Territorial Coal Regulations (C.R.C., c. 1522)

Application for lease or renewal $5.00

Annual rental per acre under lease 1.00

Registration of assignment of lease 3.00

Application for permit 1.00

Mining District

• 1 I (Name of Applicant) of (Address)(Occupation or Position), do solemnly declare:

• 2 That I did on the day of , 19, duly stake out in accordance with the requirements of these Regulations, a coal mining location, described as follows:

  (State exact position of area, in relation to a prominent topographical feature or other known point) with dimensions feet by feet, containing acres, more or less.

• 3 Attached hereto is a sketch showing the said location.

• 4 To the best of my information and belief, the location applied for is situated on land which is (Unoccupied, or state occupancy)

• 5 To the best of my information and belief, the location applied for is not already included in an existing coal lease and is not being used by any person as a source of coal, except as follows: (If none, so state) and I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.

Mining District

• 1 I, (Name of Applicant) of (Address)(Occupation or Position), hereby apply for a Permit on my own behalf or on behalf of to authorize extraction or removal of tons of coal, from the following area (Set out as accurately as possible position of area in relation to prominent topographical feature or other known point) during the period from (Date of Application) to March 31, 19

• 2 Attached hereto is a sketch of said area.

• 3 To the best of my information and belief the said area is (Unoccupied, or state occupancy)

Fee and Royalty (if applicable) calculated as follows:

Permit Fee $1.00

Royalty tons at $0.25 per ton $

Total $

are tendered herewith.

Dated at this day of 19

(Signature)

Mining District

Pursuant to application dated 19, made under the Territorial Coal Regulations,(Name of Permittee) is hereby authorized to extract or remove tons of coal from (State location of area) for the applicant’s own use and not for sale to others.

Applicable fee and royalty (if any) are calculated as follows: —

Permit Fee $1.00

Royalty on tons at $0.25 per ton $

Total $

Receipt of the sum of $ is hereby acknowledged.

This permit is issued subject to the following terms and conditions:

• 1 That this permit shall expire on the 31st day of March, 19

• 2 That within one month after the expiry of this permit the affidavit on the reverse hereof shall be completed and returned to the undersigned.

• 3 That the coal mining operations of the permittee will be carried out in a safe and proper manner, having regard to the rights of other permittees, if any, and the general public.

• 4 That this permit cannot be assigned.

• 5 That the right to extract and remove coal may be suspended if it appears that the operations of the permittee cannot for any reason be carried on in a safe and proper manner.

Issued at this day of 19

(Issuing Officer)

I, of in the (Occupation or Position) make oath and say:

• 1 That I am (The permittee or agent of the permittee as the case may be) named in the within permit and that the quantity of coal which has been extracted or removed from the permit area under this permit is tons and no more.

Mining District

in the (Territory)

I of (Address)(Occupation of applicant) hereby apply for a licence on my behalf or on behalf of to explore for coal on the following lands described as (indicate in ☐ by (x) which quarter(s) applied for)

NW Quarter ☐

SW Quarter ☐ of mineral claim staking sheet(s) No

SE Quarter ☐

NE Quarter ☐

Attached hereto is a sketch of the said area.

To the best of my information and belief the said area is (Unoccupied or state occupancy)

Fee and Deposit calculated as follows:

Licence Fee $10.00

Deposit acres $0.05 per acre being the requirements for the first year expenditure

are tendered herewith.

Dated at this day of 19

(Signature)

Licence No.

Territorial Coal Regulations

Exploration Licence

Pursuant to application dated 19 made under section 35 of the Territorial Coal Regulations(Name of Licensee) is hereby authorized to explore for coal on the Quarter(s) of the area of land shown on mineral claim staking sheet No. containing approximately acres of land, for a period of three years commencing on the day of 19 subject to the Territorial Coal Regulations.

Dated at this day of 19

Chief, Resource Management Division, Resource and Economic Development Group, Department of Indian Affairs and Northern Development.