WI0700215_GEO THERMAL_20110328

Permit Number
Program Category
Ground Water
Permit Type
WI0700215 /
Injection Water Only GSHP Well System (5QW)
Primary Reviewer
michael .rogers
Coastal SW Rule
Permitted Flow
Facilitv -
Facility Name
Kent Hathaway SFR
Location Address
41 Mistletoe Ln
Southern Shores
Owner
Owner Name
Kent
Dates /Events
NC 27949
Hathaway
Orig Issue
03/28/11
App Received Draff Initiated
03/23/11
Re q ulated Activities
Heat Pump Injection
Private residence, single family
Outfall
Scheduled
Issuance
Central Files: APS_ SWP_
03/28/11
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Kent Hathaway
owner
41 Mistletoe Ln ·
Southern Shores
Major/Minor
Minor
NC
Region
Washington
County
Dare
Facility Contact Affiliation
Owner Type
Individual
Owner Affiliation
Kent Hathaway
owner
41 Mistletoe Ln
Southern Shores
Public Notice Issue
03/28/11
NC
Effective
03/28/11
27949
27949
Expiration
Waterbody Name Stream Index Number Current Class Subbasin
CDENR
North Carolina Departrvient Q�, Environment and I`vlaturai
Division of Wale, Quality
beveny 7 aves Perdue Ccieerl H. Sullins
Governor Dire-ntor
03/28/2011
Kent Hathaway
41 Mistletoe Ln.
Southetn'Shores, NC 27949
Subject: Acknowledgement of Intent to Construct Type 5QW Injection Well System
Permit No. W10700215
41 Mistletoe Ln.
Southern Shores. NC 27949
Dear Mr. Hathaway:
Resources
Dee rreemar,
Secrezar ,
On 03/23/2011, the Aquifer Protection Section (APS) received notification of your intent to construct a closed -loop water-oni,
geothermal injection well system for the operation of a ground -source heat pump located at the address referenced above. An
individual permit is not required for the construction and operation of this type of geothermal injection well system as long as the
following conditions are met:
1. The injection well system contains only potable water,
2. The injection well system is constructed in accordance with well construction standards specified in North
Carolina Administrative Code Title 15A Section 2C Subchapter .0213, and
.3_ The required notification form and associated maps have been completely and accurately submitted,
Failure to comply with all of these conditions constitutes a violation of the North Carolina Well Construction Act and North Carolina
Administrative Code Title 15A Section 2C Subchapter _0211(u)(2), Additionally, you should contact the Dare County Health
Deparunent as they may have additional requiremems, for this type of system. Noncompliance with applicable state. county, or
municipal rules and regulations may result in the assessment of civil penalties.
Please contact Mike Rogers at [phone] or Michael.Rot-,ers(a- rncdenr.�--ov if you have any questions.
s
1
Sin freelly,
for Debra
Supervisor
cc: Washington Regional Office - APS
APS Central Files - Permit No. u'10700215
Dare County )Health Dept.
Jeff Stagg (1.A. Stagg Energy Enterprises, Inc.. P.O. Box 15452, Chesapeake, VA 23328-5482)
Chris Sterner (Chris's Electrical and Mechanical LLC, 2039 New Bern St.. Kill Devil Hills, NC 27948)
1.,4P7P PPj7=_C—,10N. 0'.
1 �5 hK•' ieriar. PaiewL North Cs,,V,ne 37699-16Y
Los 3r ,:772, '; api¢aI tiUtil@1M& P,a"t . Ikons Carom 27604
Fncry 51,--3'-=1 FAY. i-. 01 : is 5g:, PAX y"•z-i t r t}4': t-,usta:rer ervi -9; 7-64-E74E ofl' ,
tntp�w = w .nmatemualr QT N C}rf'(]�1 F�ril t7�IIic
iVF-�iia

Ma 14 11 r9'65a
plf;kston Goothe•mal f ��?�LJ 767-4'21-;"0-
DATE:
DEYAI WEND D! ,LN'V ItONIMLW A_tiD NA i'IOUk.:.. RT} S-OUR ESS
N[ TUICATION OF F,%fTFNY TO CONSTRICT A C�£�_L�3[]P GLOTHMUL
W ATF;R- NI LI WFLL r%VSTE.%t
r PIO"SOW WE'Lt.fsiti
In,A"ord!a.nt:e W,-h d+e Pi tipisw , eoCNC V�—1 k 1,A 02C. 00
WcU T}-e Carrjrrmurfo.,?: !7�> s tlir� pT�Y�sCct rent : it ll�it� �a� H:Ir-k L��f�r� rr!}; i.reD ditives) in
:,Jntiauou--i Piping iNu ix-o--pictOy isuljlutho fluid from the en-,irortrnw.I r ..
j64W Y?
Y+es__ K _ ��riIirxu�a;.unspl.,•tin�tbis fi�rru.
No
Do `'_'L co,3_•;•'A�1,.: ."vTn. u omplme -4her O W. ..rtCC]focirl; fvf- yinsraLIsi,&
_ ;1�IYve.i I:1:i [71bit- t:i:1+1 t7k�;11cith Ta XC:i FI �� Cri ViS:li [uil�
I���
Aj PROPiEWTV OWNER(S)/APPLi4-,AN r(Sk
L sl VLO Prop:rt; on pnopx#4 +_,e:i ty a bmt,"vs;na o- Z;ove-rmory ag,enc�:, swe nsrrt v-
5:T►'tIE�' i.h;l :J IL••r[TMiBr7i.3[�V�'<fV��it.eilfU'.r: I;.; �, �;tc1'i:._}- __—.._..-_�__����---...—��.�_.._...—...._.�.._�_.
4 (l) Mailing Address'-
[:i.y: - 1a n_������ __ eta?•=- �L' f�lt� l'.ucle� z.7 5 y�....___.— Gcnanty _ � +>n.r� ,...�
!l�rnelV[3�•lit-e Tice i�o. - , .�' S �- Iir1 • d d 3 � ._._�....._..; 't;ll �41:.-_...-_ �.�----- .._ . ._.. �.,..-._
Email Address: _._ ►A� F-�itr ,
(3) P►nsiC:rl AddrC,%3 0"WC]-' Li r(ifdi'COW.n1?hy» abl'3re):� - ------
[ State: C. %ip Cade: Covntp: _
S. AUK') CaIZF.D AGENT OF OWNER, W V% Y {i l'the Permit Applica:l d : + nvl au a the suk-,% ri p-aper�;,,
fta h a fetcr Iiom tiv prWx'rt} askrer Agen'. to epeywO.) IC "if i
Compeny Marne
c'nrrtacF Persar.: _�,.....,.�.�..._,..w.F.IAWNTL_ryd,:Ms-
Cite _ stale: Zi#, Co&. Cvuriy:
Office Ta'e No.; _ Cell \Iri.�_-_-
I r SOtc Address af'Coma
17FUAL 7C' zQM' id C4adon of ki we fury Me*W 81;wsl falge E
RECENEU f U!`NRQU
owi�
MAR 23 2011

Ma- 14 11 09:56e Pinkston Geolharmal
767-421.2108 a.2
9
C. WELL DRILLER INFORnIT101
Company Name .__I A Staff En: r .r±i�'t ]riW-A§ti ice:. ,6w___ _
Weil Driller Contractor's Nam.:-.
NC Coraaaor Certification No...-
Contar.t PersnnL f5t4 LL� ft•�r�ta� [enr .i a:Y
Address' P QfoJ�4 8? -- -- _ --
( itj:aiC �-.. l}ri.'L+Qt: 71xi:�5482 C
�S� •Htil—'7.1a8
R ` HEAT PUMP MNTRACTOR FNYM ATION' ;if d ffirraI than driNerl
Company Narnr >rd k";'i . kec ft t [ f e+n�Yl iet ha r► + c j GC
Contact Txeryprt: l Lr[ � }rr r1Q � �- t i I •i [! it ti r � S � `e- r1G � �..t r Cat � . ref
r Addm.ss:''jjZ��—
C:tyi�� iAV ILyp cckiL' 1 I ❑ l�C7tltlr� ._.-:.C..��. — _ --- .�
i Office 7ele No.: t,-)-4 C.[± z Y7
R. S`TATUS OF AP1. UCANT
Prir a+e: );— Federal' .__,_ Ctut1it:[°r6a): _.--...-
Sfate: Mw-4u.pa,: _ _ Nslove Artt<.-kan lands' --
F. L'tiJECTYON PROCEDURE (brief y 1-QCribehov :hc 'nju�A;oa weU(Si W.It be.rs:e,
G. W FILL CUNsTIrZI;C'rION DATA
(1 ) Proposal date tc k cara--wed:
A ]rrrdrnate depth of each boring 'wit; A
i?) Type v, tubiag Iv IV ubcd t.tupiraa_ `'V c,
[3) 5'r'ell c ssc±; is ;ha tieAW fir '.' ± �ttcrk citke► (2.-: Yes Lit 0b.4, No hCic+w.�
ta) ?'ts i' .+rx, +itc:t rlruvide u�tir.F i:tfot�rra+.inr+ �e3vw
Type. �,ltica,7ir�d siM �t+ ack titxel P1W,Ic trier (Spc•cit3)
Casing aeplh- }ram t° - ---' -tert (references to 1.4nd surface)
Casing t:: enda to abort~ @rotind __ in�h-�S
(4) Gr+ot-t I nfo (materia! surrounjing well emsing:if id,in pilrin,;F•
0) Grout tyN., New Cement Bcrtov ite _�L_ 0tticr(tipm1N-)
(b) Groutplaccrnctrt: Purr.p+nt;-_x-_ Pressum_.^ -- Other—
(r` front- 0 __ rn
If well has Cd.irindit;:ttt [ dt- Ntl: r'rori: —____— to (#defy
:NU.i 1C 5�14'?+fpn;irabtVserrn! lorrnfursised si81 Page:

Mar 141, C9:56a Pinkston Geothermal 757-421.2' 08 a.3
H. INJECTION -RELATED 9QUfPF4E.ST
Attach a diagrsrn showing the engines sing layout or lr. [+trrsf.0 r3odificatiwi cf tin: ini"ttwo cquipm"t artd cxtcriv�
piphiOuNng sss=iated uvith the iniectiof. ope-a,;vr,. .P;e Lvarufacttmrr':a bre<-irt:re Er-, � pravi:i, s I ki-,r_r+�.
irt'f.7mtatiUrt.
1. LOCATION OF WELL(b)
Adaoh taa copies of maps ShO-MN 6C fo.lnWill g;-iRIM Utian:
(1) Incl'tde a Site Map (cun b-,- dra'o,nt 51:. -vhig tw3,tip, •-rEsl-:rtv iine!�- ;A--tv 1►ole.T hr-sliest
satttres ofgrourldwow conrawiewOm- mu; tfw er-witalcz of and zism cc., b=xcen ilia pr►rpvwd well<<p,.::y
any existing sae':f O ,I., ►►�sYr di -.pre t I':i:i: +..: �:.:�f, :+s s.ePt': tanks ,?r drain field= lrar, ed %;iil in:hJ fees +of
the geothertual luatpump wt.i1 <ysA�2�. L4rM� sli f�s�r11•.:; r�fcdrijnnd.i[uludi :� trnrth.n�x•,
(2) The Site -map must 00-H the Subject prvp�,, , in ; eloboa to the sot-t unding area by rasing at icu;r rwo f xca
rvfr;tnce poiws such as made. s.t*ewnf, aaI ijur fflgh-^y inte's iiUn:.
J. C:tw MFICATION
Nate: This Permit Application must be ftmed hnv eaub per&,a, appearing es tltt
recorded lcgal property dwd.
"1 hatch%• certify, un1er panai of'uw, 7hr_. ; h.t:,a persor•.rllI x c-,xrniaa! and am +r,,iIiat• xvirh t1v infvnr+ald0
.. l rnittet? it i;•_is itn�unicnt an+l �ti attar.{ :t,entS. the ~�l:+ acd tint{ ha r•d a►!: rr,% �nclt=try of the inra yid►:: !,
itnmcctkW; respons7Wt tut ob,Atir,,6 -,:i„ inf, v-.- im 6 Tq. t tN V., 0m, rfl•, _rr:ormai;oi :s iruc, accurate and cuinr.ield.
t Lan aware !hst therc a: sig lficant pcnaitici, irrzkshn4% t zc r+ 35:.iiiill' of fines wli i rjlris.►ll;�wn; for su-w,iitin
false inf-orma:ion. } agree to e,irst=t, upar-ira, maims, w.„ rep4i:. and if applicabio, a, t:�inn the inje--tson V .J[ a+td
all rotated appurtenwices In accardree u;#. the - p a pecifeations xte a tions 0t,the Permit"
ti e!'tymt et{ Own I ,l. : ;;k
Prb11 or'] y{te l-a11 1-na'tc: and talc
4;�SnmturG ort'roLx--,.y Owner/AWhcaiit
1 i'rint r�r Ty j c 1'ta6 1;wnr: artd {;tile
i
Sig"ltlt"jm 4)i AUthaejzzd Agent, Kai;y -�
Print or TypL I'uII N:ttw a-W tit. c
Pease return tow:+ v)piev of +hc co.mOeted Af)plica+ion pacRage :i,
�iurtb Carolina !-1ENR-I)WQ
Aquifer Protection Srrtion -VIC: Prov m
1636 It►il Scrrice Ucyrter
11Aie 0. Nil' 276"46M
Tclerplbtiur [9190IS-6935
�li3ilRLr VEV � :Vr� I nWQ
L VUIUtC 5 U W Nijof!.'w'c-Ajc ul'!i L<nt rurm tR"kci Kr-WH TF��Ir}N AFP
Mar' 2 3 2011

to I'm A ..4
IN,
1. z
QLIC�,'IM L4:>O'P f�%Q_j!�A
(:3�) 2-00 r-r
L Ll
AS-7 1 /9 1 OT 78
.1110UNSCE - KOCK -6rw- L 20 36
'A
SQU I -ILqN SW
$'Wit 15. PS OX 1�.
xil.-Filij r f-R%f- fLv{
KENT K. JqA TRA WA Y
LOT 19 — SOUNDSME — BLOCK rG10 — Sv.CFrl;R-k-4? -'sWOMR-1;
A I' r & )LI W Jr fl IT^ W M 4-1 M 1 r- - fli0l" Jh:j"i.0 wvh tl f- I V A I - V A

Map of [1-991 Mis letoe Lr • Hawk, North Carolina j MapQues+
Page 1 of 1
Notes
mapquest
Map of:
(1-99] Mistletoe Ln
Kitty Hawk, NC 27949
nVIPQUest
0�q{t.
All rights reserved. Use sobiect_to UcenselCnuLvriDht
southern shores
0
01
@2011 Mapduest - Portions 92e11 tV Atl1 Q 0,1ntermap
Directions and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or
expeditiousness. You assume all risk of use. MapQuest and its suppliers shall nat be liable to you for any loss or delay resulting from your use of
MapQuest. Your use of MapQuest means you agree to our _ -_. _ ...
http://www.mapquest.com/print?a=app.corc.cc70488d8f2901 f8036acc123 3/14/2011

Map of [1-991 Mistletoe Ln, Kitty Hawk, North Carolina ! MapQuest
Page t of 1
Notes
mapquest'
Map of:
[1 -991 Mistletoe Ln
Kitty Hawk, NC 27949
>?righl l.3nrt�r3a ! r:
N,
fo
�yckfe
� � ri0y Lys 7
3
Y
n Ln
6
2
0
SnCti��.
�uFpe
a
L y
Q
—1
t'1
rntz�cuest C+` _
o too �rytrtiti�y
�;3� ^-?2411 VIOpQuest - POrtions =011 N AVI @ Q
Attrinht^ nsvrryf� }. tilts! silt:tac�,!e t iri-rtselr OC±V �r71..
Directions and maps are informational only. We make no warranties on the accuracy of Their content, road conditions or route usability or
expeditiousness. You assume all risk of use. Map0uest and its suppliers shall not be liable to you for any loss or delay resulting from your use of
MapQuest_ Your use of MapQuest means you agree to our 1. _ � „
http://www.mapquest.com/print?a=app.c.ore.ec70488d8f290if8O36acd23 3/14/2011

Map of [1-991 Mistletoe Ln, Kitty Hawk, North Carolina I MapQuest
Page 1 of 1
Notes
mapquest
Map of:
[1-991 Mistletoe Ln
Kitty Hawk, NC 27949
C2)
�s,sah t3
1. Yox �ta� t_n
w
� a �
i
� �OSI
y0
4�
- =z
,cmapquest n
0�2Wm 1
Sm IK Cz2gji MapQuest - Pordons 92011 rjAVYE0, intermap
Ail rights reserved. IIJse subject to l.irznselCn� yrrgRt
❑irections and maps are informational only. We make no warranties on the accuracy of their content, road conditions or route usability or
expeditiousness. You assume all risk of use. MapQuest and its suppliers shall not be [lab le to you for any loss or delay resulting from your use of
MapQuest. Your use of MapQuest means you agree to our
http-/Iwww.mapquest.comlprint?a--app.core.cc79488d8f2941 f8O36acd23 :3/ 14/2011

M~r 18 11 02:37p
• •
Pinkston Geothermal
RECEIVED / DENR' owa
AQUIFFR"PR(m=r.i\ON SECTION
MAR 18 2011
facsimile transmittal
To: Tonya Godwin, NCDENR Fax:
From: Tina Wyatt Date:
Re: 41 Mistletoe Lane Pages:
Southern Shores. NC 27949
Typ e 5QWWens
CC:
D Urgent □ ForReview D Please Comment
Notes:
757-421-2108 p.1
Pinkston Pump & Well
PO Box 15482
Chesapeake, VA 23328
757-421-2108 / 866-749-1980
919-733-9413
03/18/2011
8 (including cover sheet)
D Please Reply □ Please Recycle
For the above referenced, following is our Permit Application for Geothermal Installation.
If you have any questions. please contact me@ [phone] or [phone]
. . . . . . . . . . . . . . . .. . . . . . . . . . . . .
Mar 1811 02:37p Pinkston Geothermal
kla! 14,11 C9:65a Pin k3 ton 0601 h e. tymI
757-4212108 P.2
767-42"1 -'-2 4 OS 2.�
NUHTH —: -A KIJLIVA
DEPARTMENT01' XC:%:ILIEVT A M,, ;.kA RY,.'SOURCES
"'61EIR-W-Ut. MECTION A-VELL S'YSTf'4
NOYMCATION OF N'TENT TO C-0'111,s7•RUC7'A (-X)P (A OTffY-k'%LAL
QYPUSI�10 -W1- I im
Vi Oh O-C -414CAC ) A- �AQN'.(000
,Pr-JAP jI-*7;e !hO ViJI'l;W? dill; ffi� it P., I". Una vgc
DAT9. . .....
W'd] Toe Copj7emodow OL cs Ov., I v cutives) i)[
'&n the 1. k4e.
jowct bvm)'
Yes :Zom inuo wntploCku this rorim.
No Dk� tn. —Cot17rk-lu'411"9 ti� 11 p; d n.; v iv,,- it I. r-.F. "Im -IU dl�
C.1.11 -r z i.1% 1 Si pouJilt ww" VW �411 - fV(j %X --�QfA Vid I
A- r FROMM OWNER(SYAPPLICA 14 F(S
Usz ux h P rope ri y G-w-,-sar lisL: J. or, p -v;ox ru 41x: -1" -:k L' rx d v, a bust 0 - pverr men'. 4"cTic-
ymv thwu V:
M-aifing A ddn,,---
ki v ('ajj v; L-,mn
7.2 kI Pn- Z 3 2-
Phy i cil A ddr,-s z r " 'sk 0,' St! x- f- i r -2. i .1111 h an abo VO.-
Stale: C., /Jp Code: comI.N.,
!IomefOfPcc Me Nm Cafl
R A-U-TUORUIEPAGINT OFOWNIJk' AVANY til the riq% oNn
81.11L�h a let.cr rrumve Ago' Ice -,usd c,-pe!r--% !,;IC %kelk
Conpp.riy �Lmc- --- - - -- --- - -- I — -- — . - I — ... - - -- --- - --- - _
AddrvsN:
WC 5S tV A ddre!;s of Coir pam. ff an
0 Pb,L I C' 5 -l'A' N%Af;;I.a 6oc ot I(Acj it J;ur I f Rc vic:d

Mart 811 02:38p Pinkston Geotherml
. P4a� 1 b' 1 � G9:rs5a Pinkstvn Gecttic�� ms!
757-421-2108 p.3
157-421-2148 p.2
C. WELL DRILLER INFi]iti;NL TIO
Company Mama: ,v_I A St39g.Fne_, iac.
Well Qri filer C'on:rac[ar's t#Ar'i::
NC Ccntma;tor Ccrli'flc4eri No..
Canta[.t Persnrr� ) ff s'r.�_-- - -_4fiYr_r:lwu, r,ua.'.�a�r+ _.
Address: 9.0 $ux } fag? - -- --- - -- - - -
(11y: -_. � .. 'i}T G':}il� _}* 7 ti-Z i �r.It : s w 3. i?Yw�'re: S
[7fiiCe iC}C �0.: ��: -0�. r,�-��-_....------- (i,:i` r�ti} •,_, i i]-y'i'�.ti134' .- r.
®. •' 3iF.A'1` k'i;31[F C[]NTRAL'";E'[3'R i1`i�'Ci[i:�L1•L'[f3°� tit delFrn•nt€har; dri4ier�
4 [+r!laCr Paist7oa��uyi .7�7�* Yl P. �� _ _ �L:?, i:.:� 11_i!:•vi _.,_ � S �i Cf' rlC +r rg° [!��c+t'`'y_ � _ 11C''�'
/ Address_
Lir; 'ff �]iYf 6i;� ['fie Z-') I
Ciii9:.e "fete Ncv VS :) -tk 2-13; _
F S-TATUS OF APPIA :ANT
Si:169 f14Uc.iL':Dd NaJ1v;:Awc..-imt! Lands'
F. LXJECT!0N PROCEDURE ibriull} jv.wribe Luu' 01v .*tTjULr_c':T.Nfii(ai V".0 bC "5Cd:F
VE 6, W_6 III WEAL
__. _ _,iii=i;rTt• - Al_ CLf,�s'1�E [N��!' - - ----...._y__---• _ ..._. --
G_ Va ELL C€)NsTKt. C TION DATA
AppnTxiri=c depth of eacV.. tx,rin€; ("eetk
(2) 7 pc oT, Iuhi,lg to In- u3cd;coplrvtt_ "'vC rtc;:
(zy w�rr f:ts[I!�. �� �ti. we='ts } ::iur::• � ; �r�.d' ri±I-.�1 {:.:7 7Cc � �r ,t�.' do t:elt+w•!
(iL) Yi•.4 fir!'+."�� 4tICi1 i1i-iTJide ca[1(j: =lt'ilr'!iTra?l�l!I''riL+Vr
T)Fe: _-�.. coil,-iiaed �Iwl —Ishi 'k titeCI­ Pln+::ia:_^___ oTher fspmti-I
Casing cepft: I rani (rrferenr-� v) ?And urrFk-e)
Casing ex mds to above gmun+4
(bi No X - -
(4) GroLt 'aft) (zmAeriai surroun�liu well k ,:ing ui diur pipinv,)'
(J) GmuL tygs: New C=%:nt BUADi-itt; „Y _ 0tbCr(speeiF-.') R
('b) Grout placement: PUICplFia .-_ ._ . Pressum _ ()liter
(e; GIVUt dCp-,) of Wbint�' I -aten_OUC W !WIJ tta'rt,; ; [Corn__ 0 __,. t{± _ ` {` +.ttet}
iiuK.11 ltJS T,';l5irlr.. IlitilG:r:: !:r;lt1[ dr' rih: DQII. ­ _.. to„„,_;ieel)
s,ftil.t iC 3 IL' xi'.icazie:t e� LTtrns l urm (94C iwd ',:LI$1 Page I

Mar 18 11 02:38p Pinkston Geothermal
r Mar 141 G9:56a PinkstonGeo4he:mas
757-421-21 D8 p.4
7.57-421.2109 P.3
H. i�+r�IF�itol►r-]1tE11,�IlEDlefr[rtt'�
Amu a. diagram Ac_%ing the engirw sing, layout ;or rr.a :304ifiM�irn. of Chi; injc�t,wa cquiislricrri arad cxtcriC.i
pipinWiubmit assnciated with the in; asrctrn Orvalk7p, t'!s�- n'g4 pr3vi-le
inforrnstion.
1. 9.00A1'llU1V f1� WL� LJI.{5j �
A uch two Ctpins of mops Act-Nim-, Lie
(1) 1.10 late a Site NISI, {cans 4- tire. ::: SS:S 3jisiL, h •,F 1;:;= +, si Q!,:9 liald!., WiLA, L- M.-O ri 11..5it.F, ?nl: -1,::-:
saumvs of groundwaer c41n,a i,isne r+,::.'U dic cr'i, .: 1.r::a:4 -. it urncv_. b.t r c:n tfk propoud e,t::li.l
alit exisLing t+ r (a} u txr-ks v drat. fieid_ lac%Ltd ;;.•r:;�i '20 fee: ui
CD
the geath�n�al scat prl�p nci! �.:tesr , LPL ; wr€i i�:•+►! :: S 1 di�w' and Ir7L'iS=4ti a Ilr�rl a!13tt. �.
?) The Sim Ma mut t sfno:�v the sub ecr rr 't) :n -da Moc'Lo thin sLr7i7l rdin3 ana ky usii, At =cwt c rl4P AX116,
t'�. F l R• P-'•- � g
rrfurence Wrrs suaF; as rrxJ. . st:MMS.-ndic" i~itt,-seFtiuns.
J. cKscrlFtCA.'i'll' N
~tote- Tb% Permic Applic-rtion mast he sign by ea�b per:,i.,n uppxs rittg on UTA:
r,erorded Leval property deeel.
N hemb+• ienift, under panni t of 'u-, hG. i i%ate ne-sar.,Ily cxairuirtue end wm ;vq liar• tiviria 4),- ir.fvnnario
sniaa it ris d� �umha: aLrd :af; as,L�r,,:,:etLl�- lh._.:s•., Cd ural- tKvcd on ,,n�- �rtgk4ry VA' lhmw I:7GnY'�:rl�
irS:FT1bS'3sL«}�• Yt':j'�'SSr'i��l•.` C,+� a+�!"Y!r_�li r.�i.i ie=C•:: ;�!{'•++�, iys'1�'... ,3. L1F::II.CtYSt:iLiV S ... •'ru.- acutil-mr, and con-tricte.
i Salt i1wwe, dva then an 5gr':tac:an, rctittlth:i, md,-A i n.- ue vF zuYi i i:fNFyU:::s7t.iy for ,u.is1ritWmLz
false irtfmnanun_ 1 ag-ree to constralcr, upera:a srW6E3i , rK;rori:. cord fT appl;"bio. vw:i:Y, the irtjczvo y ak,.tl as,tii
all rciaw-a eppureenar,ces in arc.3r:+-z-ce witt the - OWd spccif::xli.]s.11, a:►d aIt lions +; it f'errnic.
tit , tillV_ nr l'rtrl cr[ a.A tat: Ir.lrl t;d]ll
1
{
j %;.gnaiun; c,rr'rtyl -:} Own WAppl uiit
t ?rini r Ty ptu i,lall-i-lasr,c and title
t
�` tiianait:: 4 4)fAi;th+artzcd ACenI, il'alt�' �^
Pent as l`gpc 17011 Nusr,c u td tie
P.eh5t rc(u-rs IWCJ af,,1i_v uf:hr. compit! W ADOis:xion wck.-we11r:
'4urt6 Carralina DF_N-K-j)WQ
€036 Mail Sorvice d.-cea4ur
R:afth. Nk. 27011.16_%
Tdcp h4-,Re (414) 71$-6.9M
rir'iurUIC 3 q W +lout+ccnunos'Ar acne r-vrn[Rc'.1sod b%f7allly sa+t¢

Mar 1811 02:38p Pinkston Geothermal
I
757-421-2108 P.5
RECEIVEU) DENR 'OVVU
oauipsi iDRoTFrl inq �*C TiON
MAR 2011.
�CPC,—'CQ &Y6�
C.t�Ingz- L-Oup kQ-.;—C-A
�) z0. -F �

Mar 18 11 0228p Pinkston Geotherrnal 757-421-2108 p.6
ivi.ap of li-593 Mistletoe LP • Hawk, North Carolina I MapQuest Page ] of 1
Notes
marpapest
Map of:
[1-99] Mistletoe Ln
Kstty Hawk, NC 27949
e1
71*nCluest
©�suam
24plf ft
Q,li ri:�h<< r;�5�^h.t!.'.JS^Ai:?�i, k.i^.�• :"uq-.rsgi'1
RtCESV ) I OKNR I DV40
AQtl4Fr-P �n►1»rnn+� ��C�H]�1
MAR 18 2011
So=athtrn Short-.
a
,y G�
� 5 }
02011 Ma pQuort • Pattians=0T1 rQAVIk0.lmtermap
Directions and maps are informational only. We make no warranties on the acwmry of their content, road conditions or route usability or
expeditiousness. Yau assume all risk of use. MapDuesl and its suppliers shag not be liable to you for any toss or delay resulting from your use of
iv}apauest. Your use of MapOuest means you agree to our't'gl n,:; "s v
http://www.mapgmst.coi'a/print?a�app.core.cc7O488d8f2901 f8036acd23 3114/2011

Pinkston Geothermal 757-421-2108 p•7
Mir 18 #,v tLP PL►-"] WIISTIetoe Ln, Kitty Hawk, North Carolina i Ma . PQuest - Page i of z
Notes Ht Lt3Ycl+1 L---o.
mariquest ACU�fFR���rrlrr���1
Map of: MAR 18 2011
[1-991 Mistletoe Ln
Kitty Hawk, NC 27949
�C•x:iiSiR• i_i.
Erk
rG
qTA 3 4,
r.
0
U. a h �.
hl' r
n
.� ,OVA �
9"SuIR",
t'r
a =.
n
-- t17t9t?5# yis
0�T©um
39d`iL�•' -z, rrzozi ]Ylappvest - PCWHORS CJMI NAYTIO
AR rFri his r—aeiue� uc r .ice, r3 nl
❑irectfons and maps are infnmiationaI only. We make no warranties on the accuracy of their oontent, road conditions or route usability or
expeditiousness. Yau assume ail risk of use. MapQucst and U suppliers shall nW be liable to you for any loss or delay resulting tram your use of
MapQuest. Your use of Map Quest means you agree to our F�, s as ~sue
http://www.mapquest c,om/Print?a=app.core.ec70488d8f29Dlf8Q3bacci?3 3114/2011

Mar 18 11 02:39p Pinkston Geothermal
757-421 -21 Q8 p.8
,v,ni, ur t t-"] iviisuetoe Ln, Kitty Hawk, North Carotula I MapQuest -- Page 1 of I
Notes
mar%quest'.RECEI1EC 0 DER I VWQ
AGUfFFR PRf)TFf:IT1IDfi SKON
Map of;
[1-991 Mistletoe Ln MAR
Kitty Hawk, NG 27949
i F P�i
rOx:ns_7x L' s�
S ;r
AtiLtilr`
�,rts t n
�h
���pzluesr y
2aa m
01
5Sm fr QMI west - ft$UQ s6P. I rQAYItO.Intarmap
Directions and maps are informational only. We make nc warranties on She a=Tacy of their content, road conditions or route usability a
expeditiousness. You assume all dsk of usc. MapQuest and '+ls suppliers shall not he liable to you for any Ions or delay resulting from your use of
Map Quest. Your use of MapQuest means you agree to our Terrns Of u
bttp://www.mapquest.coua/print?a=app.core-cc7O488d8f290lf8O36aed23 3/14/2011