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1Q - 3 - LOCATION INFORMATION: The center of the area where the majority of mining will occur: SECTION (write number): S 20 TOWNSHIP (write number and check direction): T ~ X North South RANGE (write number and check direction): R 6 East X West QUARTER SECTION (check one): NE X NW SE SW QUARTER/QUARTER SECTION (check one): NE ~ NW SE SW COUNTY: Hinsdale PRINCIPAL MERIDIAN (check one): ~_ 6th (Colorado) 10th (New Mexico) Ute GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation) Capitol City 6 miles east. 11,200 feet elevation 11. Primary "future (Poet-minim)" land uee (check one): _ Cropland(CR) Pastureland (PL) Rangeland(RL) X Forestry(FR) Residential (RS) Recreation (RC) _ Developed Water Resources (WR) 12. Primary "present" land uee (check one): Cropland (CR) Pastureland(PL) Rangeland(RL) X Forestry (FR) Res idential (RS) Recreation (RC) Developed Water Resources (WR) General Agriculture(GA) Wildlife Habitat (WL) _ Industrial/Commercial(IC) Solid Waste Disposal (WD) General Agriculture (GA) Wildlife Habitat (WL) Industrial/Commercial (IC) Mining (MN) 13. If this operation will use designated chemicals, or will result, or presently has acid mine drainage - you cannot use this application form. You must submit a either a 110d or 112d application form for Designated Mining Operations. In either case, you must list any acidic or toxic-forming materials, exposed or disturbed as a result of the mining operation, and whether the operation will result in or presently has acid mine drainage: No acid mine drainage. Water sample tests included herewith. 19. Description of Conversion: If you are converting an existing operation, provide a brief narrative describing the proposed change(s). Midas Mining Company will use present adit and drift of some 200 feet. No change. 15. Mans & 8xhibite: Submit TWO (2) complete, unbound conies of the following application exhibits: 6.3.1 EXHIBIT A - Legal Description and Location Map 6. 3.2 EXHIBIT B - Site Description 6. 3.3 EXHIBIT C - Mining Plan 6. 3.4 EXHIBIT D - Reclamation Plan 6. 3.5 EXHIBIT E - Maps, to include the location of any recorded easements 6. 3.6 EXHIBIT F - List of Other Permits and Licenses Required 6. 3.7 EXHIBIT G~- Source of Legal Right-to-Enter, to include holders of any recorded easements 6. 3.8 EXHIBIT H - Municipalities Within a Two-mile Radius 6. 3.9 EXHIBIT I - Proof of Filing with County Clerk 6. 3.10 EXHIBIT J - Proof of Mailing Notices of Permit Application 6. 1.2 (1)(b) ADDENDUM 1 - Notice Requirements (sample enclosed) 6. 4.19 EXHIBIT S - (as required) 6. 5 Geotechnical Stability Exhibit (as required)