2011-08-09_REVISION - M1981185 (52)

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4. Fees: 4.I 4.3 New 112d(3) Application (any other operation) 4.4 gxistine 112d(1) Amendment Fee 4.5 Existing 112d(2) Amendment Fee 4.6 Existing 112d(3) Amendment Fee 4.7 nv 112d(1) Amendment Fee 4.8 New 112d(2) Amendment Fee 4.9 Nay 112d(3) Amendment Fee 4,10 Conversion Fee Gold 5. Primary commoditie(s) to be mined: 6. Name of owner of surface of affected land: 7. Name of owner of subsurface rights of affected land: If 2 or more owners, refer to Exhibit O. 8. Tyne of minlne operation: -2- ew 112d(1) Application (affecting less than 50 acres and extracting less than 1 million tons per year) application fee 4.2 ew 112d(2) Application (larger than above but affecting less than 100 acres and extract less than 5 million tons per year 9. Location Information: the eel_ ter of the area where the majority of mining will occur lies in: COUNTY: La Plata PRINCIPAL MERIDIAN (check one): EL 6th (Colorado 28 T 36 R11 SECTION (write number): TOWNSHIP (write number and check direction): RANGE (write number and check direction): QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): James M. Clements, and James M. Clements, and Fairview Land Company I - 1 Surface 17 1 Underground Silver 0th (New Mexico) F4 _ _SE SW NENW 0 SE IDSW GENERAL DESCRIPTION (miles and direction from nearest town and approximate elevation): 4.3 miles North of Hesperus, approximately 8770 feet above mean sea level 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" Latitude (N): deg min sec Longitude (W): deg min sec 1 - 7 1 North 0 South (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 $4,600.00 amendment fee $8.050.00 amendment fee see above application fees Fairview Land Company West Ute $4,025.00