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Donald J. Self <br />PO Box 473 <br />Indian Hills,CO 89454 <br />January 28, 2016 <br />Division of Reclamation, Mining and Safety <br />Department of Natural Resources <br />Tim Cazier <br />1313 Sherman St., Room 215 <br />Denver, CO 80203 <br />Dear Tim Cazier, <br />We are pleased to enclose the application for Hardrock Mine Limited Impact 110(1) <br />for mining at the Double Eagle Claim (CMC# 251316) in Teller County,Colorado. <br />The purpose of this submittal is to formalize the intentions of mining and submit all <br />required forms and details. <br />Enclosed in this mailing are: <br />1. Completed,signed and notarized 101(1) <br />2. Second copies of item 1 <br />3. Electronic copies of item 1 will be send via email to: tim.cazier®state.co.us <br />4. $288 application fee <br />5. Two copies of: <br />a. Legal Description and map <br />b. Site Description <br />c. Mining Plan and Reclamation Plan (USDA P00) <br />d. List of Permits and Licenses (we are in communication with the <br />Colorado State Historical Preservation Office, Colorado Division of <br />Water Resources and Colorado Air Pollution Control Division) <br />e. Municipalities within a 2 mile radius (none) <br />f. Proof of Clerk submittal <br />g. Proof of mailing notices <br />Not enclosed include: <br />1. Form for CD of financial Warranty-this will come once we are assigned a <br />permit number. Our company has adequate funds already set aside in an <br />account. <br />We are only submitting the public 110(1) as there is nothing confidential in this <br />application. <br />If there are any questions or concerns regarding these documents please feel free to <br />contact Ian Merkel or myself. <br />Regards, <br />Donald J. Self