2011-08-09_REVISION - M1981185 (68)

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4.3 New 112d(3) Application (any other operation) 4.4 Existing 112d(1) Amendment Fee 4.5 Existing 112d(2) Amendment Fee 4.6 Existing 112d(3) Amendment Fee 4.7 New 112d(1) Amendment Fee 4.8 New 112d(2) Amendment Fee 4.9 New 112d(3) Amendment Fee 4.10 Conversion Fee 5. Primary commoditie(s) to be mined: 6. Name of owner of surface of affected land: Latitude (N): deg min sec Longitude (W): deg min sec -2- 4. Fees: 4.1 New 112d(1) Application (affecting less than 50 acres and extracting less than 1 million tons per year) $4,025.00 application fee 4.2 New 112d(2) Application (larger than above but affecting less than 100 acres and extract less than 5 million tons per year Gold Silver James M. Clements, and Fairview Land Company 7. Name of owner of subsurface rights of affected land: James M. Clements, and Fairview Land Company If 2 or more owners, refer to Exhibit O. 8. Type of mining operation: El Surface Underground 9. 10. Primary Mine Entrance Location (report in either Latitude/Longitude OR UTM): Latitude/Longitude: Example: (N) 39° 44' 12.98" (W) 104° 59' 3.87" Location In formation: the center of the area where the majority of mining will occur lies in: COUNTY: La Plata PRINCIPAL MERIDIAN (check one): El 6th (Colorado . ✓�. , 0th (New Mexico) Ute SECTION (write number): S 28 TOWNSHIP (write number and check direction): T 36 North El South RANGE (write number and check direction): R 11� QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): GENERAL DESCRIPTION (miles and direction from nearest town and approximate elevation): 4.3 miles North of Hesperus, approximately 8770 feet above mean sea level East West NE NW SE L_ SW NE RNW SE []SW (2 decimal places) (2 decimal places) $6,900.00 application fee $9,200.00 application fee $2,300.00 amendment fee $4,025.00 amendment fee $7,475.00 amendment fee $2,875.00 amendment fee $4400.00 amendment fee $8,050.00 amendment fee see above application fees