa, NC 28778
• Voice:828.296.4500
FAX-. 828.299.7043
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: 910,486.0707
Mooresville Regional Office
• Counties: Alexander, Cabarrus, Catawba, Cleveland, Gaston, fredell, Lincoln, Mecklenburg, Rowan, Stanly,
Union
Address: 610 East Center Ave., Suite 301, Mooresville, NC 28115
Voice: 704.663.1699
FAX: 704, 663.6040
Raleigh 7egional 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, Raleigli, NC 27609
• Voice:919.791,4200
Wa:FAX: [phone]
hirtgtosn Regional Office
• Counties: Beaufort, Bertie, 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]
-20-

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:910,350,2018
Winston-Salem Regional Office
• Counties: Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Su", Watauga, Wilkes, Yadkin
Address: 595 Waughtown Street, Winston-Salem, NC 27107
• Voice.-336.771.5000
• FAX:[phone]
-27-

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 = KyanitelSillimariite/Andalusite, PH = Phosphate, CL = Clay/Shale, PE = Peat, A U = 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.
$2000Iac.
$1800/ac.
$5001ac.(L)
Borrow
1500(Fl)
$2000(PD)
CS, DS,
500(L)
1800
2000
2000
500(L)
FS, Ml,
1500(FI)
2500(PD)
L1, PF, OL, KY
PI-1.
I000(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
F'ROIVI A THIRD PARTY CONTRACTOR. SAID ESTIMATE MUST BE PROVIDED WITHIN 30 DAYS TO
TLI E FOLLOWING ADDRESS: Mining Program, Land Quality Section, I612 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)
• MULCti AND ANCHORING COSTS PER ACRE
• ANY OTHER RECLAMATION COSTS NECESSARY TO COMPLY WITH TLIE APPROVED
RECLAMATION PLAN FOR THE SITE IN QUESTION
YOU WILL BE NOTIFIED AS SOON AS POSSIBLE OFTHE DIRECTOR'S FI:NALBOND DETERMINATION.
-28-

A.
Division of Water Quality / Surface Water Protection
,A..'mM�
NCDENln% National Pollutant Discharge Elimination System
tlaerr Gwoutin l)cwnr.�Hr or
Ewviwpw Mcr.i .wn wuuwu. ucsw�.u:s
NCG020000
NOTICE OF INTENT
FoR AGENCY USE. ONLY
Datc Receivtd
Year
Month
Da'
CCRIII Cale nl COV['fi1bC
NICIG10121
Check �i Amnunt
Permit :V%5ignCd tb
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG020000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code -14XX Mineral Mining Industry (except as specified below)
The following activities are also 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 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 Ge t
• Stormwater discharges associated with peat mining, coal mining, and metal miRnECEIVED
• Stormwater discharges from mining operations which are intermixed on site with stormwater from asphalt
operations and/or concrete operations; NOV 3 0 2011
• Stormwater discharges associated with oil and gas extraction operations; and
• Stormwater discharges associated with tourist gem mines
• NCDOT borrow pits are covered under NCS000150 DWQ—Y ARO
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 (i.e., sand
dredaina or dionino operations)
For new mining sites that require an authorization to construct (ATC) wastewater treatment facilities: This
NOI is also an APPLICATION FOR an ATC for new wastewater treatment facilities. ATC requests must be
submitted at least 90 days prior to construction'.
For existing mining sites that require an Authorization to Operate (ATO) wastewater treatment facilities:
This NOI is also an APPLICATION FOR an ATO for wastewater treatment facilities in place.
Construction, modification, or installation of any new treatment components at an existing site requires an
ATC. (If the site is already covered by NCG020000, the ATC request may be submitted without an NOI).
Some wastewater treatment facilities used to treat or recycle wastewater at mining sites will require an ATC prior
to construction per 15A NCAC 2H .0138. Please seethe NCG020000 General Permit for details about which
treatment facilities require an ATC (summarized in Table 1 below). The authorization to construct or continue
to operate will be issued at the same time as the Certificate of Coverage (COC) for the NCG02 permit. Design of
treatment facilities must comply with requirements of 15A NCAC 2H .0138 & .0139.
Construction of wastewater treatment facilities subject to the ATC/ATO requirements in the NCG02 permit
at new orexisting mining sites requires submission of three (3) sets of plans and specifications signed
Page i of 9
IAsper 15A NCAC 2H .0106
"Untess treatment facilities are designed, constructed, and put into operation by employees internal to the company who are qualified to perform
such work for their respective companies in accordance with General Statutes, 89C-25 (7), plans and specifications must be signed and sealed
by a RE.
SWU-NCG02-NOI Last revised M07/2010

NCG020000 N.O.I.
and sealed by a Professional Engineer (P.E.) or qualified staff along with this application. A copy of the
desian calculations should be included. Please see questions 18 & 19.
Table 1: Summary of Wastewater Permit Requirements
Quarterly
Monitoring?
Requires
A to C?
Mine Dewatering (MD)
Yes
No
Yes
No
MD Discharges that do not need treatment
other than E&SC to meet permit conditions
✓
✓
MD Discharges that need treatment other than
E&SC to meet permit conditions
✓
Process Wastewater
Other Recycle
✓
✓
Closed Loop Recycle
✓
✓
Any Other Process WW
✓
✓
i For questions, please contact the DWO Regional Office for your area. (See page 7)
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed}:
Owner Name JOHN R. LANE, JR.
Owner Contact JOHN R. LANE, JR., KEN ELLIOTT
Street Address 433 GATES SCHOOL ROAD
City GATES Slate —NC _ ZIP Code 27937
Telephone No, 252-357-1279 Fax:
E-mail Address _rit�ilgtric-I'�) crt_ib ircifnail_corTi, ken@ kenobx.com
2) Location of facility producing discharge:
Facility Name EURE SAND MINE
Facility Contact JOHN R. LANE JR., KEN ELLIOTT
Street Address FORT ISLAND ROAD
City _EURE, RT1 State NC ZIP Code
County GATES COUNTY
Telephone No, 252-357-1279, 252-339-9021 Fax:
Contact E-mail _ritalkanc@ el7ib rciriiciii.corri, kente kenobx cram
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). From intersection of NC 37 and NC 137 in downtown
Gatesville,go west 4.4 miles on NC 137 to intersection of Taylor Mill Road (SR 1118), travel south on Taylor
Mill Road 1.6 miles, taking second paved left onto Fort Island Road (SR 1220)_, travel south 0.5„mile on Fort
Island Road to dirt road entrance on the right.
4) Latitude 36°23"58.28" Longitude-76`50"54.26" (degrees, minutes, seconds)
Page 2 of 9
SWU-NCG02-NOi Last revised 617/2010

NCG020000 N.O.I.
Permits:
5) This NPDES Permit Application applies to which of the following:
V New or Proposed Facility Date operation is to begin JANUARY, 2012
❑ Existing
❑ New Permit not applicable — ATC request only. NPDES Permit Number
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 1442
7) Provide a narrative description of the types of minerals mined at this facility:
SAND & TOPSOIL_
8) Is this mine an inactive mine site?
v/ No
❑ Yes If yes, do you posses an "Inactive Renewal' from DLR and notified the DWQ Regional Office or
have you certified to the DWQ that the site has been stabilized? ❑ No ❑ Yes
9) Does this facility already have a valid Mining Permit from the Division of Land Resources (DLR)?
No If No, please indicate the status of the Mining Permit application: SUBMITTED OCTOBER 2011
❑ Yes If yes, please provide the Mining Permit number: Please also provide a
copy of your DLR Mining Permit with this DWQ application.
Note: DWQ cannot issue a COC for the NCGO20000 General Permit until a Mining Permit is issued or
renewed by the Division of Land Resources (DLR).
10) Does this facility have any other NPDES permits?
❑ No
Yes If yes, list the permit numbers for all current NPDES permits for this facility: _STORMWATER
SUBMITTED NOVEMBER 2011
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
V No
❑ Yes if yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does total area of this mine site include ready -mix and asphalt areas?
No
❑ Yes
If yes, do they have DWQ stormwater permits (if owned by the same company)? ❑ No
(provide permit number )
If not owned by the same company, who is the owner?
13) Will this mining operation precede development activities at this site?
V No
❑ Yes
❑ Yes
14) Is this mine located within one of the 20 Coastal Counties and will it add more than 10,000 fe of impervious
surface?
Page 3 of 9
SWU-NCG02-NOI Last revised 6f112010

NCG020000 N.O.i.
❑ No
Yes if yes, you may be required to apply for an additional state stormwater permit. Check with your
local Regional Office. See contact information and checklist below.
15) is this mine located the Neuse, Tar -Pamlico, or Catawba River Basin, or the Randleman or Jordan
Water supply Watersheds?
v No
❑ Yes If yes, what size stream buffers are included on site? ft. Please show buffers in site plans.
Discharge Points, Receiving Waters & Wetlands:
16) 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 end up in? CHOWAN RIVER
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
Receiving water classification (if known): B, NSW
Note: Discharge of process wastewater to receiving waters classified as WS-II to WS-V or SA must be
approved by the N.C. Dept. of Environmental Health. It DEH does not approve, coverage under
NCG020000 cannot be granted. No new discharges of wastewater are permitted in receiving
waters classified as WS-I or freshwater ORW. Wastewater discharges to Saltwater ORW will
not be approved under the NCG02 General Permit.
17) If your facility has wastewater discharges and they are to HWO, PNA waters (Primary Nursery Areas) waters,
what is the flow rate? (See Ilitti)://wavw_ncd(Tlf.natii-naF)s/FNA-._map s/index,hinil, for map)
18) Discharge Points:
Number of discharge points (ditches, pipes, channels, etc. that convey discharges from the property):
Onsite: Stormwater: _1 Mine dewatering: Process Wastewater Overflow:
Offsite: Stormwater: Mine dewatering: Process Wastewater Overflow:
Discharge points should be clearly marked on the submitted site plan.
Please provide short narrative description of discharges:
25 year stormwater overflow discharge only. Rainwater will drain back into excavation during normal
operations. Overflow will be sheet -flow rate across flat -top berm, or through notched spillway lied with riprV.
a) Is your mine dewatering and discharging? (Answer only if you are dewatering)
V No
❑ Yes If yes, where to? Surface Waters and/or Wetlands (on -site or off -site)
Other (on -site or off -site) Describe:
b) Are you dewatering but not discharging? (Answeronly if you are dewatering)
No
❑ Yes If Yes, please explain how you are dewatering, and where that water will be directed:
Page 4 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N.O.I.
19) Will mining operations require dewatering near wetlands or impact any stream, groundwater, or wetlands?
No
❑ Yes
Note: 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 (O&M) Plan that has been approved by the
Division.
For sites that may drain wetlands — apgLgval of a Pumping O&M plan maybe required prior to
coverage under this general permit. The Pumping O&M Plan should be submitted to the
appropriate Regional Office and must 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 end of document. Contact your local Regional Office for questions specific to your mine.
20) If you are dewatering, are there wetlands or surface waters within 400' of the mine pit perimeter?
V No, but wetlands are within 400' of mine pit, no dewatering
❑ Yes If yes, what distance are they from the mine pit perimeter?
21) Have you been required to obtain a 4041401 Certification permits?
feet.
❑ No
V 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. -
attached
22) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ No V Yes If yes, please attach to application submission.
Stormwater BMPs:
23) Does this facility employ any best management practices for stormwater control?
❑ No V Yes If yes, please briefly describe: attached _
24) Does this facility have a Stormwater Pollution Prevention Plan?
V No ❑ Yes
It yes, when was it implemented?
25) Will vehicle maintenance activities occur at this facility?
-, No ❑ Yes
Page 5 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 NA.I.
Wastewater Treatment Facilities:
26) Will mine dewatering discharges occur? (An ATCIATO is required for wastewater treatment facilities'
dewatering discharges where E&SC devices alone will not meet effluent limits and/or protect water quality
standards).
V No
❑ Yes
27) Will discharges of overflows from process wastewater treatment systems occur? (ATC or ATO required,
unless closed -loop recycle system)
No
❑ Yes
If yes, answer the following questions for each wastewater treatment system:
Please describe the type of process used to treat and/or recycle the process wastewater, Give
design specifics (i.e. design volume, retention time, surface area, etc.). Existing treatment facilities
should be described in detail, and design criteria or operational data should be provided (including
calculations) to ensure that the facility can comply with requirements of the General Permit. [Use
separate sheet(s)]
Does this facility employ chemical additives to flocculate suspended solids? ❑ No ❑ Yes
If yes, please state the name, manufacturer and the quantity of average daily usage of the
chemical additive
Note: Please see our website for a fist of evaluated polyacrylamfde (PAMS) products for use in North Carolina.
Does this facility overflow only during rainfall events exceeding the 10-yr, 24-hr rainfall event?
❑ No V Yes, possibly
28) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
V No
❑ Yes If so, include information to demonstrate protection from flooding. (Minimum design requirements for
treatment works include protection from the 100-year flood, per 15A NCAC 2H .0219.)
Other:
29) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
v No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
V No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
Page 6 of 9
SWU-NCG02-NOI Last revised 6/7l2010

NCG020000 N.O.I.
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:_
Vendor address:
30) Are you applying for a mining permit in the some location as a previously permitted mine?
❑ No
N/ Yes If yes, specify permit number and name if known: Eure Sand Mine, appl submitted Oct 2011, pending
31) Does your site have an active landfill within the mining permit boundary?
No
❑ Yes If yes, specify type: ❑ LCID ❑ Other:
32) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? See permit
text online for secondary containment requirements.
V No
❑ Yes
Final Checklist:
This application will be returned as incomplete unless all of the following items have been included and
initialed for. Please show that the following required information has been included by initialing in each
space below.
Fee of $100 made payable to NCDENR
Completed application and all supporting documents
Copy of the valid approved mining permit (MP) for the facility or indication of MP application status
Copy of a county map or other general location map that shows the mining site and nearest major roads
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.
2 copies of large-scale site plan with topographical lines with all outfalls, applicable buffers and wetlands
clearly delineated
A copy of your DLR mining permit
A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 22 above.
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 State
Stormwater permit. Regional Office Contact:
• Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas and total drainage area.
If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the followin and contact your local regional office about a Pumping O&M Plan (see below
for contact information). You may be required to provide an approved Pumping O&M plan pri'orto
NCG02 issuance.
2 copies of detailed Full Size Plans 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).
Well information (design, depths, maintenance)
Physical monitoring for the wetlands areas
Settling pond sizing information, if applicable
Page 7 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N.0.I.
-OR-
Level spreader design, if applicable
Detains about dewatering method
Cone of influence calculations
Description of measures to prevent erosion and flooding
Description & information about 401/404 permits that have been obtained
Copy of US Army Corps of Engineers wetiand delineations or approved wetland delineation (if
applicable)
l have contacted my local regional office about a Pumping O&M Plan.
Regional Office Contact: . Date contacted:
I will not any impact nearby wetlands, surface waters or groundwater by dewatering.
If an ATC or ATO is required, three (3) sets of plans, specifications, and design calculations, signed, sealed,
and dated by a P.E. ATC and ATO requirements in NCG02000 are summarized in Table 1 on Page 2 of
this NOI (see the permit text for more details). Plans shalt show all pertinent design features, including the
location of the outfall(s), If stormwater is flowing off -site, the plan must show that stormwater will not be
mixed with wastewater.
Certification: North Carolina General Statute 143-215.6 b (i) 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 rulemaking 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 Managementj 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).
1 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
protection 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.
Page 8 of 9
SWU-NCG02-NO) Last revised 6/7/2010

NCG020000 N.O.l.
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: John R. Lane. Jr.
Title: _.Applicant / Owner
of
November 8. 2011
(Date Signed)
Notice of Intent must be accompanied by a check or motley order for $100.00 made payable to NCDENR.
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWO Regional Office for your area.
DW0 Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office
... [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office ...[phone]
Wilmington Office
... [phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 9 of 9
SWU-NCG02-NOI Last revised 6/7/2010

_0 01 PG Office Use Only. -
Corps action ID no.
�-1
I r r I ° '" DWQ project no.
MForm Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Section 404 Permit ❑ Section 10 Permit
Corps:
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification -- Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ❑ No
For the record only for Corps Permit:
❑ Yes ❑ No
If. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties, if yes, answer 1 h
below.
® Yes ❑ No
In. is the project located within a NC DCM Area of Environmentat Concern (AEC)?
❑ Yes o
2. Project Information REC
t: I V a Li
2a. Name of project.
Eure Sand Mine
2b. County:
Gates 0 2011
2c. Nearest municipality 1 town:
Eure, NC
2d. Subdivision narne;
2e. NCDOT only, T.I.P. or state
project no:
_
3. Owner Information
3a. Name(s) on Recorded Deed:
J. Roger & Rita Lane, George Mac Miller, Charles T. Hofler
3b. Deed Book and Page No.
DB 263 PG 640, DS 284 PG 246
3c, Responsible Party (for LLC if
applicable):
3d. Street address:
PO Box 485
3e. City, state, zip:
Gatesville, NC 27938
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.3 December 10, 2008 Version
/ i Ak"

4. Applicant Information (if different from owner)
4a. Applicant is:]
Agent Other, specify: Son
John R. Lane, Jr.
4b. Name:
4c. Business name
(if applicable);
Lane Farms
4d. Street address:
433 Gates SchoolRoad
4e. City, state, zip:
Gatesville, NC 27938
4f. Telephone no..
[phone], [phone]
4g. Fax no.:
4h. Email address:
rAalane@embargmaiLcom
5. Agent/Consultant Information (if applicable)
5a. Name:
Ken Elliott
5b. Business name
(if applicable):
Elliott Consulting
5c. Street address:
622 Rocky Hock Creek Road
5d. City, state, zip:
Edenton, NC 27932
5e. Telephone no.:
[phone], [phone]
5f, Fax no.:
5g. Email address:
[e-mail]
Page 2of10
PCN Form -- Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel 10):
0200505, 0200252
Latitude: 36,3972 Longitude: - 76.8594
1b. Site coordinates (in decimal degrees):
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size:
322.6 acres (total 2 parcels) acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:
Chowan River
2b. Water Quality Classification of nearest receiving water:
B; NSW
2c, River basin:
Chowan
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
High sandy land interspersed with pocosin wetland, mostly logged over woodland with some full growth woodland
remaining.
3b. List the total estimated acreage of all existing wetlands on the property:
173.0 acres (total 2 parcels)
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
None
3d. Explain the purpose of the proposed project:
Sand mine excavation, 6 ponds to be excavated at this time for sand & topsoil
3e. Describe the overall project in detail, including the type of equipment to be used:
Attached
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property !
project (including aft prior phases) in the past? Yes ❑ Na j] Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ❑ Preliminary ® Final
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: True Line Surveying, PC
Name (if known): Curk T. Lane Other:
4d. If yes. list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
August 13, 2010
S. Project History
5a. Have permits or certifications been requested or obtained for ❑Yes ®Na ❑ Unknown
project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Mining permit application submitted to NCDLR in Sept 2011
6. Future Project Plans
6a. Is this a phased project? ®Yes ❑ No
6b. If yes, explain.
Phase 1:18.82-acres excavation proposed start immediately; Phase 2: approximately 16-acres excavation planned after
completion Phase t; Phase 3. approx 7-acres excavation planned after Phase 2.
Page 3 of 10
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory i
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted,
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non-404, other)
(acres)
Temporary T
W1 O P ❑ T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.046
W2 ®P (] T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0 139
W3 0 P ❑ T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.242
W4 ®P ❑ T
Direct
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.015
W5 ® P [:IT
Direct
-
Pocosin
❑ Yes
® No
® Corps
® DWQ
0.012
W6 ❑ P ❑ T
-
❑ Yes
❑ No
❑ Corps
❑ DWQ
0.028
2g. Total wetland impacts
0.482
2h. Comments: All impacts are linear - access 7 haul roads for mining equipment. V
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f-
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non-404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
Si ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps—
❑ DWQ
3h. Total stream and trilratary irnpacty I
3i. Comments:
Page 4 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4. Open Water Impacts
It there are proposed impacts to takes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S, then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Tem ora T
01 ❑P❑T
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
Ali% Total open water irnpacty
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c,
5d.
_
5e.
Wetfand Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
131
P2
5f. Total
5g. Comments:
5h, Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then enmplete the chart below. If yes, then individually list all buffer impacts
beiow, ii an im acts re uire n�iti aiiort then ou MUST ftill out Section D of this form.
6a.
❑ Neuse ❑TOr-Pamlico El Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6c.
6d.
6e.
6f,
69.
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
'Temporary T
impact
re wired?
131 ❑P❑T
❑Yes
❑ No
62 ❑POT
❑Yes
❑ No
B3 ❑ P ❑ T
Yes
❑ No
fill. Total buffer impacts
6i. Comments:
Page 5 of 10
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Sand road crossing wetlands at narrowest points, using pre-existing roads; access roads will level flow -across roads with
culverts
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Install heavy duty silt fence along perimeter of roads crossing wetlands, install 12in culverts every 200ft through wetlands.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation For
impacts to Waters of the U.S, or Waters of the State?
® Yes ❑ No
21). ll'ye,,, mitigation is required by (check all thrai apply):
❑ DWQ ® Corps
2c. 1f yes, which mitigation: option will be used for this
project.
❑ Mitigation bank
❑ Payment to in -lieu fee program
® Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purehased tatted, receipt and letter) -Type Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. if using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
S. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Owner will be requesting USACE Wilmington District to hold conservation easement of 5.0 acres for the site.
Conservation declaration will be added to property deed and attached to this application.
Page b of 10
PCN Form — Version 13 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. ff yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Caicutate the
amount of mitigation required.
6c.
Zone Reason for impact
6d,
Total impact
(square feet)
Multiplier
6e.
RegUired mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zane 2 --
-------
--
______ f .5
6f. Total buffer mitigation required:
fig, if buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h, Cornments:
Page 7of10
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified Yes No
Q
within one of the NC Riparian Buffer Protection Rules?
1 b, if yes, then is a diffuse flow plan included? if no, explain why.
❑ No Yes ❑
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 3.54% inci unexcavated buffers %
2b. Does this project require a Stormwater Management Plant?
❑ Yes ® No
2c. if this project DOES NOT require a Stormwater Management Plan, explain why: Low percentage impervious surface
2d. if this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ® DWQ Stormwater Program
❑ DWQ 401 unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
Gates County, North Carolina
❑ Phase It
❑ NSW
3b. Which of the following locaily-implemented Stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
® Other: CAMA Core Use Land
Program
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4. DWQ Stormwater Program Review
® Coastal counties
❑ HOW
4a. Which of the tollowing state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
®Yes ❑ No
attached?
6. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Flan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1,
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (feder ailstatellocal) funds or the
❑ Yes
® No
use of public (federallstate) land?
1b.
If you anslwered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you an�wered "yes" to the above, has the document review been finalized by the
State Cl aring House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes
❑ No
letter.)
Comments:
2.
Violations (DWO Requirement)
2a.
Is the site in violation of DWO Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
No
or Riparian Buffer Rules (15A NCAC 2B ,0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4.
Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, of available capacity of the subject facility.
No sewage disposal on property.
Page 9 of 10
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
® Yes [] No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
® Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS Species Report for North Carolina
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Essential Fish Habitat Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ yes No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Trust for Historic Preservation, NC Dept of Cultural Resources, NC Office of State Archaeology
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ❑ No
8b. It yes, explain how project meets FEMA requirements: Berms around excavations, stormwater & wastewater plena riled
8c. What source(s) did you use to make the floodplain determination? Floodplain Mapping Information System
John R. Lane, Jr.
"VAgelignature
Nov. 8, 2011
Applicant/Agent's Printed Name
Date
Applic
is if an letter From the applicant
(Agent's signature valid only authorization
is rovidad.
Page 1 U of 10
PCN Form — Version 1.3 December 10, 2008 Version

OPERATION AND MAINTENANCE PLAN �� V 9V
SAND MINE EXCAVATION — EMERGENCY OVERFLOW �J
Operator: John R. Lane, Jr., 433 Gates School Road, Gates, NC 27937 NOV 3 0 2011
Job Location: Eure Sand Mine, Fort Island Road (SR 1120), Rt. 1, Eure, NC
County: Gates County ' A ���' � f f�A ` R
Prepared by: Ken Elliott, consultant DVW �j
0
Date: November 17, 2011
This plan defines responsibilities for operating the Eure Sand Mine safely, and that overflow wastewater
will not degrade or negatively impact any wetlands or waters of the state.
Description and Operation of the Eure Sand Mine:
Eure Sand Mine will be a group of 6 new excavations totaling 18.82 acres located 2.1 miles south of
Eure, NC on high sandy land adjacent to pocosin wetland. At this time Mr. Lane is filing an application
with DLR for a new permit for this excavation, along with a Nationwide 14 permit from the US Army
Corps of Engineers and a Stormwater Permit from NCDENR.
Because of adjacent wetlands on the tract Mr. Lane will be required to maintain a SOft wide undisturbed
buffer (no mining activity) and a 25ft wide unexcavated buffer (may contain berms & roads) between
any excavation and the adjacent pocosin wetlands. The excavation areas and buffers will be carefully
marked to prevent mining activity from occurring outside of designated areas. Mr. Lane will be
constructing a sand berm around the perimeter of all unexcavated buffers so that all rainfall inside the
mining activity areas will drain back into the excavated pit instead of into the adjacent wetlands.
Sedimentation and Erosion Control
Temporary sand berm around perimeter of excavation area will be constructed with 3:1 slope on inside
and 2:1 slope on outside, with 2ft - 4ft flat top. Slopes will be sowed with ground cover after
construction for coverage within 7 days.
Berms & Rainfall Overflow Protection
During normal operation, rainfall on processing areas and interior roads wilt drain back into the
excavated pit. During times of excess rainfall causing larger than designed peak flows, 2 types of
overflow protection will be used.
1. A level topped vegetated berm crest will be constructed on the entire berm system around each
excavation area. This provides a very flat berm top so that water will overflow along the berm
length in a thin layer so as not to create erosion problems.
2. A notched spillway will be located at the lowest end of each berm system and will be lined with
rock riprap and vegetation. This emergency spillway will be designed so that it will safely carry
the maximum expected flow from a 25-year storm.

Maintaining the Berm System
Inspections and maintenance are required to obtain the intended function of the berm system, and to
maintain the life of any adjacent wetlands or waters of the State. Items to inspect and maintain during
the 10 year life of the mine permit are:
• 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 spillway structures in berms regularly, replace dislodged rock as necessary.
Monitoring the Process and Effects of Dewatering
Analytical and qualitative monitoring of overflow mine wastewater will be in accordance with the
NCGO20000 permit, as follows:
• All ponds in the Eure Sand 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 following
significant (1/2-inch) rainfall events for damages, and all structures will be repaired immediately.
• Special inspections will be conducted immediately following severe storms, vandalism, and
other significant events.
• overflow of mining wastewater after severe storms will be monitored bi-annually at three
stream sites on the property, located inside the wetland areas. Water samples (grab samples)
will be tested for pH, 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.
Records
Data will be collected as follows:
• Data will be collected from samples taken from wetland sampling sites after severe storm
events causing overflow from the excavation areas.
• Elliott Consulting will maintain the following records in a permanent file at the Elliott Consulting
office at 622 Rocky Hock Creek Road, Edenton, NC 27932: 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 excavating Eure Sand Mine
t
will not degrade or negatively impact any wetlands or waters of the State.
Signed,
Ken Elliott
for John R. Lane, Jr.
November 17, 2011
I

Sand Berm with Overflow Rock Baffle / Weir
Practice Standards and Specifications 6.$7 -- Check Dam with Weir
Eure Sand Mine
Rt, 1, Eure, NC
Gates County
SAND IEft T I 1 RIPRAPdSIIALLERGRMEL 3FTxSFT
- L AAEiYI 11fJ q E.O.f-BM-fLE-------..---- . SAND IER0
IFTSAHO UNA
Definition: Small stone dam structure with a weir outlet with sediment storage area on the upper side, installed in
sand berm.
Purpose: To reduce erosion in overflow drainage outlet during major rainstorms by reducing velocity of flow, and
provide sediment control.
Siting: To be placed at lower end of sand mine disturbed area perimeter berm (8ft x 3ft sand berm).
Aggregate Size: NC DOT Class B stone lined with NC DOT #5 or #57 stone on upper side.
Construction Specifications: Keep center stone section 6 inches below top of sand berm. Place sediment control stone
minimum 1ft thick on upstream side of berm at weir. Provide 9ft long stone apron on lower side of berm to flush with
surrounding grade.
Maintenance: Inspect check dams weekly and after significant rainfall and repair immediately if needed. Clean out
limbs, sediment and other debris that could clog the weir. Add stones to check dam to maintain correct height.
Maintain vegetative ground cover on berm, repair berm erosion as needed.
Ken Elliott, consulting
November 17, 2d11