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PIAN OF OPERATIONS FOR MINING ACTIVITIES AUG is384861v.12/11) <br />ON NATIONAL FOREST SYSTEM LANDS ayeN0.05960022 <br />S)Uth i 19It. <br />USE OF iias FARM lS OPTIONAL! 1 TIME USERS SHOULD DRECT QUESTIONS REGARDNIG THIS F 1)i s t t!t' <br />REGULATIONS(36 CFR 22IIA)TO THE FOREST SERVICE DISTRICT OFFICE NEAREST YOUR AREA OF PITERE" <br />Rt <br />g <br />e r <br />Submitted by: . r,..l 1 c/„ ,;f 51-1;./'O 7//a <br />Signature nog Date <br />Signature Title Date <br />dd/YY) <br />Plan Received by: _ C,1c?0 l IST cit?,/is <br />sig, re elle Date <br />Onlideft <br />I. GENERAL INFORMATION <br />A. Name of Mine/Project: Double Eagle <br />B. Type of Operation: Exploration-Quartz and feldspar specimens <br />lode,placer,mil,exploration,development,production,other) <br />C. Is this a(®newlpcontinuing)operation? (check one). <br />If continuing a previous operation,this plan(Drepiaces/pmodifles/Dsuppiements)a previous plan of <br />operations. (check one) <br />D. Proposed start-up date(nwNddyy)of operation: 07/01/15 <br />5 years including 1 approximately 30 consecutive day period <br />E. Expected total duration of this operation: once per year. <br />F. If seasonal,expected date(mm/ddlry)of annual reclamation/stabilizationstabilization close out 11/15/15 <br />G Expected date(mm/ddyy)for completion of all required reclamation: 11/15120 <br />II. PRINCIPALS <br />A. Name,address and phone number of operator: <br />Donald J.Self;P.O.Box 473,Indian Hills,CO 89454;(303)898.7539 <br />B. Name,address,and phone number of authorized field representative(if other than the operator). <br />Attach authorization to act on behalf of operator. <br />NA <br />C. Name,address and phone number of owners of the claims(if different than the operator): <br />NA <br />RECEIVED <br />AUG 1 3 2015 <br />wore space is needrd a fill oat a boot of hyorwrdon,use asiMkiowd sham and mach form) <br />South 2GT <br />acyl L. 1ir_.