2011-08-09_REVISION - M1981185 (55)

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-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 $6,900.00 application fee 4.3 ne2 112d(3) Application (any other operation) $9,200,00 application fee 4.4 p xlstin 112d(1) Amendment Fee $2,300.00 amendment fee 4.5 Existine 112d(2) Amendment Fee $4,025.00 amendment fee 4.6 Existing 112d(3) Amendment Pee _$7,475.00 amendment fee 4.7 New 112d(1) Amendment Fee $2,875.00 amendment fee 4.8 N „ ew 112d(2) Amendment Fee $4,600.00 amendment fee 4.9 New 112d(3) Amendment Fee $8,050.00 amendment fee 4.10 Conversion Fee see above application fees 5. Primary commoditie(s) to be mined: Gold Silver 6. Name of owner of surface of affected land: 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. Tyne of minine operation: PRINCIPAL MERIDIAN (check one): J SECTION (write number): TOWNSHIP (write number and check direction): RANGE (write number and check direction): QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): I I Surface 9. Location Information: the center of the area where the majority of mining will occur lies in: COUNTY: La Plate _ 6th (ColoradoOtOth (New Mexico) Ute 28 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" GENERAL DESCRIPTION (miles and direction from nearest town and approximate elevation): 4.3 miles North of Hesperus, approximately 8770 feet above mean sea level Latitude (N): deg min see (2 decimal places) Longitude (W): deg min sec (2 decimal places) Underground South